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Background: With ever-increasing life expectancy globally, it is imperative to build knowledge of how older peoples' views of their own aging, considering their health-related circumstances, affect quality of life for practitioners and policy-makers alike. Based on our literature review, we wanted to determine whether older adults' attitudes toward their own aging would partly mediate the effect of their health satisfaction ratings upon their quality of life. Furthermore, would these attitudes mediate the relationship between health satisfaction and quality of life in the same way when we account for older adults' country of origin, and their age and gender?, Methods: This was a secondary analysis of cross-sectional survey data collected in 20 countries taking part in the 2003 WHOQOL-OLD Field study. The study sample consisted of 4593 adults whom were, on average, 72.10 years of age (range = 60 to 100 years of age); 42.8% were female. The WHOQOL-BREF measured quality of life and health satisfaction. The Attitudes to Aging Questionnaire measured participants' attitudes toward physical change, psychosocial loss, and psychological growth. All items in both questionnaires were measured on a 5-point Likert scale. Questionnaire responses were analyzed using multilevel modeling and path analysis., Results: All three attitudes to aging partly mediated the relationship between health satisfaction and physical, psychological, social, environmental, and global quality of life. These partial mediations manifested in the same way across all 20 country samples, regardless of age or gender. Attitudes toward physical change were the strongest mediator of health satisfaction upon global and domain-specific quality of life, followed by psychosocial loss and psychosocial growth., Conclusions: Our study is the first cross-cultural study with a large sample to show that quality of life judgements, between 60 to 100 years of age, are a product of older men's and women's perceptions of health-related circumstances, and attitudes toward physical and psychosocial aspects of the aging self. A prospective study of the linkages between older peoples' subjective views of health and attitudes toward the aging self over time using multiple subjective measures of health is warranted. Understanding these linkages may help practitioners and policy makers consider strategies to enhance quality of life.

The purpose of this study was to examine the nature of the care provided to people with chronic kidney disease within a larger study of nurse-run, physician-monitored clinics, as well as how patients, nurses, and nephrologists described their experience with the clinics. Interviews were conducted with 7 nurses, 5 physicians, and 23 patients. Data collection also entailed review of 40 randomly selected charts. Identified themes related to characteristics of the nurse, patient-centred care, health promotion, teaching, dealing with problems, time, protocols, consultation and referrals, clinic logistics, paperwork/documentation, and nurse-physician collaboration. Challenges and outcomes were also described as part of the experience with the clinic. Patients were actively engaged in self-management and reported high levels of satisfaction with care as well as improvements in selected outcomes. Overall, the perceptions of this model of care were positive and the approach warrants further exploration.

The purpose of this study was to explore how people with chronic kidney disease (CKD) describe/story experiences of liminality associated with CKD and its treatment. This narrative inquiry was undertaken using secondary data. The people relating the stories described a number of liminal spaces, including living/not living independence/dependence, restrictions/freedom, normal/not normal, worse off/better off and alone/connected. Awareness of the liminal spaces can help nurses provide care that addresses the complexity of CKD.

The purpose of this research was to explore the relationships between sexual activity and intimacy and quality of life (QOL) of older adults. The authors' research question was "To what extent do age, gender, marital status, health status, education, satisfaction with personal relationships, sexual activity, and satisfaction with intimacy explain older adults' ratings of QOL?" A secondary analysis was conducted using results from a cross-sectional survey. Data were available from a convenience sample of 426 individuals living in British Columbia, Canada, who volunteered to complete the questionnaire. Instruments included the WHOQOL-100, WHOQOL-OLD, and a demographic data sheet. It was found that the strongest contributors to the variance of overall QOL were satisfaction with personal relationships, followed by health status andsexual activity. Age, gender, marital status, and education were not significant. The implications for gerontological nurses include the need to support personal relationships for older adults, to encourage health promotion, and to ensure sexuality is discussed with older adults.

The purpose of this study was to explore the effects of spirituality on quality of life (QOL) in older adults when age, gender, social support, and health status are controlled. A secondary analysis of data was conducted using results from a cross-sectional survey of older adults. Data were available from a convenience sample of 426 people living in British Columbia, Canada, who volunteered to complete the questionnaire. Instruments included the WHOQOL-100 and a demographic data sheet. The results show spirituality was not a significant factor contributing to QOL in this sample, and that the strongest predictors of overall QOL were social support and health satisfaction. Given difficulties in measuring spirituality and homogeneity of the sample, further research is warranted.

The purpose of this project was to test the WHOQOL-100, an instrument for assessing quality of life (QOL), developed to facilitate cross-cultural comparison. The instrument was tested with a convenience sample of 144 people. The mean age of participants was 58 years and 41% were female.Test-retest reliability was .86 for the physical domain, .78 for the psychological domain, .91 for independence, .87 for social relationships, .77 for environment, and .60 for spirituality. Consistency reliability was .77 for physical, .79 for psychological, .89 for independence, .71 for social relationships, .80 for environment, and .89 for spirituality/ personal beliefs. Correlations of the various domains with other instruments, including the SF-36, the Self-Anchoring Striving Scale, and the Visual Analogue Scale for Pain, supported the convergent validity of the instrument. The instrument was able to discriminate between healthy and ill populations, providing support for construct validity.

Context: There is concern that a disproportionately high number of people of South Asian origin await transplantation in Canada. The donation rate is low in this population, and it is difficult to obtain good tissue matches., Objective: To explore the values and beliefs regarding organ donation among Indo-Canadian people living in British Columbia., Design: A naturalistic qualitative study was designed. Individual interviews and focus groups were held to collect data pertaining to beliefs regarding organ donation., Setting: Lower Mainland of British Columbia, Canada., Participants: A total of 40 Indo-Canadian persons participated; a wide range of ages, religions, and backgrounds were represented., Results: The major themes that emerged from the data related to context (including family/community, religion, trust in the healthcare system, and knowledge about organ donation); and values and beliefs (including intergenerational considerations, death and dying, and the organ donation process). Participants noted that people from their community were reluctant to discuss death and relatedissues such as organ donation. Although there was recognition of the importance of individual decision making pertaining to organ donation, the participants believed that family and community members also should be involved., Conclusions: Beliefs varied considerably among participants, and one should not make assumptions about the beliefs of any one individual based primarily on that individual's membership in an ethnocultural community.

The authors' purpose in this study is to explore the values and beliefs regarding organ donation of Chinese Canadians. Data collection involved individual interviews (n = 15) and focus groups. The major organizing categories were the importance of context, and values and beliefs. The context included little knowledge about donation and possible influence of spiritual or cultural values. Lack of communication and the need to preserve an intact body were themes that emerged in relation to death and dying. In relation to organ donation, most participants thought it was "a noble deed," but fears about organ donation were similar to those reported in other studies. It is important to note the considerable diversity in beliefs among these participants.