Degree Name

DrPH (Doctor of Public Health)


Public Health

Date of Award


Committee Chair or Co-Chairs

Deborah Slawson

Committee Members

Robert Pack, Jameson K. Hirsch


Older adults have an increased risk for illness and disease, factors that can lead to functional impairment and intensify the need for reliance on supportive services. Planning for long-term care needs is a vital component of healthy aging and continued autonomy. Yet, many older adults fail to make plans in advance, perhaps due to differences in personal characteristics.

The moderating effects of trait hope on the relationship between health-related quality of life (HRQoL) and preparation for future care needs (PFCN) was studied in a sample of 65 older adult primary care patients (<65 years) in western New York. Participants completed a questionnaire on 5 dimensions of PFCN (awareness of risk, information gathering, decisions about care preferences, concrete planning, and active avoidance). In addition, data were collected on five HRQoL domains (physical function, physical role function, emotional role function, social function, and bodily pain) and trait hope. Moderated multiple regression was used to test the moderator hypothesis controlling for personal characteristics. Post-hoc probing was used to further examine significant interactions.

At the bivariate level, social functioning, physical functioning, and emotion-based role were inversely related to PFCN and positively related to hope. Multivariate moderation models covarying age, sex, race, education, illness burden, and functional impairment indicated that hopefulness, particularly agentic thinking or goal identification, moderated the relationship between those three HRQoL dimensions and PFCN behaviors.

Among those with greater role limitations, lower hope was associated with more awareness of risk and information gathering and less concrete decision making, whereas among individuals with fewer role limitations and better social and physical functioning, higher levels of hopefulness were associated with increased decision making.

These results highlight the need for health professionals to gain a better understanding of their patients'intrapersonal characteristics when discussing issues related to future care planning.

Document Type

Dissertation - unrestricted


Copyright by the authors.