title: Assessment of factors influencing morale in the elderly.
abstract: BACKGROUND
  We examined the relationship between morale measured by the Philadelphia Geriatric Morale Scale (PGC) and disability, social support, religiosity, and personality traits. Instruments predicting morale were then tested against PGC domains.
  
  
  METHODS
  The study utilized a cross-sectional survey with a multistage cluster sampling design. Instruments used were disability (disease burden; WHO Disability Score-II, WHODAS-II), social support (Duke Social Support Scale, DUSOCS; Lubben Social Network Scale, LSNS-6; Medical Outcomes Study Social Support Survey, MOS-SSS), religiosity (Revised Intrinsic-Extrinsic Religious Orientation Scale, I/E-R), and personality (Ten-Item Personality Inventory, TIPI). These were plotted as bar charts against PGC, resolved with one-way ANOVA and Kruskal-Wallis tests, then corrected for multiple comparisons. This process was repeated with PGC domains. Contribution of factors was modeled using population attributable risk (PAR) and odds ratios. Effect of confounders such as gender, age, and ethnicity were checked using binary logistic regression.
  
  
  RESULTS
  All instruments showed clear relationships with PGC, with WHODAS-II and DUSOCS performing well (ANOVA p<0.001). For PGC domains, attitude toward aging and lonely dissatisfaction trended together, while agitation did not. PAR, odds ratios, and Exp(β) were disability (WHODAS-II: 28.5%, 3.8, 2.8), social support (DUSOCS: 28.0%, 3.4, 2.2), religiosity (I/E-R: 21.6%, 3.2, 2.1), and personality (TIPI: 27.9%, 3.6, 2.4). Combined PAR was 70.9%.
  
  
  CONCLUSIONS
  Disability, social support, religiosity, and personality strongly influence morale in the elderly. WHODAS-II and DUSOCS perform best in measuring disability and social support respectively.
authors.affiliation: Institute of Gerontology, Universiti Putra Malaysia, Serdang, Selangor Darul Ehsan, Malaysia. lokesengcheong@yahoo.com.sg
authors.forename: Seng Cheong
authors.initials: SC
authors.lastname: Loke
authors.forename: Siti S
authors.initials: SS
authors.lastname: Abdullah
authors.forename: Sen Tyng
authors.initials: ST
authors.lastname: Chai
authors.forename: Tengku A
authors.initials: TA
authors.lastname: Hamid
authors.forename: Nurizan
authors.initials: N
authors.lastname: Yahaya
mesh_terms: D000368:Aged; D000704:Analysis of Variance; D015986:Confounding Factors, Epidemiologic; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities; D006801:Humans; D009013:Morale; D010555:Personality Inventory; D011581:Psychological Tests; D012067:Religion; D012944:Social Support