Exploring the Impact of Shame on Health-Related Quality of Life in Older Individuals

J Nurs Scholarsh. 2021 Jul;53(4):439-448. doi: 10.1111/jnu.12663. Epub 2021 Apr 19.

Abstract

Purpose: To explore the relationship between shame, ageing, physical disease, and quality of life in Greek older people.

Design and methods: A cross-sectional design using a stratified random cluster sample of older adults from Open Care Centers for the Elderly in the region of Epirus, Greece. Data were collected using (a) the Short Form-36 Health Survey, (b) the Other As Shamer Scale, and (c) the Experience of Shame Scale. Data were analyzed using SPSS software.

Results: Internal shame was positively correlated with external shame (Pearson's r(177) =, p < .01), with negative effect on the mental component in both men and women (effect on women bW = -0.173, pW = .004, effect on men bM = -0.138, p​M = .047), b = path analysis beta coefficient and with a significant negative effect on the physical health component for men. External shame was found to have a significant negative effect on women's mental health (b = -0.266, p = .002) and a nonsignificant effect on the physical health component. Age was negatively related with the physical health component in both groups (bW = -0.392, pW = .002 and bM = -0.384, pM = .003), while the presence of a bodily disease corresponded with a lower physical health component score for men (b = -4.267, p = .033).

Conclusion: Shame in older individuals is present in both sexes. Older males suffering from a physical disease displayed a greater decline of the health-related quality of life on physical health components, leading to greater internal shame. Older females suffering from a physical disease displayed a greater decline of health-related quality of life on mental health components, leading to greater external shame.

Clinical relevance: These results indicate the need for developing assessment and care plans for older individuals that incorporate in them the concept of shame as a factor in dealing with and adapting to physical disease.

Keywords: Older individuals; physical disease; quality of life; shame.

MeSH terms

  • Aged
  • Aging
  • Cross-Sectional Studies
  • Female
  • Humans
  • Male
  • Quality of Life*
  • Shame*
  • Women's Health