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

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 b W = ‐0.173, p W = .004, effect on men b M = ‐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 (b W = ‐0.392, p W = .002 and b M = ‐0.384, p M = .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.