Quality of Life in People With Severe Dementia and Its Association With the Environment in Nursing Homes: An Observational Study

Palm, Rebecca; Trutschel, Diana; Sorg, Christian G G; Dichter, Martin N.; Haastert, Burkhard; Holle, Bernhard

doi:10.1093/geront/gny017

Cited by 12 publications

(11 citation statements)

References 34 publications

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“…In fact, the results of our subsequent analysis con rmed these assumptions only partly. Finally, we could not show that residents of dementia-speci c (segregated) living units or small living units had better care outcomes compared to residents from other living units [20]. One reason why we did not nd the expected results may be the a priori de nition of the living unit types.…”

Section: Introductionmentioning

confidence: 64%

Empirical development of a typology on residential long-term care units in Germany - results of an exploratory multivariate data analysis

Bergmann

Ströbel

Holle

et al. 2020

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Background: Organizational health care research focuses on describing structures and processes in organizations and investigating their impact on the quality of health care. In the setting of residential long-term care, this effort includes the examination and description of structural differences among the organizations (e.g., nursing homes). The objective of the analysis is to develop an empirical typology of living units in nursing homes that differ in their structural characteristics. Methods: Data from the DemenzMonitor Study were used. The DemenzMonitor is an observational study carried out in a convenience sample of 103 living units in 51 nursing homes spread over 11 German federal states. Characteristics of living units were measured by 19 variables related to staffing, work organization, building characteristics and meal preparation. Multiple correspondence analysis (MCA) and agglomerative hierarchical cluster analysis (AHC) are suitable to create a typology of living units. Both methods are multivariate and explorative. We present a comparison with a previous typology (created by a nonexplorative and nonmultivariate process) of the living units derived from the same data set.Results: The MCA revealed differences among the living units, which are defined in particular by the size of the living unit (number of beds), the additional qualifications of the head nurse, the living concept and the presence of additional financing through a separate benefit agreement. We identified three types of living units; these clusters occur significantly with a certain combination of characteristics. In terms of content, the three clusters can be defined as: "house community", "dementia special care units” and "usual care". Conclusion: A typology is useful to gain a deeper understanding of the differences in the care structures of residential long-term care organizations. In addition, the study provides a practical recommendation on how to apply the results, enabling housing units to be assigned to a certain type. The typology can be used as a reference for definitions.

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Section: Introductionmentioning

confidence: 64%

Empirical development of a typology on residential long-term care units in Germany - results of an exploratory multivariate data analysis

Bergmann

Ströbel

Holle

et al. 2020

Preprint

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“…In order to test the main hypothesis, a sum score was created across all 37 items at baseline. Further, we studied the determinants of QoL according to the literature [25][26][27] to establish nine subscales: care relationship (7 items), positive affect (6 items), negative affect (3 items), restlessness (3 items), positive self-image (3 items), social relationship (6 items), social isolation (3 items), feeling at home (4 items), and having something to do (2 items) (Table). These subscales are sum scores across the respective items, which were presented in a Likert format ranging from never (0), rarely (1), and sometimes (2) to frequently (3).…”

Section: Methodsmentioning

confidence: 99%

“…The varimax-rotated PCA solution accounted for 67.2% of the overall variance. Next to the subscales, we created a composite sum score across all 37 items, which has been used extensively in the literature as well [25][26][27][28][29][30]. Thus, in our analyses, we look into both the comprehensive sum score (Table 2) as well as subscale results ( 'positive affect', 'negative affect', 'restlessness', and 'social relationships' of the full 37-item version of QUALIDEM (i.e., subscale B, subscale C, subscale D, and subscale F) [8,31].…”

Section: Methodsmentioning

confidence: 99%

Quality of life in people with dementia living in nursing homes: validation of an eight-item version of the QUALIDEM for intensive longitudinal assessment

et al. 2020

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Purpose Our aim was to examine whether quality of life which was repeatedly assessed over time is related with the comprehensive assessment of quality of life (QoL) and thereby to validate a brief QoL assessment. Method This longitudinal study used a comprehensive assessment of quality of life at baseline (QUALIDEM; 37 items) to validate an eight-item version of QUALIDEM to assess momentary quality of life which was repeatedly administered using a tablet device after baseline. In all, 150 people with dementia from 10 long-term facilities participated. Momentary quality of life and comprehensive quality of life, age, gender, activities of daily living (Barthel Index), Functional assessment staging (FAST), and Geriatric Depression (GDS) have been assessed. Results Comprehensive and momentary quality of life showed good internal consistency with Cronbach's alpha of .86 and .88 to .93, respectively. For multiple associations of momentary quality of life with the comprehensive quality of life, momentary quality of life was significantly related to comprehensive quality of life (B = .14, CI .08/.20) and GDS (B = − .13, CI − .19/− .06). More specifically, the comprehensive QUALIDEM subscales 'positive affect', 'negative affect', 'restlessness', and 'social relationships' showed significant positive associations with momentary quality of life (p < .001). Conclusion We found that momentary quality of life, reliably assessed by tablet, was associated with comprehensive measures of quality of life and depressive symptoms in people with dementia. Broader use of tablet-based assessments within frequent QoL measurements may enhance time management of nursing staff and may improve the care quality and communication between staff and people with dementia.

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“…Current research proposes the implementation of quality of life measurements to cover residents' viewpoints on care (Becker et al 2005;Brandenburg & Günther 2015;de Boer et al 2017;Grabowski et al 2014;Hassler & Wolf-Ostermann 2010;Kok et al 2018;Palm et al 2018;Vaarama et al 2008). So far only a few studies investigating subjective quality of life in older people can be found.…”

Section: Introductionmentioning

confidence: 99%

“…So far only a few studies investigating subjective quality of life in older people can be found. They mainly focus on older, multi-morbid patients without dementia (Hassler & Wolf-Ostermann 2010;Holzhausen 2009;Warnke et al 2004), address patients with dementia partly in special settings (Auer, et al 2017;Ettema et al 2005;Gertz & Berwig 2008;Kok et al 2018;Logsdon et al 2002;Palm et al 2018;Sixsmith et al 2008), and consider care-related measures in nursing home residents (Becker et al 2005;Schaal et al 2015;Vaarama et al 2008). According to our research there is still a complete lack of studies on groupliving nursing homes residents in Germany and elsewhere, apart from one preliminary pilot study published in 2013.…”

Section: Introductionmentioning

confidence: 99%

A Comparison between independent living elders and residents in 25 German Nursing Homes following the Group-Living Principle. An empirical study focusing on the subjective perspective of quality of live

Simon¹

2020

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Objective. The purpose of this study was to analyse the subjective quality of life (QoL) perceived by older people in German nursing homes following the group-living principle.Methods. The Nottingham Health Profile (NHP) as health-related QoL measuring instrument was employed in 25 nursing homes (n=404 participants). A comparison with the national German representative sub-sample of independent living elders (age-group over 75) was conducted. Psychometric properties and appropriateness were analysed.Results. Our findings indicate an acceptable perception of residents’ QoL. The mean NHP scale scores show, that the perceived QoL of residents in group-living nursing home reached nearly the same level as independently living elders (national German reference values, age group over 75 years, except for the NHP sub-scale physical mobility). QoL related results on life satisfaction and feeling of happiness confirm the NHP findings. The preliminary pilot study protocol could be replicated, according to good scientific practice.Conclusions and implications. The report presents the first major investigation in the research field of subjective quality of life in group-living nursing homes. The study focused on people over 75 years of age with age-specific reduced physical and mental abilities. The NHP should also be considered as a reliable, valid and for older people appropriate instrument. Due to the lack of research on residents’ perspectives, further studies should follow to establish age-specific and care setting-specific reference data for nursing home residents. In particular, more research is needed to answer the question, which care setting best meets people’s essential needs in older age.

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Quality of Life in People With Severe Dementia and Its Association With the Environment in Nursing Homes: An Observational Study

Abstract: Structural and organizational characteristics of care units, which in turn have implications for residents characteristics and the quality of care, may influence the QoL of residents. This may explain the interaction we observed.

Cited by 12 publications

References 34 publications

Empirical development of a typology on residential long-term care units in Germany - results of an exploratory multivariate data analysis

Empirical development of a typology on residential long-term care units in Germany - results of an exploratory multivariate data analysis

Quality of life in people with dementia living in nursing homes: validation of an eight-item version of the QUALIDEM for intensive longitudinal assessment

A Comparison between independent living elders and residents in 25 German Nursing Homes following the Group-Living Principle. An empirical study focusing on the subjective perspective of quality of live

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