Factors Affecting Quality of Life Among the Elderly in Long-Term Care Hospitals

10.1097/jnr.0000000000000413

Hee-Kyung CHANG；Cho-Rong GIL；Hye-Jin KIM；Han-Ju BEA

depression ； long-term care hospital ； nurse-patient interaction ； older people care ； quality of life

The Journal of Nursing Research

29卷1期（2021 / 02 / 01）

1 - 9

英文

Background: There are challenges in sustaining person-centered care in aged care settings. Key related issues of concern such as quality of life among the older people in long-term care hospitals and interactions with nursing staff have been described previously. Purpose: This study was designed to explore the factors affecting quality of life among older people living in long-term care hospitals in South Korea. Methods: Older adult patients (N = 202) in three long-term care hospitals completed measures of cognitive functions, depression, care dependency, and interactions between nurse and patient and a quality-of-life assessment tool. Univariate analyses were used to examine the relationships among these variables, and a multiple linear regression analysis was used to explore the extent to which these variables predicted quality of life in these patients. Results: The significant factors associated with quality of life were found to be cognitive functions (r = .373, p ＜ .001), care dependency (r = .350, p ＜ .001), and depression (r =-.504, p ＜ .001). The regression model with depression and care dependency as predictor variables accounted for 25.7%of the variance in quality of life. Conclusions/Implications for Practice: The correlation found in this study between quality of life and depression and care dependency provides additional evidentiary support for developing and applying nursing interventions that reduce depression and care dependency in older adult populations.

1. Astell, A. J.,Ellis, M. P.,Bernardi, L.,Alm, N.,Dye, R.,Gowans, G.,Campbell, J.(2010).Using a touch screen computer to support relationships between people with dementia and caregivers.Interacting with Computers,22(4),267-275.
2. Barca, M. L.,Engedal, K.,Laks, J.,Selbæk, G.(2011).Quality of life among elderly patients with dementia in institutions.Dementia and Geriatric Cognitive Disorders,31(6),435-442.
3. Bowling, A.(1995).What things are important in people's lives? A survey of the public's judgements to inform scales of health related quality of life.Social Science & Medicine,41(10),1447-1462.
4. Brownie, S.,Nancarrow, S.(2013).Effects of person-centered care on residents and staff in aged-care facilities: A systematic review.Clinical Interventions in Aging,8,1-10.
5. Cho, M. J.,Bae, J. N.,Suh, G. H.,Hahm, B. J.,Kim, J. K.,Lee, D. W.,Kang, M. H.(1999).Validation of Geriatric Depression Scale, Korean version (GDS) in the assessment of DSM-III-R major depression.Journal of Korean Neuropsychiatric Association,38(1),48-63.
6. Coyle, C. E.,Dugan, E.(2012).Social isolation, loneliness and health among older adults.Journal of Aging and Health,24(8),1346-1363.
7. De Vries, N. M.,Van Ravensberg, C. D.,Hobbelen, J. S. M.,Rikkert, M. O.,Staal, J. B.,Nijhuis-Van der Sanden, M.W. G.(2012).Effects of physical exercise therapy on mobility, physical functioning, physical activity and quality of life in community-dwelling older adults with impaired mobility, physical disability and/or multi-morbidity: A meta-analysis.Ageing Research Reviews,11(1),136-149.
8. Demnitz, N.,Esser, P.,Dawes, H.,Valkanova, V.,Johansen-Berg, H.,Ebmeier, K. P.,Sexton, C.(2016).A systematic review andmeta-analysis of cross-sectional studies examining the relationship between mobility and cognition in healthy older adults.Gait & Posture,50,164-174.
9. Dijkstra, A.,Brown, L.,Havens, B.,Romeren, T. I.,Zanotti, R.,Dassen, T.,Van Den Heuvel, W.(2000).An international psychometric testing of the care dependency scale.Journal of Advanced Nursing,31(4),944-952.
10. Flesner, M. K.(2009).Person-centered care and organizational culture in long-term care.Journal of Nursing Care Quality,24(4),273-276.
11. Gajewski, P. D.,Falkenstein, M.(2016).Physical activity and neurocognitive functioning in aging-A condensed updated review.European Review of Aging and Physical Activity,13(1),1-7.
12. Gligoroska, J. P.,Manchevska, S.(2012).The effect of physical activity on cognition–physiological mechanisms.Materia Sociomedica,24(3),198-202.
13. Gräske, J.,Meyer, S.,Worch, A.,Wolf-Ostermann, K.(2015).Family visits in shared-housing arrangements for residents with dementia–A cross-sectional study on the impact on residents' quality of life.BMC Geriatrics,15(1),Article 14.
14. Grimaud, E.,Taconnat, L.,Clarys, D.(2017).Cognitive stimulation in healthy older adults: A cognitive stimulation program using leisure activities compared to a conventional cognitive stimulation program.Geriatrie et Psychologie Neuropsychiatrie du Vieillissement,15(2),214-223.
15. Haas, B. K.(1999).A multidisciplinary concept analysis of quality of life.Western Journal of Nursing Research,21(6),728-742.
16. Haugan, G.,Moksnes, U. K.,Løhre, A.(2016).Intrapersonal self-transcendence, meaning-in-life and nurse–patient interaction: Powerful assets for quality of life in cognitively intact nursing home patients.Scandinavian Journal of Caring Sciences,30(4),790-801.
17. Haugan, G.,Rannestad, T.,Hanssen, B.,Espnes, G. A.(2012).Self-transcendence and nurse–patient interaction in cognitively intact nursing home patients.Journal of Clinical Nursing,21(23-24),3429-3441.
18. Kamińska, M.,Brodowski, J.,Karakiewicz, B.(2015).Fall risk factors in community-dwelling elderly depending on their physical function, cognitive status and symptoms of depression.International Journal of Environmental Research and Public Health,12(4),3406-3416.
19. Kim, E. J.(2000).Psychometric testing of the care dependency scale for the institutionalized Korean demented patients.Journal of Korean Academyof Psychiatric andMental Health Nursing,9(3),303-314.
20. Kim, H. J.,Moon, S. Y.,Kim, S. Y.,Han, S.-H.(2008).Assessment of the quality of life in patients with Alzheimer's disease.Journal of the Korean Neurological Association,26(4),308-313.
21. Kim, I.(2018).Care dependency of post-stroke patients and its affecting factors.Korean Journal of Rehabilitation Nursing,21(2),100-109.
22. Kim, J.,Song, R.,Kim, K. W.,Kim, J. L.(2016).Effect of cognitive function, social activity participation and social support on quality of life of community-dwelling elderly.Journal of Korean Geriatric Psychiatry,20(1),25-32.
23. Kwon, Y. C.,Park, J.H.(1989).Korean version of Mini-Mental State Examination (MMSE-K).Journal of the Korean Neuropsychiatric Association,28(1),125-135.
24. Lin, F.,Friedman, E.,Quinn, J.,Chen, D. G. D.,Mapstone, M.(2012).Effect of leisure activities on inflammation and cognitive function in an aging sample.Archives of Gerontology and Geriatrics,54(3),398-404.
25. Logsdon, R. G.,Gibbons, L. E.,McCurry, S. M.,Teri, L.(1999).Quality of life in Alzheimer's disease: Patient and caregiver reports.Journal of Mental Health and Aging,5(1),21-32.
26. McDermott, C.,Coppin, R.,Little, P.,Leydon, G.(2012).Hospital admissions fromnursing homes: A qualitative study of GP decision making.British Journal of General Practice,62(601),e538-e545.
27. Meinerding, M.,DeFeis, B.,Sunderaraman, P.,Azar, M.,Lawless, S.,Perez-Vivaldo, C.,Gu, Y.,Stern, Y.,Cosentino, S.(2018).Assessing dependency in a multiethnic community cohort of individuals with Alzheimer's disease.Innovation in Aging,2(1),1-7.
28. Ministry of Health and Welfare. (2019). Medical law. Retrieved November 23, 2019, from http://www.law.go.kr/%EB%B2%95%EB%A0%B9/%EC%9D%98%EB%A3%8C%EB%B2%95
29. Morgan, S.,Yoder, L. H.(2012).A concept analysis of person centered care.Journal of Holistic Nursing,30(1),6-15.
30. National Statistical Office. (2019a). 2019 elderly statistics. Retrieved September 28, 2020, from http://kostat.go.kr/portal/korea/kor_nw/1/6/1/index.board?bmode=read&bSeq=&aSeq=377701&pageNo=2&rowNum=10&navCount=10&currPg=&searchInfo=&sTarget=title&sTxt=
31. National Statistical Office. (2019b). Hospital present conditions based on cities and provinces. Retrieved September 28, 2020, from http://kosis.kr/statHtml/statHtml.do?orgId=354&tblId=DT_MIRE01#
32. Ok, E. M.,Lee, J. Y.(2017).A study on influential factors to the quality of life in geriatric hospital elderly inpatient.Journal of Wholistic Nursing Science,10(1),1-12.
33. Olsen, C.,Pedersen, I.,Bergland, A.,Enders-Slegers, M. J.,Patil, G.,Ihlebaek, C.(2016).Effect of animal-assisted interventions on depression, agitation and quality of life in nursing home residents suffering from cognitive impairment or dementia: A cluster randomized controlled trial.International Journal of Geriatric Psychiatry,31(12),1312-1321.
34. Park, S. H.,Ahn, S. N.(2017).The effect of dual task programon reducing the risk of dementia in older adults.Research Journal of Pharmacy and Technology,10(7),2255-2259.
35. Sagong, H.,Lee, G. E.(2016).Person-centered care and nursing service quality of nurses in long-term care hospitals.Journal of Korean Academy of Community Health Nursing,27(4),309-318.
36. Sheikh, J. I.,Yesavage, J. A.(1986).Geriatric Depression Scale (GDS): Recent evidence and development of a shorter version.Clinical Gerontologist: The Journal of Aging and Mental Health,5(1–2),165-173.
37. Shimada, H.,Makizako, H.,Lee, S.,Doi, T.,Tsutsumimoto, K.,Harada, K.,Hotta, R.,Bae, S.,Harada, N. K.,Suzuki, T.(2016).Impact of cognitive frailty on daily activities in older persons.The Journal of Nutrition, Health & Aging,20(7),729-735.
38. Shin, B. M.,Han, S. J.,Jung, J. H.,Kim, J. E.,Fregni, F.(2011).Effect of mild cognitive impairment on balance.Journal of the Neurological Sciences,305(1-2),121-125.
39. Shin, H. Y.(2006).A preliminary study on the Korean version of quality of life-Alzheimer's disease scale in community-dwelling elderlywith dementia.Journal of Preventive Medicine and Public Health,39(3),243-248.
40. Shin, S. H.,Park, J. S.(2018).A structural equation model of quality of life in nursing home residents.Journal of Korean Gerontological Nursing,20(3),193-203.
41. Song, H. J.(2012).Long-termcare hospital systems in developed countries and the implications for Korea.Journal of the Korean Geriatrics Society,16(3),114-120.
42. Svantesson, U.,Jones, J.,Wolbert, K.,Alricsson, M.(2015).Impact of physical activity on the self-perceived quality of life in non-frail older adults.Journal of Clinical Medicine Research,7(8),585-593.
43. Ten Brinke, L. F.,Bolandzadeh, N.,Nagamatsu, L. S.,Hsu, C. L.,Davis, J. C.,Miran-Khan, K.,Liu-Ambrose, T.(2015).Aerobic exercise increases hippocampal volume in older women with probable mild cognitive impairment: A 6-month randomized controlled trial.British Journal of Sports Medicine,49(4),248-254.
44. Tyndall, A. V.,Clark, C. M.,Anderson, T. J.,Hogan, D. B.,Hill, M. D.,Longman, R. S.,Poulin, M. J.(2018).Protective effects of exercise on cognition and brain health in older adults.Exercise and Sport Sciences Reviews,46(4),215-223.
45. Yi, M. J.,Lee, J. S.(2015).Nurse's experiences of the death of patients in geriatric hospitals.Journal of Korean Academy of Nursing,45(4),513-522.

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