Quality of life in nursing homes following the group-living principle: A pilot study measuring the quality of life from the subjective perspective of dependent-living elderly

[Public Reporting on long-term Care Facilities in Germany: Current State and Evaluation of Quality Information]

OBJECTIVES

Little is known about public reporting on long-term care facilities. In this study, we (1) identify the websites that are available for a search on long-term care facilities in Germany, (2) describe them systematically with regard to general information and range of functions, 3) capture the information on quality available on the websites and 4) evaluate the extent to which they can be useful for those in need.

METHODS

1) Systematic internet search to identify the websites. 2) Analysis of the websites with regard to defined inclusion and exclusion criteria. 3) Data collection from the included websites. 4) Description of the general content and the range of functions of the websites. 5) Collection of quality-related information on long-term care facilities (structure, process and outcome quality, costs, quality inspections results, user feedback). 6) Evaluation of the usefulness of information by analyzing the information using a catalogue of criteria.

RESULTS

A total of 24 websites were identified with information on long-term care facilities. Only 4 websites allowed a direct online comparison of several facilities and 17% allowed consumer feedback online. All websites provided information on structural quality, but none on the outcome quality. Across all websites, the usefulness of information for the consumers amounted to 19%. The thematic area on location and accessibility of a facility offered relatively detailed information (79%), while only to 9% was dedicated to the thematic area on care.

CONCLUSION

There is a large number of websites that can be searched for information on long-term care facilities. They show a range of heterogeneous functions and information. More websites should offer a function of comparison of multiple facilities. With regard to the information available, consumer preferences do not yet seem to be sufficiently taken into account. Further researches should focus on the evaluation of the impact of outcome quality on decision-making and the analysis of the validity of consumer feedback.

Assessing the quality of life and well-being of older adults with physical and cognitive impairments in a German-speaking setting: A systematic review of validity and utility of assessments / Die Erfassung von Lebensqualität und Wohlbefinden älterer Menschen mit psychischen und kognitiven Einschränkungen: ein systematisches Literaturreview zur Validität und Praktikabilität deutschsprachiger Assessments

Background

For health professionals working with older adults with physical and cognitive impairments, improving or maintaining clients’ quality of life and well-being is of crucial importance. The aim of this study was to evaluate validity and utility of assessments of quality of life and well-being in German suitable for this group of clients.

Methods

In an initial literature search, we identified potentially viable assessments based on existing systematic reviews. We then conducted a systematic literature search in the databases Medline, CINAHL, and PsycINFO using keywords related to validity, utility, client group, and German. Assessments for which sufficient evidence was found were evaluated regarding their validity and utility when used with older adults with physical and cognitive impairments.

Results

For 14 of 27 initially identified assessments, sufficient evidence was found to evaluate validity and utility with this client group. WHOQOL-BREF, WHOQOL-OLD, WHO-5, EUROHIS-QOL 8, SF-36, SF-12, EQ-5D, NHP, SEIQOL-DW, SWLS, PANAS, DQOL, QOL-AD, and QUALIDEM were evaluated based on 82 studies. Of these, WHOQOL-BREF, WHO-5, SF-36, SF-12, EQ-5D, NHP, QUALIDEM, QOL-AD and DQOL are presented here.

Conclusion

Assessments differed widely in the way they operationalized quality of life/well-being, use of self-evaluation or evaluation-by-proxy, and amount of available evidence for their validity and utility. On the basis of our results in regard to the assessments’ validity, utility, and appropriateness of operationalization of quality of life/well-being to the client group, three assessments were recommended for use: WHOQOL-BREF for self-evaluation, QUALIDEM for evaluation-by-proxy in case of severe dementia, and EQ-5D for cost-utility analyses.

Resident health-related quality of life in Swiss nursing homes

BACKGROUND

Health-related quality of life (HRQOL) levels and their determinants in those living in nursing homes are unclear. The aim of this study was to investigate different HRQOL domains as a function of the degree of cognitive impairment and to explore associations between them and possible determinants of HRQOL.

METHOD

Five HRQOL domains using the Minimum Data Set - Health Status Index (MDS-HSI) were investigated in a large sample of nursing home residents depending on cognitive performance levels derived from the Cognitive Performance Scale. Large effect size associations between clinical variables and the different HRQOL domains were looked for.

RESULTS

HRQOL domains are impaired to variable degrees but with similar profiles depending on the cognitive performance level. Basic activities of daily living are a major factor associated with some but not all HRQOL domains and vary little with the degree of cognitive impairment.

LIMITATIONS

This study is limited by the general difficulties related to measuring HRQOL in patients with cognitive impairment and the reduced number of variables considered among those potentially influencing HRQOL.

CONCLUSION

HRQOL dimensions are not all linearly associated with increasing cognitive impairment in NH patients. Longitudinal studies are required to determine how the different HRQOL domains evolve over time in NH residents.