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Caycho-Rodríguez T, Carbajal-León C, Vilca LW, Reyes-Bossio M, Gallegos M, Esteban RC, Noe-Grijalva M, Gallegos WLA, Delgado-Campusano M, Muñoz-Del-Carpio-Toia Á. Impact of COVID-19 on quality of life in Peruvian older adults: construct validity, reliability and invariance of the COV19-Impact on Quality of Life (COV19-QoL) measurement. PSICOLOGIA-REFLEXAO E CRITICA 2023; 36:13. [PMID: 37212958 DOI: 10.1186/s41155-023-00256-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 05/12/2023] [Indexed: 05/23/2023] Open
Abstract
The aim of the present study was to translate into Spanish and evaluate the psychometric evidence of the Impact on Quality of Life (COV19-QoL) applied to a sample of Peruvian older adults (N = 298; 58.1% women, 41.9% men, mean age 65.34 years [SD = 11.33]). The study used techniques from the Classical Test Theory (CTT) and Item Response Theory (IRT). The findings confirmed the single factor structure of the COV19-QoL, high internal consistency reliability, measurement invariance by gender, and all items demonstrated adequate discrimination and difficulty indices. In this sense, the items allow adequate discrimination between low, medium and high levels of the impact of the COVID-19 pandemic on quality of life. In addition, a greater perceived impact of the pandemic on quality of life is necessary to answer the higher response options of the COV19-QoL. In conclusion, the COV19-QoL is a valid measurement scale of the impact of the COVID-19 pandemic on the quality of life of Peruvian older adults.
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Affiliation(s)
- Tomás Caycho-Rodríguez
- Facultad de Psicología, Universidad Científica del Sur, Campus Villa II, Ctra. Panamericana S 19, Villa EL Salvador, Lima, Peru.
| | - Carlos Carbajal-León
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Lindsey W Vilca
- South American Center for Education and Research in Public Health, Universidad Norbert Wiener, Lima, Peru
| | - Mario Reyes-Bossio
- Facultad de Psicología, Universidad Peruana de Ciencias Aplicadas, Lima, Peru
| | - Miguel Gallegos
- Programa de Pós-Graduação em Psicologia, Pontificia Universidade Católica de Minas Gerais, State of Minas Gerais, Belo Horizonte, Brazil
- Centro Interdisciplinario de Investigaciones en Ciencias de la Salud y del Comportamiento. Consejo Nacional de Investigaciones Científicas y Técnicas, Entre Ríos, Argentina
| | - Renzo Carranza Esteban
- Facultad de Ciencias de La Salud, Grupo de Investigación Avances en Investigación Psicológica, Universidad San Ignacio de Loyola, Lima, Perú
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Detwiler BP, Caskie GIL, Johnson NL. It's Complicated: Minority Stress, Social Support, In-Group Social Contact, and Sexual Minority Older Adults' Well-Being. THE GERONTOLOGIST 2023; 63:350-360. [PMID: 35767630 DOI: 10.1093/geront/gnac092] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND OBJECTIVES We applied the Minority Stress Model to sexual minority older adults to examine how distal minority stressors of ageism and heterosexism related to psychological well-being (life satisfaction, quality of life, psychological distress, and loneliness). We investigated social support and in-group social contact as stress-ameliorating factors and tested for a potential intersection of stress due to minority identities. RESEARCH DESIGN AND METHODS A sample of 189 sexual minority older adults (50-86 years; M = 60.41) completed survey measures online. Hierarchical regression analyses with interaction terms were utilized to test study hypotheses. RESULTS Findings offered partial support for the Minority Stress Model. Large effect sizes were obtained, explaining 32%-56% of the variance in psychological well-being with models including ageism, heterosexism, stress-ameliorating factors, and demographics. Ageism and heterosexism related to greater psychological distress; however, heterosexism became nonsignificant after controlling for stress-ameliorating factors. Ageism and heterosexism's relations to loneliness and quality of life followed similar patterns. Social support was a strong predictor of better psychological well-being for all measures. In-group social contact buffered against distress resulting from ageism, but heightened distress resulting from heterosexism. The interaction of ageism and heterosexism was not significant. DISCUSSION AND IMPLICATIONS Ageism was a distinct source of distress for sexual minority older adults. Although social support emerged as crucial to well-being, the mixed findings related to in-group contact as a stress-ameliorating factor may indicate a need for tailored social engagement to optimize community connection as protective for sexual minority older adults.
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Affiliation(s)
- Bethany P Detwiler
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Grace I L Caskie
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
| | - Nicole L Johnson
- Department of Education and Human Services, Lehigh University, Bethlehem, Pennsylvania, USA
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Davison TE, McCabe MP, Busija L, Martin C, Graham A. Trajectory and Predictors of Mental Health Symptoms and Wellbeing in Newly Admitted Nursing Home Residents. Clin Gerontol 2022; 45:1103-1116. [PMID: 34872469 DOI: 10.1080/07317115.2021.2010154] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVES This study determined changes in multiple aspects of mental health and wellbeing in newly admitted nursing home residents, and identified risk and protective factors. METHODS Participants were 204 residents recently admitted to one of 42 nursing homes in Melbourne, Australia. A subgroup of 82 participants were followed up eight months post-admission. Depression, anxiety, stress, adjustment, and quality of life were assessed at baseline and follow-up. Predictive factors (demographics, health, transition factors, nursing home characteristics) were examined in multiple regression analyses. RESULTS Rates of depression and anxiety were high at both baseline and follow-up. Low self-rated health and medical comorbidity predicted poor wellbeing at baseline. Higher perceived control in the relocation to the nursing home and engagement in meaningful activities were associated with better post-admission outcomes. Baseline psychotropic medication use predicted lower anxiety at follow-up but did not impact depressive symptoms. CONCLUSIONS There were no significant changes in mental health and wellbeing from one to eight months post-admission. The negative effect of residing in a for-profit nursing home requires further investigation. CLINICAL IMPLICATIONS Individual activity scheduling and an opportunity to participate in relocation decision-making and planning may support resident wellbeing post-admission.
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Affiliation(s)
- Tanya E Davison
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,Research and Innovation, Silver Chain Group, Melbourne, Australia
| | - Marita P McCabe
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Ljoudmila Busija
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Catherine Martin
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Monash e-Research Centre, Monash University, Melbourne, Australia
| | - Annette Graham
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
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Davison TE, McCabe MP, Busija L, Graham A. Program to Enhance Adjustment to Residential Living (PEARL): Effect on Adjustment, Anxiety, Quality of Life, and Stress. Clin Gerontol 2022; 45:1117-1129. [PMID: 35856170 DOI: 10.1080/07317115.2022.2100729] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVES The Program to Enhance Adjustment to Residential Living (PEARL) is a five session intervention primarily designed to address high rates of depression in newly admitted residents. This study reports the efficacy of PEARL on secondary outcomes of resident adjustment, symptoms of anxiety, quality of life, and stress. METHODS A cluster randomized controlled trial was conducted with 219 newly admitted nursing home residents (M age = 85.5 years) from 42 nursing homes. Outcomes were assessed at baseline, post-intervention, and at two and six month post-intervention follow-up, compared to a standard care condition. RESULTS There was a significant overall condition by time interaction for adjustment (p = .027) and quality of life (p = .015), but not for stress (p = .309). While the overall condition by time interaction was not significant for anxiety (p = .221), there was a significant interaction contrast six-month post-intervention, indicating a greater decrease in anxiety scores in the intervention group relative to control (p = .039). CONCLUSIONS This study demonstrates the broad effects of PEARL on the wellbeing of newly admitted residents. CLINICAL IMPLICATIONS PEARL is a brief intervention that may be feasible for routine use in nursing homes to facilitate adjustment and improve residents' quality of life.
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Affiliation(s)
- Tanya E Davison
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,Research & Innovation, Silverchain, Melbourne, Australia
| | - Marita P McCabe
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia
| | - Ljoudmila Busija
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Annette Graham
- School of Health Sciences, Swinburne University of Technology, Hawthorn, Australia.,Mitchell Institute, Victoria University, Footscray Park, Australia
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Cousi C, Igier V, Quintard B. French cross-cultural adaptation and validation of the Quality of Life-Alzheimer's Disease scale in Nursing Homes (QOL-AD NH). Health Qual Life Outcomes 2021; 19:219. [PMID: 34526034 PMCID: PMC8443115 DOI: 10.1186/s12955-021-01853-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/02/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND No specific scale to measure Quality of Life in Alzheimer's Disease in Nursing Homes (QoL-AD NH) exists in French. We aimed to translate and culturally adapt the QoL-AD NH participant scale into a French version and evaluate its psychometric properties with residents in French nursing homes (EHPAD). METHODS First, the QoL-AD NH was cross-culturally adapted into French according to guidelines. Secondly, a convenience group of residents with mild to moderate dementia answered the Folstein's test and the QoL-AD NH. They also answered the Dementia Quality of Life and the Geriatric Depression Scale to test convergent and divergent validity. Known-group validity was tested with a comparison group of residents without dementia. Exploratory Structural Equation Modeling (ESEM) was used after Exploratory Factor Analysis (EFA) to identify factors and measure invariance across age and mental state groups. Reliability (internal consistency, McDonald's omega and test-retest) were also measured. RESULTS Following successful adaptation of the QoL-AD NH, 174 residents (mean age 86.6) from 7 nursing homes with mild to moderate dementia participated in the validation study. We retained a 3-factor model of the scale after ESEM identifying: "Intra & interpersonal environment-related QoL", "Self-functioning-related QoL" and "Perceived current health-related QoL" that were invariant across age and mental state groups. The QoL-AD NH had acceptable convergent (ρ range 0.24-0.53) and divergent validity (ρ range - 0.43 to - 0.57) and good known-group validity with 33 residents without dementia (t(205) = 2.70, p = .007). For reliability, the results revealed very good and adequate internal consistency (α = 0.86 for total scale and ≥ 0.71 for subscales). All total omega values exceeded the threshold 0.70. The hierarchical omega was 0.50, supporting the multidimensionality of the scale. Hierarchical omega subscale values exceeded the minimal level 0.50 except for the third factor, although reliable, would deserve more items. Test-retest was good with ICC (3,1) = 0.76. CONCLUSIONS The QoL-AD NH French participant version has globally good reliability and validity for evaluating residents' quality of life. However, further studies must rework and confirm the factor structure, test sensitivity to change and responsiveness.
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Affiliation(s)
- Christophe Cousi
- CLESCO ED 326, Centre for Studies and Research in Psychopathology and Health (CERPPS), University of Toulouse Jean-Jaurès, Toulouse, France. .,INSERM BPH, UMR 1219, Team "Handicap, Activity, Cognition, Health", University of Bordeaux, Bordeaux, France.
| | - Valérie Igier
- CLESCO ED 326, Centre for Studies and Research in Psychopathology and Health (CERPPS), University of Toulouse Jean-Jaurès, Toulouse, France
| | - Bruno Quintard
- INSERM BPH, UMR 1219, Team "Handicap, Activity, Cognition, Health", University of Bordeaux, Bordeaux, France
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Yamada T, Nakaaki S, Sato J, Sato H, Shikimoto R, Furukawa TA, Mimura M, Akechi T. Factor structure of the Japanese version of the Quality of Life in Alzheimer's Disease Scale (QOL-AD). Psychogeriatrics 2020; 20:79-86. [PMID: 31020753 DOI: 10.1111/psyg.12459] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 02/16/2019] [Accepted: 04/01/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND The Quality of Life in Alzheimer's Disease Scale (QOL-AD) developed by Logsdon et al. in1999 is believed to be useful for evaluating responses from both patients and their caregivers. We previously confirmed both the reliability and the validity of the Japanese version of the QOL-AD. However, the factor structure of this scale should be confirmed because the QOL-AD covers multiple facets of dementia patients' lives. Thus, we performed a factor analysis of the Japanese QOL-AD. Then, we examined the correlations between each of the identified QOL factor scores and the results of other scales. METHODS The Japanese version of the QOL-AD was given to 132 AD patients and 132 caregivers. Four other tests were also performed at the same time: the Mini-Mental State Examination, the Neuropsychiatric Inventory (NPI), the Hyogo Activities of Daily Living Scale (HADL), and the Short Memory Questionnaire. A factor analysis using Varimax rotation was used to examine the dimensions underlying the QOL-AD. In addition, we examined the Pearson correlations between each of the identified QOL factor scores and the results of the other four tests. RESULTS Factor analyses of both versions of the Japanese QOL-AD (both the patients' and the caregivers' responses) revealed three factors that were named 'psychological wellbeing', 'human relationships', and 'physical and social environment'. The 'psychological wellbeing' factor was significantly correlated with the Mood factor of the NPI. The 'human relationships' factor was significantly correlated with the Psychosis factor of the NPI. The 'physical and social environment' factor was significantly correlated with the HADL. CONCLUSIONS Both the patients' and the caregivers' responses to the Japanese version of the QOL-AD were composed of three factors: 'psychological wellbeing', 'human relationships', and 'physical and social environment'. The present results support the multi-domain concept of QOL proposed by Lawton.
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Affiliation(s)
- Takahiro Yamada
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Shutaro Nakaaki
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan.,Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Junko Sato
- Department of Speech-Language-Hearing Therapy, School of Rehabilitation Science Seirei Christopher University, Japan
| | - Hirofumi Sato
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
| | - Ryo Shikimoto
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Toshi A Furukawa
- Department of Health Promotion and Human Behavior (Cognitive-Behavioral Medicine), Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | - Tatsuo Akechi
- Department of Psychiatry and Cognitive-Behavioral Medicine, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan
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Kisvetrová H, Školoudík D, Herzig R, Vališ M, Jurašková B, Krulová P, Langová K, Bermellová J, Yamada Y. Psychometric Validation of the Czech Version of the Quality of Life - Alzheimer's Disease Scale in Patients with Early-Stage Dementia. Dement Geriatr Cogn Disord 2018; 46:109-118. [PMID: 30145599 DOI: 10.1159/000492490] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Accepted: 07/26/2018] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND/AIMS The aim of this study was to perform a psychometric validation of the Czech version of the Quality of Life - Alzheimer's Disease scale (QoL-AD) for patients with early-stage dementia. METHODS The sample included 212 patient-proxy pairs. For convergent validity, the Czech version of the Bristol Activities of Daily Living Scale (BADLS-CZ), the Short Physical Performance Battery (SPPB), and the Geriatric Depression Scale (GDS) were used. RESULTS The reliability of the QoL-AD for patients and caregivers was good (Cronbach's α = 0.85, ICC = 0.25-0.54). A positive correlation existed between the QoL-AD and the SPPB, and negative correlations existed between the QoL-AD and the BADLS-CZ as well as between the QoL-AD and the GDS. Factor analysis resulted in a three-factor solution (physical and mental health, family life, and social security). CONCLUSION The Czech version of the QoL-AD has good psychometric properties in compliance with international recommendations.
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Affiliation(s)
- Helena Kisvetrová
- Center for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - David Školoudík
- Center for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Roman Herzig
- Neurology Clinic, University Hospital, Hradec Králové, Czech Republic
| | - Martin Vališ
- Neurology Clinic, University Hospital, Hradec Králové, Czech Republic
| | - Božena Jurašková
- Third Internal Clinic of Gerontology and Metabolism, University Hospital, Hradec Králové, Czech Republic
| | - Petra Krulová
- Neurology Clinic, University Hospital, Ostrava, Czech Republic
| | - Kateřina Langová
- Center for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Jana Bermellová
- Center for Research and Science, Faculty of Health Sciences, Palacký University, Olomouc, Czech Republic
| | - Yukari Yamada
- Human Health Sciences, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Abstract
UNLABELLED ABSTRACTObjective:To study longitudinal changes in the quality of life (QoL) in persons with and without dementia, and explore the factors associated with baseline QoL and changes of QoL over the follow-up period. DESIGN Prospective longitudinal study. SETTING Data were collected from 17 municipalities in Norway in the period from January 2009 to August 2012. A total of 412 persons were included, 254 (61.7 %) persons without dementia and 158 (38.3 %) with dementia at baseline. SUBJECTS Persons 70 years of age or older, receiving municipal care services. Main outcome measures include the following: self-rated and proxy-rated QoL over a period of 18 months, cognitive status, functional status, neuropsychiatric symptoms, and demographics. RESULTS Longitudinal changes in QoL were small, despite changes in clinical variables. Proxy ratings of patients QoL were lower than the patients' own ratings. Belonging to a group with low QoL trajectory was associated with symptoms of depression, reduced physical and instrumental functioning, and more severe dementia. CONCLUSION Patients and proxies evaluated the patients' QoL differently and QoL did not necessarily correspond with deterioration in clinical parameters. To prevent impaired QoL, we need to address identified factors and keep an approach open to the individual perceptions of QoL.
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Lima S, Gago M, Garrett C, Pereira MG. Predictors and Moderators of Quality of Life in Alzheimer's Disease Patients. J Alzheimers Dis 2018; 54:1113-1121. [PMID: 27567826 DOI: 10.3233/jad-160256] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a chronic degenerative disease leading to global cognitive and functional decline. Quality of Life (QOL) is an important variable in the effectiveness of intervention programs in dementia. OBJECTIVE This study analyzed the relationships between gender, psychological variables and QOL, the predictors of QOL, and the role of spirituality as a moderator between functionality and QOL. METHOD A cross-sectional study was conducted with 128 patients with mild AD. RESULTS Being a male, good social support, and high functionality were significant predictors of better QOL. Spirituality was a moderator in the relationship between functionality and QOL. CONCLUSION These results reinforce the importance of gender, psychological morbidity, social support, and functionality, with special emphasis on the role of spirituality, regarding intervention programs that promote QOL, in patients with mild AD.
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Affiliation(s)
- Sara Lima
- School of Psychology, University of Minho, Braga, Portugal.,Research Group of Family Health and Ilness for Research Center on Psychology, University of Minho, Braga, Portugal.,CESPU - Cooperativa de Ensino Superior Politécnico e Universitário, Portugal and Institute of Research and Advanced Training in Heath Sciences and Technologies (INFACTS/CESPU), Portugal
| | - Miguel Gago
- Serviço de Neurologia for Department of Neurology, Hospital Senhora da Oliveira, Guimarães, Portugal.,Academic Center Human Research Program, Hospital Senhora da Oliveira, Guimarães, Portugal.,Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal
| | - Carolina Garrett
- Faculty of Medicine, University of Porto, Portugal.,Department of Neurology, Hospital S. João, Portugal
| | - M Graça Pereira
- School of Psychology, University of Minho, Braga, Portugal.,Research Group of Family Health and Ilness for Research Center on Psychology, University of Minho, Braga, Portugal
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Lin A, Brook J, Grill JD, Teng E. Participant-Informant Relationships Affect Quality of Life Ratings in Incipient and Clinical Alzheimer Disease. Am J Geriatr Psychiatry 2017; 25:297-307. [PMID: 27818119 PMCID: PMC5316499 DOI: 10.1016/j.jagp.2016.10.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 10/10/2016] [Accepted: 10/11/2016] [Indexed: 11/19/2022]
Abstract
OBJECTIVE Clinical trials in incipient and clinical Alzheimer disease (AD) often include informant-reported outcomes. Whereas informant reports in AD dementia may be modulated by the nature of participant-informant relationships, whether informant type affects reporting at earlier disease stages is less certain. We sought to determine the effects of participant-informant relationships on informant assessments of quality of life (QOL), functional abilities, and behavioral symptoms in individuals with normal cognition (NC), mild cognitive impairment (MCI), and mild-to-moderate AD dementia. DESIGN Cross-sectional. SETTING Easton Center for Alzheimer Disease Research at the University of California, Los Angeles. PARTICIPANTS A total of 399 individuals who met criteria for NC (N = 100), MCI [amnestic (N = 125) and nonamnestic (N = 61)], and AD (N = 113). Participants were subdivided into groups based on informant-participant relationships (spouse versus other). MEASUREMENTS We examined informant effects on the Quality of Life-Alzheimer's Disease (QOL-AD) scale, the Functional Activities Questionnaire (FAQ), and the Neuropsychiatric Inventory (NPI). RESULTS After adjustments for demographic and cognitive factors, spouse informants reported higher participant QOL in the amnestic MCI and AD groups than did other informants. No informant effects were seen on QOL-AD ratings in the nonamnestic MCI or NC groups or on the FAQ or NPI in the MCI and AD groups. CONCLUSIONS Participant-informant relationships may modulate informant responses on subjective measures such as the QOL-AD in both incipient and clinical AD. Clinical trials that use informant measures may need to address these effects.
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Affiliation(s)
- Amy Lin
- Keck School of Medicine, University of Southern California, Los Angeles, CA
| | - Jenny Brook
- Department of Medicine, David Geffen School of Medicine, University of California, Los Angeles, CA
| | - Joshua D Grill
- Department of Psychiatry and Human Behavior, Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA
| | - Edmond Teng
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, CA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA.
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Torisson G, Stavenow L, Minthon L, Londos E. Reliability, validity and clinical correlates of the Quality of Life in Alzheimer's disease (QoL-AD) scale in medical inpatients. Health Qual Life Outcomes 2016; 14:90. [PMID: 27301257 PMCID: PMC4908755 DOI: 10.1186/s12955-016-0493-8] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2015] [Accepted: 06/07/2016] [Indexed: 11/14/2022] Open
Abstract
Background There is a lack of standardisation in quality of life (QoL) measurements to be used in older multimorbid patients. An ideal QoL measurement should be reliable, valid, subjective, multidimensional, feasible and generic. We hypothesised that the QoL-AD (Quality of Life in Alzheimer’s Disease) scale could have these properties. Our aim was to determine the psychometric properties and clinical correlations of QoL-AD in a population of elderly, multimorbid medical inpatients. Methods QoL-AD was performed in 200 medical inpatients, and available caregivers. Reliability was determined using cronbach’s alpha and corrected item-total correlations. The agreement between patient and proxy ratings were examined using intra-class correlations (ICC). Correlations between QoL-AD and demographic data, comorbidity, cognitive tests, ADL (activities of daily living) and depression were examined. To characterise the underlying constructs of QoL-AD, an exploratory factor analysis was performed. Results In total, 199 patients fulfilled the QoL-AD rating, with 139 proxy ratings. Cronbach’s alpha (95 % CI) was 0.74 (0.68–0.79) for patients and 0.86 (0.83–0.90) for proxies. Patient-proxy ICC (95 % CI) was 0.31 (0.16–0.46). Lower QoL was correlated to depression, cognitive impairment, ADL impairment and solitary living, but not with comorbidity. The factor analysis gave a three-factor solution, with factors representing phsyical, social and psychological well-being. Conclusion The QoL-AD scale showed some promising properties but more research is needed before it can be recommended in this setting. If replicated, the finding that cognitive impairment, depression and ADL impairment were more associated with lower QoL than somatic comorbidity could have clinical implications for further studies aiming to improve QoL in this population. Electronic supplementary material The online version of this article (doi:10.1186/s12955-016-0493-8) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Gustav Torisson
- Clinical Memory Research Unit, Lund University, Simrisbanvägen 14, S 20502, Malmö, Sweden.
| | - Lars Stavenow
- Deparment of Internal Medicine, Skåne University Hospital, Malmö, Sweden
| | - Lennart Minthon
- Clinical Memory Research Unit, Lund University, Simrisbanvägen 14, S 20502, Malmö, Sweden
| | - Elisabet Londos
- Clinical Memory Research Unit, Lund University, Simrisbanvägen 14, S 20502, Malmö, Sweden
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Buasi N, Permsuwan U. Validation of the Thai QOL-AD version in Alzheimer's patients and caregivers. Australas Med J 2014; 7:251-9. [PMID: 25031647 PMCID: PMC4082250 DOI: 10.4066/amj.2014.2078] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Quality of life (QOL) plays an important role in determining the improvement of patient care in Alzheimer's disease (AD). The simple and easily used Thai instrument for measuring QOL is still limited. AIMS This study aimed to translate the Quality of Life-Alzheimer's Disease (QOL-AD) scale original version into a Thai version and test its psychometric properties. METHOD A Thai version of QOL-AD was translated following the sequential method. The validation was tested in 136 pairs of patients and their caregivers. Mild to moderate Alzheimer's patients were recruited from outpatient clinics at Chiang Mai Neurological Hospital and Chiang Mai Psychiatry Hospital from April to September 2012. Internal consistency, factor analysis, and construct validity were evaluated. RESULTS Internal consistency of Thai QOL-AD version was good for both patients (0.82) and caregivers (0.82). The results of factor analysis indicated three factors (physical and psychological well-being, social well-being, and close interpersonal relationships) in the patient group, while four factors were found (social well-being, functional ability, psychological well-being, and physical well-being) in the caregiver group. The scaling success in the patient group was around 80-83 per cent for convergent validity, and 70-83 per cent for discriminant validity. The caregiver group showed higher scaling success in convergent validity except for the psychological well-being domain. The scaling success of discriminant validity was around 44-83 per cent for caregivers. CONCLUSION The findings of the study demonstrate a good reliability of a Thai QOL-AD version for both patient and caregiver groups. Validity, especially in the caregiver group, might need to be re-examined.
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Gómez-Gallego M, Gomez-García J, Ato-García M. Confirmatory factor analysis of the quality of life in Alzheimer's disease scale in patients with Alzheimer's disease. Exp Aging Res 2014; 40:266-79. [PMID: 24785591 DOI: 10.1080/0361073x.2014.896664] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: Quality of life (QoL) has become an important outcome measure in clinical trials for Alzheimer's disease (AD). The Quality of Life in Alzheimer's Disease (QoL-AD) Scale is widely used for assessing QoL of patients with AD. This research aims to determine the factor structure of the QoL-AD Scale in AD patients. METHODS One hundred thirty-nine patients with mild-to-moderate AD were administered the QoL-AD Scale. Based on the model proposed for healthy people, confirmatory factor models were built using modification indices and residual analysis to improve the model fit. RESULTS Confirmatory factor analysis indicated poor fit for both the initial model and the single-factor model. Two models showed a good fit: a three-factor model (perceived health, perceived environment and perceived functional ability) and a two-factor model (perceived physical health and perceived psychological health). Because no differences in fit were found between both models, the authors proposed the more parsimonious solution as the best model. CONCLUSION These results provide evidence supporting the construct validity of the QoL-AD Scale. This instrument seems to measure the perception of two related constructs (behavioral competence and environment) and could be used together with instruments measuring psychological well-being and the perception of health.
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Affiliation(s)
- María Gómez-Gallego
- a Department of Neuroscience , Catholic University of Murcia , Campus of Jerónimos, Murcia , Spain
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Burkard C, Rochat L, Blum A, Emmenegger J, Juillerat Van der Linden AC, Van der Linden M. A daily-life-oriented intervention to improve prospective memory and goal-directed behaviour in ageing: A pilot study. Neuropsychol Rehabil 2014; 24:266-95. [DOI: 10.1080/09602011.2014.887023] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Schiffczyk C, Romero B, Jonas C, Lahmeyer C, Müller F, Riepe MW. Efficacy of short-term inpatient rehabilitation for dementia patients and caregivers: prospective cohort study. Dement Geriatr Cogn Disord 2013; 35:300-12. [PMID: 23572117 DOI: 10.1159/000348357] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/19/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS The efficacy of nonpharmacological and multicomponent treatments in patients with dementia is under discussion, as is the ongoing debate which endpoints best measure efficacy. METHODS 194 dyads of dementia patients and their proxies interested in a combined short-term inpatient rehabilitative treatment were assessed in the patients' homes. RESULTS Analysis showed that cognition in male patients (cognitive part of the Alzheimer's Disease Assessment Scale: p = 0.048) and depressive mood in female patients were improved after treatment at the 3-month follow-up (Geriatric Depression Scale: p = 0.030). Moreover, the burden on male caregivers was reduced (behavioral pathology in Alzheimer's Disease Rating Scale: p = 0.002) at 3 months. CONCLUSION Combined short-term rehabilitative treatment of patients and psychosocial intervention for caregivers is modestly effective in patients with dementia and their caregivers, but may be subject to gender-specific effects.
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Affiliation(s)
- Claudia Schiffczyk
- Division of Mental Health and Old Age Psychiatry, Department of Psychiatry and Psychotherapy II, Ulm University, Ulm, Germany
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Jeng HL, Chen YF. Comparisons of latent factor region means of spatial ability based on measurement invariance. LEARNING AND INDIVIDUAL DIFFERENCES 2013. [DOI: 10.1016/j.lindif.2013.06.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Charras K, Gzil F. Judging a book by its cover: uniforms and quality of life in special care units for people with dementia. Am J Alzheimers Dis Other Demen 2013; 28:450-8. [PMID: 23687183 PMCID: PMC10852696 DOI: 10.1177/1533317513488915] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
OBJECTIVES In certain health care facilities, the staff commonly wear uniforms for dementia care. Wearing uniforms are often believed to improve the well-being of institutionalized people with dementia (PwD) by facilitating orientation and preserving hygiene. However, when studied more thoroughly, it appears that their use counters to person centeredness. This study aims to investigate the impact of wearing uniforms on the quality of life (QoL) of institutionalized PwD. METHOD A natural experimental design was operated in 4 special care units (SCUs) in France. Two SCUs served as an experimental group (caregivers wearing street clothes except when performing hands-on physical care; N = 13) and 2 served as a comparison group (caregivers wearing uniforms; N = 14). The QoL of PwD was measured using the QoL-Alzheimer's Disease scale, and focus groups were carried out with caregivers. RESULTS Overall and significantly enhanced QoL scores were observed for the experimental street clothing staff group when compared to the uniform group. Caregivers also reported subjective impressions of overall beneficial outcomes for PwD when the caregivers were not wearing uniforms and reported feeling more at ease when interacting with them. CONCLUSION Results are discussed in terms of intergroup relationships, living and working conditions, and ethical issues.
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Affiliation(s)
- Kevin Charras
- Psyschosocial Interventions Department, Fondation Médéric Alzheimer, Paris, France.
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Abstract
BACKGROUND Over the last 20 years, a number of instruments developed for the assessment of health-related quality of life (HRQL) in dementia have been introduced. The aim of this review is to synthesize evidence from published reviews on HRQL measures in dementia and any new literature in order to identify dementia specific HRQL instruments, the domains they measure, and their operationalization. METHODS An electronic search of PsycINFO and PubMed was conducted, from inception to December 2011 using a combination of key words that included quality of life and dementia. RESULTS Fifteen dementia-specific HRQL instruments were identified. Instruments varied depending on their country of development/validation, dementia severity, data collection method, operationalization of HRQL in dementia, psychometric properties, and the scoring. The most common domains assessed include mood, self-esteem, social interaction, and enjoyment of activities. CONCLUSIONS A number of HRQL instruments for dementia are available. The suitability of the scales for different contexts is discussed. Many studies do not specifically set out to measure dementia-specific HRQL but do include related items. Determining how best to operationalize the many HRQL domains will be helpful for mapping measures of HRQL in such studies maximizing the value of existing resources.
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Schiffczyk C, Romero B, Jonas C, Lahmeyer C, Müller F, Riepe MW. Appraising the need for care in Alzheimer's disease. BMC Psychiatry 2013; 13:73. [PMID: 23497052 PMCID: PMC3599515 DOI: 10.1186/1471-244x-13-73] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2012] [Accepted: 02/26/2013] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Increasing incidences of dementia necessitate the improvement of supportive measures for patients suffering from this disease and their proxies. Clinicians without psychiatric backgrounds and others involved in appraising the supportive needs of dementia patients, such as those who allocate nursing insurance, base their appraisals on the ability of patients to perform basic and instrumental activities of daily living (B-ADL, iADL). Our aim was to investigate whether a reduced ability of the patient to perform ADL is sufficient to adequately assess the supportive needs of family caregivers. METHODS Cross-sectional baseline data were obtained from dementia patients and their proxies in the context of a nationwide prospective cohort study on non-pharmacological treatment of dementia. To our knowledge, the present study is the first country-wide study to assess patients and proxies in their domestic surroundings (e.g. Mini-Mental State Examination (MMSE) Behave-AD, B-ADL and iADL for patients; Quality of Life (QOL) and depression of the proxy). RESULTS Logistic and linear regression analysis show that the allocation of nursing care allowance provided by German mandatory nursing insurance is associated with scores on the B-ADL- and iADL scales, but not with the severity of behavioural symptoms or the supportive time the proxies spend on caring. However, the severity of cognitive and non-cognitive symptoms of dementia patients, correlate with each other and both parameters correlate with the time the proxy spends on caring. The time spent on caring is associated with an increase in depression and a reduction in the quality of life of the proxy. CONCLUSIONS Basic and instrumental activities of daily living do not sufficiently reflect the perceived burden of care experienced by the proxy who has to cope with the imposition of the dementia patients' behavioural symptoms. When allocating nursing care, patients' behavioural symptoms should also be taken into consideration, because depressive symptoms of proxies are linked to non-cognitive symptoms in dementia patients. To provide better health care, it is necessary to identify and treat psychiatric symptoms in proxies who care for dementia patients as early as possible.
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Affiliation(s)
- Claudia Schiffczyk
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
| | - Barbara Romero
- Alzheimer Therapiezentrum Bad Aibling, Bad Aibling, Germany,Freelance Psychologist, Berlin, Germany
| | - Christina Jonas
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
| | - Constanze Lahmeyer
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
| | | | - Matthias W Riepe
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
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Larsson V, Engedal K, Aarsland D, Wattmo C, Minthon L, Londos E. Quality of life and the effect of memantine in dementia with lewy bodies and Parkinson's disease dementia. Dement Geriatr Cogn Disord 2012; 32:227-34. [PMID: 22122992 DOI: 10.1159/000334523] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/17/2011] [Indexed: 01/08/2023] Open
Abstract
AIM To investigate quality of life (QOL) and the effect of memantine treatment in patients with Lewy body dementias. METHODS A secondary analysis of a randomized controlled study in 70 patients with Parkinson's disease dementia (PDD) or dementia with Lewy bodies (DLB) over 24 weeks using caregiver-rated QOL-Alzheimer's disease (AD) in domains according to the WHO's classification of health. RESULTS Baseline QOL shows lower ratings for body functions over environmental factors in DLB/PDD. Treatment with memantine significantly improves life as a whole compared to placebo and improves total QOL, body function and structure. CONCLUSION This study shows that memantine improves QOL in Lewy body dementias. We also demonstrate important QOL patterns which can be used in clinical practice.
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Affiliation(s)
- Victoria Larsson
- Clinical Memory Research Unit, Department of Clinical Sciences, Lund University, Malmö, Sweden.
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Jonas C, Schiffczyk C, Lahmeyer C, Mueller F, Riepe MW. Staging dementia using proxy-reported activities of daily living. Dement Geriatr Cogn Disord 2012; 32:111-7. [PMID: 21952470 DOI: 10.1159/000331420] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/29/2011] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIM It has been questioned whether cognitive and behavioral scales sufficiently address the impact of dementia on the everyday life of patients. Therefore, other instruments are used, such as scales of activities of daily living (ADL). Our goal was to analyze variables influencing the appraisal of ADL. METHOD Prospective cohort study on 202 patients with dementia and their proxies. RESULTS Two clusters of patients were identified. These clusters differed significantly in their constituting variables and all variables that informants reported regarding the patients. However, severity of dementia and other variables were similar in the two clusters. CONCLUSION We conclude that ratings of basic and instrumental ADL by proxy are modulated by the informants' variables, particularly if these informants are female. Use of ADL scales to assess the impact of dementia or treatment thereof needs to be handled cautiously.
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Affiliation(s)
- Christina Jonas
- Department of Psychiatry and Psychotherapy II, Mental Health and Old Age Psychiatry, Ulm University, Germany
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Tarride JE, Oremus M, Pullenayegum E, Clayton N, Raina P. How does the canadian general public rate moderate Alzheimer's disease? J Aging Res 2012; 2011:682470. [PMID: 22229093 PMCID: PMC3250621 DOI: 10.4061/2011/682470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2011] [Accepted: 10/11/2011] [Indexed: 11/20/2022] Open
Abstract
Objectives. The objectives of this study were to elicit health utility scores for moderate Alzheimer's disease (AD) using members of the general public. Methods. Five-hundred Canadians were chosen randomly to participate in a telephone interview. The EQ-5D was administered to estimate the health utility score for respondents' current health status (i.e., no AD) and for a hypothetical moderate AD health state. Regression analyses were conducted to explain the perceived utility decrement associated with AD. Results. The mean age of the respondents was 51 years, 60% were female, and 42% knew someone with AD. Respondents' mean EQ-5D scores for their current health status and a hypothetical moderate AD were 0.873 (SD: 0.138) and 0.638 (SD: 0.194), respectively (P < 0.001). Age, gender, and education were significant factors explaining this decrement in utility. Conclusion. Members of the general public may serve as an alternative to patients and caregivers in the elicitation of health-related quality of life in AD.
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Affiliation(s)
- Jean-Eric Tarride
- Programs for Assessment of Technology in Health (PATH) Research Institute, St. Joseph's Healthcare Hamilton, 25 Main Street West, Suite 2000, Hamilton, ON, Canada L8P 1H1
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Validation of the Spanish version of the QoL-AD scale in Alzheimer disease patients, their carers, and health professionals. NEUROLOGÍA (ENGLISH EDITION) 2012. [DOI: 10.1016/j.nrleng.2011.03.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Gómez-Gallego M, Gómez-Amor J, Gómez-García J. Validación de la versión española de la escala QoL-AD en pacientes con enfermedad de Alzheimer, cuidadores y profesionales sanitarios. Neurologia 2012; 27:4-10. [DOI: 10.1016/j.nrl.2011.03.006] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2010] [Revised: 01/27/2011] [Accepted: 03/06/2011] [Indexed: 11/17/2022] Open
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Moyle W, Murfield JE, Griffiths SG, Venturato L. Assessing quality of life of older people with dementia: a comparison of quantitative self-report and proxy accounts. J Adv Nurs 2011; 68:2237-46. [DOI: 10.1111/j.1365-2648.2011.05912.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Schiffczyk C, Jonas C, Lahmeyer C, Müller F, Riepe MW. Gender-dependence of substituted judgment on quality of life in patients with dementia. BMC Neurol 2011; 11:118. [PMID: 21961477 PMCID: PMC3198923 DOI: 10.1186/1471-2377-11-118] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2011] [Accepted: 09/30/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Substituted judgment asks the proxy to decide what the patient would have decided, had he or she been competent. It is unclear whether substituted judgment of the patient's quality of life can serve as a surrogate measure in patients with dementia. METHODS 212 patients with dementia and their proxies were interviewed in their homes. Dementia syndrome was characterized with cognitive, non-cognitive and functional scales. Quality of life (QoL) was assessed with the QoL-AD. RESULTS Substituted judgment of the patient's QoL was unrelated to dementia severity but also correlated with the proxie's own QoL (r = 0.356; p < 0.001). Gender-specific analysis reveals that for male proxies the most important variable is severity of patient's depression (r = -0.895; p = 0.001) while for female proxies it is the proxie's own QoL (r = 0.371; p < 0.001). Subjective burden correlates with the proxie's QoL in females (r = -0.282; p = 0.001) but not in males (r = -0.163, p = 0.161). CONCLUSION Substituted judgment of the patient's QoL does not correlate with dementia severity. Substituted judgment is subject to proxy-related variables in a gender-dependent fashion and therefore not suited to serve as an appropriate surrogate of the patients' quality of life.
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Affiliation(s)
- Claudia Schiffczyk
- Department of Psychiatry and Psychotherapy II, Mental Health & Old Age Psychiatry, Ulm University, Ulm, Germany
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