The role of social relationships among elderly community-dwelling and nursing-home residents: findings from a quality of life study

Quality of life among geriatric population residing in Bhavnagar city, Gujarat, Western India

Background

All of the health status, lifestyle, satisfaction, mental state, or well-being, all facets of health status together reflect the multidimensional nature of quality of life (QOL) in an individual. Our objective is to assess quality of life and factors affecting quality of life.

Methods

We conducted a community-based cross-sectional study among 260 subjects (aged ≥ 60 years) residing in 13 wards of Bhavnagar city during September 2019-2020 after taking permission from ethics committee (no. 892) using the World Health Organization Quality of Life BREF-25 (WHO QOL BREF-25) scale. We assessed psychiatric morbidity using General Health Questionnaire-12 scale. Independent t-test was performed to find out factors associated with quality of life.

Result

Among 260 subjects, 36% were males. Study found highest score in psychological domain and lowest score in physical domain of WHO QOL BREF-25 scale. Physical health was better among Muslims, geriatrics <75 year of age, not addicted abusive substance and no co-morbid condition, whereas geriatrics belonged to upper socio-economic status and normal as per General Health Questionnaire-12 scale had better social relationship. Environmental domain score was significantly better among males and geriatric without co-morbidity.

Conclusion

These findings highlight the importance of active ageing interventions in order to improve the quality of life.

Conceptualising relevant social context indicators for people receiving home care: A multi-method approach in Flanders, Belgium

Despite an increasing awareness of the impact of the social context of a person on personalised care planning, there is currently no generally accepted classification of social context. As a result, home care professionals have a partial understanding of what social context is and how it affects and can even benefit their work. In this study, we define the main themes and concepts of the social context in the home care setting. The goal in this study is twofold. Initially, we want to offer a multidimensional and practical model of social context, founded on the perspectives of care users and professional caregivers in home care. This model of social context, in turn, will be the foundation for the development of a Social Supplement for the interRAI assessment instruments. We conducted nine focus groups in Flanders between September and November 2017. Fifty-four people participated. The focus groups followed a semi-structured format based on themes identified from the literature and three in-depth interviews with experts. Questions focused on defining the main themes of 'social context' and their subcategories. At the end of each discussion, participants were asked to consider which concept could be suitable and essential for a Social Supplement to the current interRAI instruments. Focus groups were recorded, transcribed and analysed using NVivo. We used investigator and theoretical triangulation to ensure the quality of our analysis, and identified five overarching themes of social context; (a) care and support, (b) physical environment, (c) life and care goals, (d) psychosocial well-being and (e) civic engagement. These main themes were mentioned throughout the nine focus group discussions, even though a diverse group of stakeholders participated. This model provides the basis for the development of a Social Supplement for the interRAI assessment instruments in Flanders, Belgium.

Mature and Older Adults’ Perception of Active Ageing and the Need for Supporting Services: Insights from a Qualitative Study

The improvement in life expectancy, economic conditions, and technological and medical progress have radically changed the demographic structure of many societies. Since many countries now have an ageing population, by adopting a life-course study perspective, this paper aims to explore the needs of older adults (over 60), and the currently adult population which will become older in the coming decades (50–60 years). In detail, the study investigates the lifestyles of the target populations by focusing on two main areas concerning health (healthy diet; attitudes towards physical activity) and socio-relational-housing and living conditions (social housing, senior co-housing in rural environments, etc.). A qualitative study was carried out based on 16 in-depth interviews developed over one month (February 2022). The conduct of the interviews was supported by the Italian Center for Sensory Analysis (CIAS). Emerging from the results, the concept of active ageing is perceived by mature and older adults in a positive and optimistic way. The sample considered want to re-engage in life, continuing to be active, useful, and maintaining their self-esteem, social life and independence. However, despite older people’s major concerns being preserve their physical abilities and social integration, this target group adopts behaviours focused more on current well-being rather than worrying too much about how this well-being will change as they age.

Exploring Quality of Life Reported by Norwegian Older Adults Using Classification Tree Approach on Group Profiles

This study aims to explore the variation between- and within subgroups of older adults with regard to low, medium, and high levels of self-reported quality of life (QoL) measured by the WHOQOL-BREF scale. The contribution of interacting personal and contextual life conditions to QoL was examined in a sample of 1,910 (sample frame 6,000) Norwegian men and women aged 62 to 99 years. The data collected by a postal questionnaire were analyzed using the Chi-square Automatic Interaction Detection (CHAID) classification method in order to detect unique profiles of groups who shared common characteristics. The CHAID model revealed 15 relatively homogenous groups, but distinct from one another, whose profiles were defined by unique constellations of several interacting variables significantly related to a given QoL level. Mental functioning was predominantly linked to perception of life meaning along with health status, and/or in some cases living arrangement, loneliness, neighborhood quality, and satisfaction with income, and placed an individual at different likelihood levels of reporting low, medium, or high QoL. Socio-demographics had no statistically significant impact on QoL for any subgroup. Through this individual-oriented approach, a periodically ongoing assessment of subjective quality of life (QoL) may be sufficiently powerful to allow detecting and addressing personal concerns and specific needs that detract from quality of life in advancing age.

The Relationship between Health Status and Social Activity of Perimenopausal and Postmenopausal Women (Health Status and Social Relationships in Menopause)

The quantity and quality of interpersonal relations (including participation in University of the Third Age-U3A) play an important role for women during menopausal changes. Women who have a social network are found to be more positive about menopause, and are less likely to be depressed. This case-control study aimed to analyze the relationship between participating in formal social groups and health status related to physical activity and climacteric and depressive symptoms. The study was conducted among 621 peri- and postmenopausal women aged 50-64 years. The women were classified into two groups: U3A and controls. The participants were selected using a multistage sampling method. The IPAQ (The International Physical Activity Questionnaire), Kupperman Index (KI), and Beck Depression Inventory were used for data collection. Significant differences between the groups were confirmed in the area of professional work (p < 0.001), free time (p < 0.001), and sitting (p < 0.05). The average KI score in the U3A group was higher (t-Student = 2.12, p < 0.05). Depressive symptoms were found in 43.49% of U3A women vs. 51.15% in controls (p < 0.01). We conclude that participation in formal social groups is associated with higher level of physical activity and reduced severity of both climacteric and depressive symptoms.

Activities of daily living, life orientation, and health-related quality of life among older people in nursing homes: a national cross-sectional study in China

PURPOSE

This study aimed to explore the current status of activities of daily living (ADLs), life orientation, and health-related quality of life (HRQoL) among older people in nursing homes and to further examine the mediating role of life orientation in the impact of ADLs on HRQoL.

METHODS

A national cross-sectional study was conducted among older people aged 60 and above in nursing homes by the randomly stratified cluster sampling method. The status of ADLs, life orientation and HRQoL were measured using an ADL scale, a life orientation scale and the SF-12v2 scale, respectively. Multiple linear regression models were used to identify explanatory factors associated with ADLs, life orientation, and HRQoL. The potential mediating role of life orientation in the relationship between ADL and HRQoL was explored by mediation analysis.

RESULTS

The overall prevalence of ADL disability was 52.67%, and 84.37% of older people in nursing homes had a negative life orientation. The mean scores of physical health and mental health among older people in nursing homes were 45.44 ± 6.46 and 42.67 ± 8.48, respectively. Some sociodemographic characteristics were associated with poor physical health and mental health. After adjustments were made for covariates, the life orientation score mediated 13.81% of the total effect of the ADL score on physical component score of HRQoL and mediated 45.33% of the mental component score of HRQoL.

CONCLUSION

A sizeable proportion of older people had ADL disability and negative life orientation, and HRQoL was poor among older Chinese people in nursing homes. Life orientation partially mediates the relationship between ADLs and HRQoL.

Prevalence of Depression and Its Influence on the Quality of Life of Jordanians Living in Residential Care Facilities

BACKGROUND

As a third-world country experiencing a rise in the elderly population and changes to traditional family structures, improving psychological health is critical to improving quality of life (QoL) in the older adults living in residential care facilities in Jordan.

PURPOSE

This study aimed to (a) estimate the prevalence of depression among nursing home (NH) residents in Jordan; (b) measure perceived QoL in these NH residents in the dimensions of mobility, self-care, usual activity, pain and discomfort, and anxiety/depression; and (c) assess the influence of depression on each of these QoL dimensions.

METHODS

This cross-sectional study recruited a convenience sample of 155 participants living in a residential care facility in Jordan. The instruments used included a sociodemographic and clinical questionnaire, the Mini-Mental State Examination, a Geriatric Depression Scale (GDS), and the EuroQol, which is a five-dimension, five-level questionnaire. The data were presented as means, standard deviations, and percentages as well as adjusted odds ratios (AORs) with 95% confidence intervals (CIs).

RESULTS

A high prevalence of depression was found in the study population, with 72.3% having a score between 6 and 9 on the GDS, which is suggestive of depression. Moreover, 18.1% scored ≥ 10 on the GDS, which is indicative of a nearly continual state of depression. With regard to the QoL dimensions, 84.5% of the participants reported experiencing pain, 81.9% reported anxiety/depression, 80.6% reported problems performing usual activities, 75.5% reported problems with self-care, and 63.2% reported mobility difficulties. Pain, anxiety, and depression were found to be significantly associated with level of depression (AOR = 2.78 and 95% CI [1.18, 6.57], AOR = 5.81 and 95% CI [2.14, 15.78], and AOR = 4.75 and 95% CI [1.87, 12.07], respectively).

CONCLUSIONS

Depression is common among NH residents in Jordan and is associated significantly with poor QoL. This study yielded empirical data that may be used to develop strategies to enhance or promote the mental health status and QoL of NH residents in Jordan.

The role of geriatric palliative care in hospitalized older adults

Take-Away Points:1. Geriatric palliative care requires integrating the disciplines of hospital medicine and palliative care in pursuit of delivering comprehensive, whole-person care to aging patients with serious illnesses.2. Older adults have unique palliative care needs compared to the general population, different prevalence and intensity of symptoms, more frequent neuropsychiatric challenges, increased social needs, distinct spiritual, religious, and cultural considerations, and complex medicolegal and ethical issues.3. Hospital-based palliative care interdisciplinary teams can take many forms and provide high-quality, goal-concordant care to older adults and their families.

Development of a quality of life questionnaire for nursing home residents in mainland China

OBJECTIVE

To develop and validate a quality of life (QOL) questionnaire for nursing home (NH) residents in mainland China.

METHODS

A cross-sectional study including a development sample (n = 176) and validation sample (n = 371) of NH residents aged 60 and older was conducted between 2015 and 2016 in Jinan, Shandong Province, China. Resident interviews, literature reviews, expert panels, and pilot studies were used to identify QOL domains and items pertinent to NH life. Exploratory and confirmatory factor analysis were used to develop and validate a QOL questionnaire. Reliability (internal consistency, spilt-half reliability, and test-retest reliability) and validity (construct and criterion validity) were evaluated for the questionnaire.

RESULTS

The self-report Chinese NH QOL questionnaire had 9 domains and 38 items including physical health (4 items), food enjoyment (6 items), security (3 items), environmental comfort (5 items), autonomy (2 items), meaningful activity (3 items), interrelationship (6 items), family relationships (3 items), and mood (6 items). The nine-factor model was confirmed with the following fit indices: χ²/df = 1.872, root mean square error of approximation = 0.049, comparative fit index = 0.913, and Tucker-Lewis index = 0.903. The 38-item NH QOL questionnaire showed satisfactory construct validity, criterion validity, internal consistency (Cronbach's alpha = 0.89, spilt-half reliability = 0.73, test-retest reliability = 0.76).

CONCLUSIONS

The NH QOL questionnaire appears to be a reliable and valid instrument and should be incorporated into a set of quality measures for use with NH residents in mainland China.

Factors influencing the quality of life among Indonesian elderly

Purpose

In spite of being a significant public health concern, quality of life (QoL) amongst elderly in nursing home (NH) settings is rarely analyzed. The purpose of this paper is to examine the level of QoL and factors influencing QoL amongst elderly NH residents in Indonesia.

Design/methodology/approach

A survey was conducted amongst 181 elderly at three NHs in three districts in Yogyakarta province, Indonesia. Purposive sampling was used for the study site and sample collection. Face-to-face interviews were performed using the WHO Quality of Life BREF Indonesian version questionnaire to assess elderly QoL. Multivariate linear regression was performed to determine the factors influencing the QoL amongst elderly NH residents.

Findings

The response rate was 66.3 percent. A total of 64.1 percent of elderly had a fair level of QoL, whereas 16.6 percent still had a poor level of QoL. A total of 86.7 percent of elderly lived in an NH due to compulsion, and more than half (53.6 percent) perceived inadequacy of care. The QoL was significantly low amongst those who live in NHs due to compulsion, no social support resources, not receiving any kind of support, having three chronic diseases and perceived inadequacy of care (p<0.05). Multivariate analysis revealed that perceived adequacy of care reasons for living in NH was associated with QoL (p<0.001).

Originality/value

Perceived adequacy of care and reason for living in an NH were highlighted as predictors of QoL amongst elderly NH residents. Improving adequate healthcare services and developing treatment strategies to enforce the adaptation process is required in order to maintain the QoL in elderly NH residents.