Measurement of Well-Being in Gerontopsychiatric Nursing Home Residents: Development of the Laurens Well-Being Inventory for Gerontopsychiatry

Analyzing the Layout of Long-Term Care Facilities: A Psycho-Spatial Approach

When planning long-term care facilities (LTCFs), architects strive to design buildings that support high well-being (WB) levels for those who live and work in them. To achieve this goal, architects must understand what defines WB in old age and how these qualities can be achieved through the designed physical layout. This task must be achieved while tackling additional challenges, such as considering the official planning guidelines, codes, and additional requests given by the client. During the planning process, architects use their subjective impressions by visiting similar institutions, their personal experience as architects, and their subjective assumptions on what residents and caregivers may consider desirable. Once built, there are a lack of methodological ways to evaluate an existing LTCF unit's plan as a supportive tool for higher levels of WB. The current study aims to create a methodological tool to analyze LTCF units' layout, giving scores to each plan based on five aspects of WB that they support. In our article, we demonstrate this methodology's application on 40 plans of LTCFs, demonstrating its effectiveness. We believe that the approach presented in this article will contribute to furthering the quality of planning of LTCFs benefiting residents and caregivers alike.

Assessing the well-being of residents in nursing facilities

Purpose

Well-adapted and validated well-being (WB) instruments for the nursing home population are scarce. To our knowledge, the Laurens Well-Being Inventory for Gerontopsychiatry (LWIG) is a practical and reliable well-being assessment tool that has never been validated for German nursing home populations. Therefore, the purpose of our study was to (1) translate and cross-culturally adapt the LWIG to a German context and (2) test the reliability and validity of the German LWIG in a group of older nursing home residents using the Rasch model.

Methods

This study has a cross-sectional, descriptive study design. Cross-cultural adaption of the LWIG-GER from English to German was performed according to a standardized method. The data obtained from 104 long-term nursing home residents (57 women, 47 men) aged 60–99 years (mean 79.5, standard deviation ±9.11) were analyzed for psychometric testing (exploratory and confirmatory factor analysis, item fit, McDonald’s ω, convergent validity, and known-group validity, Rasch).

Results

The final LWIG-GER consists of 19 items with three subscales, including “psychological WB”, “social WB”, and “physical WB”. The LWIG-GER showed good overall reliability with McDonald’s ω of 0.83; the LWIG-GER dimensions’ scores were significantly correlated with depression, functional performance, activities, fear of falling, and education.

Conclusions

Our findings suggest that the German language version of the LWIG is a reliable and valid tool for measuring WB in nursing home residents. Furthermore, we propose that the LWIG-GER questionnaire can broaden and deepen our understanding of residents’ perception of quality of care and their environment.

Psychiatric and behavioral problems and well-being in gerontopsychiatric nursing home residents

OBJECTIVES

Gerontopsychiatric nursing home residents are residents with a chronic mental condition (not dementia), in combination with one or more physical disorders. Psychiatric and behavioral problems are common within this population. The objective of this study is to examine these behaviors and their relationship to the level of both observed and self-rated well-being in the gerontopsychiatric population.

METHOD

Both gerontopsychiatric residents, and their primary formal caregiver in several nursing homes in The Netherlands were asked to participate in a structured interview concerning psychiatric and behavioral problems and resident well-being. Psychiatric and behavioral problems were measured with the Neuropsychiatric Inventory Questionnaire (NPI-Q) and the Cohen Mansfield Agitation Index (CMAI). Well-being was measured through the self-rated Laurens Well-being Inventory for Gerontopsychiatry (LWIG), and the observer rated Laurens Well-being Observations for Gerontopsychiatry (LWOG).

RESULTS

A total of 126 residents participated in the study with ages varying from 42 to 90. Different types of chronic mental disorders such as schizophrenia spectrum disorder, bipolar disorders and personality disorders were prevalent in the population. Most psychiatric and behavioral problems are associated with lower observed and self-rated well-being. For irritability and affective problem behaviors the relationship with well-being was the most evident.

CONCLUSION

In daily care practice the relationship between well-being and psychiatric and behavioral problems should be taken into account in care planning and treatment. To further explore the direction and details of this relationship, more research is needed.