Details

Autor(en) / Beteiligte

• Naylor, Mary D., PhD, RN, FAAN
• Hirschman, Karen B., PhD, MSW
• Hanlon, Alexandra L., PhD
• Abbott, Katherine M., PhD, MGS
• Bowles, Kathryn H., PhD, RN, FAAN
• Foust, Janice, PhD, RN
• Shah, Shivani, MPH
• Zubritsky, Cynthia, PhD

Titel

Factors Associated With Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports

Ist Teil von

• Journal of the American Medical Directors Association, 2016-01, Vol.17 (1), p.44-52

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2016

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Objectives Advance knowledge about changes in multiple dimensions of health related quality of life (HRQoL) among older adults receiving long-term services and supports (LTSS) over time and across settings. Design A prospective, observational, longitudinal cohort design. Setting Nursing homes (NHs), assisted living facilities (ALFs), community. Participants A total of 470 older adults who were first-time recipients of LTSS. Measurement Single-item quality-of-life measure assessed every 3 months over 2 years. HRQoL domains of emotional status, functional status, and social support were measured using standardized instruments. Results Multivariable mixed effects model with time varying covariates revealed that quality-of-life ratings decreased over time ( P  < .001). Quality-of-life ratings were higher among enrollees with fewer depressive symptoms ( P  < .001), higher general physical function ( P  < .001), enhanced emotional well-being ( P  < .001), and greater social support ( P  = .004). Ratings also were higher among those with increased deficits in activities of daily living ( P  = .02). Ratings were highest among enrollees who received LTSS from ALFs, followed by NHs, then home and community-based services (H&CBS), but only findings between ALFs and H&CBS were statistically significant ( P  < .001). Finally, ratings tended to decrease over time among enrollees with greater cognitive impairment and increase over time among enrollees with less cognitive impairment ( P  < .001). Conclusions Findings advance knowledge regarding what is arguably the most important outcome of elderly LTSS recipients: quality of life. Understanding associations between multiple HRQoL domains and quality of life over time and directly from LTSS recipients represents a critical step in enhancing care processes and outcomes of this vulnerable population.