Factors Associated With Changes in Perceived Quality of Life Among Elderly Recipients of Long-Term Services and Supports
| Autor: | Kathryn H. Bowles, Karen B. Hirschman, Mary D. Naylor, Katherine M. Abbott, Cynthia Zubritsky, Janice B. Foust, Shivani Shah, Alexandra L. Hanlon |
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| Rok vydání: | 2016 |
| Předmět: |
Male
Time-varying covariate Gerontology Health Status Article 03 medical and health sciences Social support 0302 clinical medicine Quality of life (healthcare) Assisted Living Facilities Humans Medicine Longitudinal Studies Prospective Studies 030212 general & internal medicine Mid-Atlantic Region Prospective cohort study General Nursing Depression (differential diagnoses) Aged Aged 80 and over Depression business.industry 030503 health policy & services Health Policy Social Support General Medicine Middle Aged Home Care Services Long-Term Care Nursing Homes Term (time) Long-term care Quality of Life Female Observational study Geriatrics and Gerontology Cognition Disorders 0305 other medical science business |
| Zdroj: | Journal of the American Medical Directors Association. 17:44-52 |
| ISSN: | 1525-8610 |
| Popis: | 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.A prospective, observational, longitudinal cohort design.Nursing homes (NHs), assisted living facilities (ALFs), community.A total of 470 older adults who were first-time recipients of LTSS.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.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 (HCBS), but only findings between ALFs and HCBS 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).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. |
| Databáze: | OpenAIRE |
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