Swanson Mark W, McGwin Gerald, Elliott Amanda F, Owsley Cynthia
Department of Optometry, School of Optometry, University of Alabama at Birmingham.
J Optom. 2009;2(3):148-154. doi: 10.3921/joptom.2009.148.
The purpose of this study was to evaluate the association between the federally mandated Minimum Data Set (MDS) Vision Patterns assessment for nursing home residents in the United States and an assessment of their vision-targeted quality of life as assessed by certified nursing assistants (CNAs). METHODS: Participants were 371 residents over the age of 55 from 17 nursing homes in the Birmingham, Alabama metropolitan area and the CNAs directly assigned to their care. CNAs assessed the vision-targeted quality of life of residents in their charge using the Nursing Home Vision-Targeted Health-Related Quality of Life (NHVQoL) questionnaire. MDS assessment categories assigned to each resident by the MDS nurse coordinator ("adequate", "impaired", "moderately impaired", "highly impaired", "severely impaired") were obtained from the medical record. Visual acuity was measured using logMAR charts by trained research staff. RESULTS: CNA rated NHVQoL subscale scores decreased as the MDS rating indicated more vision impairment (all P's for trend < 0.05). Almost all mean scores were in the 80s and 90s for those in the adequate, impaired, and moderately impaired categories. For those with MDS ratings of severely or highly impaired, NHVQoL subscale scores (except ocular symptoms) were dramatically lower (P ≤ 0.001) than those rated as moderately impaired. CONCLUSIONS: Ratings by CNAs on the vision-targeted quality of life of nursing home residents under their care is in general agreement with the MDS category assigned by the nurse coordinator. However, CNA ratings are largely homogeneous in the adequate vision to moderately impaired categories.
本研究旨在评估美国联邦政府规定的针对养老院居民的最低数据集（MDS）视力模式评估与由认证护理助理（CNA）评估的以视力为目标的生活质量之间的关联。方法：参与者为来自阿拉巴马州伯明翰市大都会区17家养老院的371名55岁以上居民以及直接负责照料他们的CNA。CNA使用养老院视力相关健康生活质量（NHVQoL）问卷评估其负责照料的居民以视力为目标的生活质量。MDS护士协调员为每位居民分配的MDS评估类别（“正常”“受损”“中度受损”“高度受损”“严重受损”）从病历中获取。由经过培训的研究人员使用对数视力表测量视力。结果：随着MDS评级显示视力损害程度增加，CNA评定的NHVQoL子量表得分下降（所有趋势P值<0.05）。对于处于正常、受损和中度受损类别的居民，几乎所有平均得分都在80分和90分。对于MDS评级为严重或高度受损的居民，NHVQoL子量表得分（眼部症状除外）显著低于（P≤0.001）中度受损居民。结论：CNA对其照料的养老院居民以视力为目标的生活质量的评级总体上与护士协调员分配的MDS类别一致。然而，在视力正常到中度受损类别中，CNA评级在很大程度上是同质的。
