School of Medicine, University of California at San Francisco, San Francisco, California 94121, USA.
J Am Geriatr Soc. 2012 Mar;60(3):569-76. doi: 10.1111/j.1532-5415.2011.03844.x. Epub 2012 Jan 30.
To determine perceived quality of life in a diverse population of elderly adults with late-life disability.
Qualitative cross-sectional study.
Community-dwelling participants were recruited from San Francisco's On Lok Lifeways program, the first Program of All-inclusive Care for the Elderly. On Lok enrollees meet Medicaid criteria for nursing home placement.
Sixty-two elderly adults with a mean age of 78 and a mean 2.4 activity of daily living dependencies and 6.6 instrumental activity of daily living dependencies were interviewed. Respondents were 63% female, 24% white, 19% black, 18% Latino, 32% Chinese American, and 6% other race.
Elderly adults who scored higher than 17 points on the Mini-Mental State Examination were interviewed. Interviews were conducted in English, Spanish, and Cantonese. Respondents were asked to rate their overall quality of life on a 5-point scale. Open-ended questions explored positive and negative aspects of participants' daily experiences. Interviews were analyzed using modified grounded theory and digital coding software.
Eighty-seven percent of respondents rated their quality of life in the middle range of the quality-of-life spectrum (fair to very good). Themes were similar across ethnic groups. Most themes could be grouped into four domains that dependent elderly adults considered important to their quality of life: physical (e.g., pain), psychological (e.g., depression), spiritual or religious (e.g., religious coping), and social (e.g., life-space). Dignity and a sense of control were identified as themes that are the most closely tied to overall quality of life.
Factors that influence quality of life in late-life disability were similar across ethnic groups. As the number of elderly adults from diverse backgrounds with late life disability increases in the United States, interventions should be targeted to maximize daily sense of control and dignity.
确定晚年失能的老年人群体对生活质量的感知。
定性的横断面研究。
社区居住的参与者是从旧金山的 On Lok Lifeways 项目中招募的，该项目是第一个全面关怀老年人的计划。On Lok 的注册者符合医疗补助护理院安置的标准。
对 62 名平均年龄为 78 岁、平均有 2.4 项日常生活活动依赖和 6.6 项工具性日常生活活动依赖的老年人进行了访谈。受访者中 63%为女性，24%为白人，19%为黑人，18%为拉丁裔，32%为华裔，6%为其他种族。
接受 Mini-Mental State Examination 测试得分高于 17 分的老年人接受了访谈。访谈以英语、西班牙语和粤语进行。受访者被要求在 5 分制上对他们的整体生活质量进行评分。开放性问题探讨了参与者日常经历的积极和消极方面。使用改良的扎根理论和数字编码软件对访谈进行分析。
87%的受访者将自己的生活质量评为生活质量谱的中等范围（一般到很好）。各民族群体的主题相似。大多数主题可分为四个领域，依赖的老年人认为这些领域对他们的生活质量很重要：身体（例如，疼痛）、心理（例如，抑郁）、精神或宗教（例如，宗教应对）和社会（例如，生活空间）。尊严和控制感被确定为与整体生活质量最密切相关的主题。
影响晚年失能生活质量的因素在不同种族群体中相似。随着美国晚年失能的背景各异的老年人数增加，干预措施应针对最大限度地提高日常控制感和尊严感。
