Nikmat Azlina W, Hawthorne Graeme, Al-Mashoor Syed H
Universiti Teknologi MARA, Malaysia
University of Melbourne, Australia.
Dementia (London). 2015 Jan;14(1):114-25. doi: 10.1177/1471301213494509. Epub 2013 Jul 8.
Living arrangements play an important role in determining the quality of life (QoL) of people with dementia. Although informal care (home-based) is favored, the transition to formal (institutional) care often becomes necessary, especially in the later stages of dementia. Nevertheless, there is currently no definitive evidence showing that informal or formal care provides a higher QoL for those with dementia.
To compare the QoL of people with dementia in the nursing home and home care, and identify factors that differentiate their QoL.
This was a cross-sectional survey. A total of 49 people with dementia ≥60 years old were recruited from government nursing homes and hospitals (home care). Consenting participants were assessed on cognitive severity, QoL, activities of daily living (ADLs), depression, and social isolation/connectedness by the Short Mini Mental State Examination (SMMSE), the WHO-8 (the EUROHIS-QOL), Short Assessment of Quality of Life (AQoL-8), Barthel Index (BI), Cornell Scale for Depression (CSDD), and Friendship Scale (FS).
There were significant differences in QoL, HRQoLs, ADLs, and social connectedness among people with dementia in home care (n = 19) and those in nursing homes (n = 30) (p < 0.01). No significant differences were found by socio-demographic factors, cognitive severity, or depression between the study cohorts.
Older adults with dementia who were living at home experienced higher QoL, ADLs, and social connectedness compared with those living in institutional care. Support should be provided enabling home care and empowering caregivers to provide better care for people with dementia.
生活安排在决定痴呆症患者的生活质量（QoL）方面起着重要作用。尽管非正式护理（居家护理）更受青睐，但向正式（机构）护理的转变往往变得必要，尤其是在痴呆症后期。然而，目前尚无确凿证据表明非正式或正式护理能为痴呆症患者提供更高的生活质量。
比较养老院和居家护理中痴呆症患者的生活质量，并确定区分他们生活质量的因素。
这是一项横断面调查。从政府养老院和医院（居家护理）招募了49名年龄≥60岁的痴呆症患者。通过简短简易精神状态检查表（SMMSE）、世界卫生组织生活质量量表简表（WHO-8，即EUROHIS-QOL）、生活质量简短评估量表（AQoL-8）、巴氏指数（BI）、康奈尔抑郁量表（CSDD）和友谊量表（FS），对同意参与的参与者进行认知严重程度、生活质量、日常生活活动能力（ADL）、抑郁以及社交隔离/社交联系方面的评估。
居家护理组（n = 19）和养老院组（n = 30）的痴呆症患者在生活质量、健康相关生活质量、日常生活活动能力和社交联系方面存在显著差异（p < 0.01）。研究队列之间在社会人口统计学因素、认知严重程度或抑郁方面未发现显著差异。
与住在机构护理机构的痴呆症老年人相比，居家生活的老年人生活质量更高，日常生活活动能力更强，社交联系更紧密。应提供支持，促进居家护理，并增强护理人员为痴呆症患者提供更好护理的能力。
