Hulsman B, Chubon S J
Public Health Nurs. 1989 Sep;6(3):141-6. doi: 10.1111/j.1525-1446.1989.tb00587.x.
In an attempt to prevent premature institutionalization of disabled adults, some states have developed services funded under a Medicaid waiver to maintain these clients in their homes. Evaluation reports of these programs have emphasized cost analysis and have described various approaches to case management. No studies have reported on the quality of life of the clients receiving the services. In this exploratory study, the quality of life of 20 clients in a community long-term care program was compared with that of 20 persons requiring comparable levels of care but residing in a nursing home. Mean scores on the quality of life measure were virtually equal for the two groups, but the distribution of scores by group was very different. Demographically the groups differed. Community residents were younger than nursing home residents and included a larger percentage of blacks. Part of one's judgment of quality of life may stem from a comparison of oneself with one's peers. Verbal, oriented nursing home residents may rate themselves more favorably in comparison to peers with dementia, while community residents compare themselves with healthy adults and rate their quality of life as lower.
为防止残疾成年人过早被机构收容，一些州制定了由医疗补助豁免计划资助的服务项目，以便让这些客户居家生活。这些项目的评估报告强调成本分析，并描述了各种个案管理方法。尚无研究报告接受这些服务的客户的生活质量情况。在这项探索性研究中，将一个社区长期护理项目中20名客户的生活质量与20名需要类似护理水平但居住在养老院的人员的生活质量进行了比较。两组在生活质量测量方面的平均得分几乎相等，但两组得分的分布差异很大。两组在人口统计学特征上存在差异。社区居民比养老院居民年轻，黑人所占比例更大。一个人对生活质量的部分判断可能源于将自己与同龄人进行比较。能言语、定向力正常的养老院居民与患有痴呆症的同龄人相比，可能会给自己更高的评价，而社区居民将自己与健康成年人比较，会认为自己的生活质量较低。
