School of Nursing,College of Medicine,Chang Gung University,Tao-Yuan,Taiwan.
Department of Neurology,Chang Gung Memorial Hospital,No. 199,Tun-Hwa North Road,Taipei,10547Taiwan.
Int Psychogeriatr. 2015 May;27(5):825-36. doi: 10.1017/S1041610214002506. Epub 2014 Dec 3.
Factors affecting quality of life (QOL) ratings for people with dementia (PWD) have been well studied, but few studies have examined the effect of residence on PWD- and caregiver-rated QOL for PWDs. We designed this study to determine the factors related to PWD- and caregiver-rated QOL in dementia as well as factors related to the discrepancy in these ratings.
For this cross-sectional study, we analyzed data from a convenience sample of 106 PWD-family caregiver dyads (58 community-dwelling dyads and 48 nursing-home dyads). PWDs' data included socio-demographic variables, QOL (assessed by the Quality of Life-Alzheimer's Disease [QOL-AD] scale), cognition, dementia severity, depression, comorbidities, and quality of the dyadic relationship. Caregivers' data included socio-demographic variables, depressive symptoms, and mutuality of the dyadic relationship.
QOL-AD scores were lower when rated by caregivers than by PWDs. The key factors positively related to both PWD- and caregiver-rated QOL for PWDs were fewer PWD depressive symptoms and higher quality of the PWD-caregiver relationship. The key factors related to the discrepancy in PWD- and caregiver-rated QOL in dementia were PWD residence in a nursing home and lower dementia severity, as well as higher caregiver depression, being an adult child caregiver, and lower caregiver-PWD mutuality.
Caregiver-rated QOL for PWDs and the discrepancy in rated QOL were significantly associated with PWD residence. If caregiver-rated QOL is needed, the effect of residence of PWD should be taken into consideration. Caregivers' depressive status and mutuality with PWD must be also carefully assessed.
影响痴呆患者（PWD）生活质量（QOL）评分的因素已有大量研究，但很少有研究探讨居住环境对 PWD 和照护者对 PWD 的 QOL 评分的影响。我们设计了这项研究，以确定与痴呆患者 PWD 和照护者的 QOL 相关的因素，以及与这些评分差异相关的因素。
在这项横断面研究中，我们分析了来自 106 对 PWD-家庭照护者的便利样本的数据（58 对社区居住的照护者对和 48 对疗养院居住的照护者对）。PWD 的数据包括社会人口统计学变量、QOL（由生活质量-阿尔茨海默病量表[QOL-AD]评估）、认知、痴呆严重程度、抑郁、合并症和双元关系质量。照护者的数据包括社会人口统计学变量、抑郁症状和双元关系的互惠性。
照护者对 PWD 的 QOL-AD 评分低于 PWD 自评。与 PWD 和照护者对 PWD 的 QOL 均呈正相关的关键因素是 PWD 抑郁症状较少和 PWD-照护者关系质量较高。与痴呆患者 PWD-和照护者的 QOL 评分差异相关的关键因素是 PWD 居住在疗养院和痴呆严重程度较低，以及照护者抑郁程度较高、是成年子女照护者和照护者与 PWD 的互惠性较低。
PWD 的照护者对 PWD 的 QOL 评分和评分差异与 PWD 的居住环境显著相关。如果需要照护者对 QOL 的评估，应考虑 PWD 的居住环境的影响。还必须仔细评估照护者的抑郁状况和与 PWD 的互惠性。
