Psychological and Behavioral Medicine Unit,Faculty of Medicine,Universiti Teknologi MARA Malaysia,Sungai Buloh Campus,47000 Sungai Buloh,Selangor,Malaysia.
Int Psychogeriatr. 2015 May;27(5):815-24. doi: 10.1017/S1041610214002609. Epub 2014 Dec 11.
The evaluation of quality of life (QoL) among older adults has become increasingly important, and living arrangements play a pivotal role in determining the QoL of people with cognitive impairment (PWCI). Although informal care (home-based) is favored, transition to formal care (residential care) often becomes necessary, especially in the later stages of cognitive impairment. The primary objective was to compare the QoL of PWCI in the community and nursing homes. Additionally, factors differentiate the QoL of PWCI in these two settings were identified.
This is a quasi-experimental study design involving 219 older adults with cognitive impairment, aged 60-89 years old from both nursing home and home care. Participants completed the EUROPE Health Interview Survey-QoL (WHO-8), the Short Mini-Mental State Examination (SMMSE), the Barthel Index (BI), the Geriatric Depression Scale (GDS-15), and the Friendship Scale (FS).
There were significant differences in QoL, depression, social connectedness (p < 0.01) and cognitive functions (p = 0.01) between home care recipients and nursing home participants. No significant differences were observed with regards to health condition, co morbidities and physical functions between study cohorts.
Older adults with cognitive impairment living at home experienced higher QoL, had better cognitive function, were less depressed and reported higher social connectedness compared to those living in institutional care. Therefore, support should be provided in enabling home care and empowering caregivers to provide better care for PWCI.
评估老年人的生活质量（QoL）变得越来越重要，生活安排在确定认知障碍老年人（PWCI）的生活质量方面起着关键作用。尽管人们更喜欢非正式护理（家庭护理），但过渡到正式护理（养老院护理）往往是必要的，尤其是在认知障碍的后期阶段。主要目的是比较社区和养老院中 PWCI 的生活质量。此外，还确定了这两种环境中 PWCI 生活质量的差异因素。
这是一项准实验研究设计，涉及来自养老院和家庭护理的 219 名年龄在 60-89 岁之间的认知障碍老年人。参与者完成了欧洲健康访谈调查生活质量（WHO-8）、简短的迷你精神状态检查（SMMSE）、巴氏量表（BI）、老年抑郁量表（GDS-15）和友谊量表（FS）。
家庭护理受助者和养老院参与者在生活质量、抑郁、社会联系（p<0.01）和认知功能（p=0.01）方面存在显著差异。研究队列在健康状况、合并症和身体功能方面没有观察到显著差异。
与居住在机构护理中的认知障碍老年人相比，居住在家中的认知障碍老年人的生活质量更高，认知功能更好，抑郁程度更低，社会联系更紧密。因此，应该为家庭护理提供支持，并授权护理人员为 PWCI 提供更好的护理。
