Vaarama Marja
Division of Welfare and Health Policies, National Institute for Health and Welfare, P.O. Box 30, 00271 Helsinki, Finland.
Eur J Ageing. 2009 Apr 16;6(2):113-125. doi: 10.1007/s10433-009-0115-y. eCollection 2009 Jun.
Promoting quality of life is a central theme in recent ageing policies, but what quality of life means in concrete terms for people in different stages of old age is rather unclear. This study presents a multi-dimensional model of care-related quality of life (crQoL) and, based on analyses of three Finnish cross-sectional datasets from the years 2004-2007, examines the distinctions between dimensions of QoL by age and gender, with a special focus on older home care clients. Correlation analyses (Pearson) and stepwise linear regression were applied to analyse variation in QoL by age group and the association between QoL and perceived quality of home care. The results suggest that individual QoL and the priorities of (physical, psychical, social, and environmental) dimensions in the assessment of QoL by older persons vary considerably and exhibit distinct profiles in different stages of ageing. In addition, four dimensions for good care corresponding to the crQoL model were identified and their empirical relevance demonstrated. From the perspective of older people in need of help, home care is not just about giving them the instrumental help they need to perform their daily activities, but rather about giving responsive care that reflects their personal preferences or their view on a "good life", and treats them with dignity and respect. The criteria for the evaluation of quality of home care should reflect these insights, and policy measures should take these differences into account.
提升生活质量是近期老龄政策的核心主题，但生活质量对于处于不同老年阶段的人而言具体意味着什么却相当不明确。本研究提出了一个与护理相关的生活质量（crQoL）的多维模型，并基于对2004年至2007年芬兰三个横断面数据集的分析，研究了按年龄和性别划分的生活质量维度之间的差异，特别关注老年家庭护理客户。应用相关分析（皮尔逊）和逐步线性回归来分析不同年龄组生活质量的差异以及生活质量与感知到的家庭护理质量之间的关联。结果表明，老年人在评估生活质量时的个人生活质量以及（身体、心理、社会和环境）维度的优先次序差异很大，并且在老龄化的不同阶段呈现出不同的特征。此外，确定了与crQoL模型相对应的优质护理的四个维度，并证明了它们的实证相关性。从需要帮助的老年人的角度来看，家庭护理不仅仅是为他们提供进行日常活动所需的工具性帮助，更是提供能反映他们个人偏好或他们对“美好生活”看法的响应性护理，并给予他们尊严和尊重。家庭护理质量的评估标准应反映这些见解，政策措施也应考虑到这些差异。
