Archipel Landrijt, Knowledge Centre for Specialized Care, Drosserstraat 1, 5623 ME, Eindhoven, The Netherlands.
Department of Primary and Community Care, Radboudumc Alzheimer Centre, Radboud University Medical Centre, Nijmegen, The Netherlands.
Qual Life Res. 2019 Mar;28(3):751-759. doi: 10.1007/s11136-018-2041-y. Epub 2018 Nov 7.
To explore the association between apathy and health-related quality of life (HRQoL) from resident and proxy perspectives and whether cognition and depression moderate this relationship.
Secondary analyses with baseline data from a cluster randomized trial on the effects of a care program for depression in Nursing Homes (NHs) were conducted. For HRQoL, the Visual Analogue Scale (VAS) and the Dutch version of the European Quality of Life (EQ-5D) were administered to 521 NH residents, and to professional caregivers reporting from the perspective of the NH resident (Resident-Proxy) and from their own perspective (Proxy-Proxy). Utility scores (U) were calculated for the three perspectives. Apathy, depression, and cognition were measured using the 10-item Apathy Evaluation Scale, the Cornell Scale for Depression in Dementia, and the standardized Mini-Mental State Examination, respectively.
Mixed models adjusted for clustering within NH units revealed that apathy was negatively associated with HRQoL both from the Resident-Proxy perspective (EQ-5D VAS: estimated effect, - 0.31, P < 0.001; EQ-5D Utility: - 0.30, P < 0.001) and from the Proxy-Proxy perspective (VAS: - 0.29, P < 0.001; U: - 0.03, P < 0.001), but not from the Resident-Resident perspective (VAS: - 0.05, P = 0.423; Utility: - 0.08, P = 0.161). Controlling for depression and cognition and their interaction terms with apathy did not change the results.
Apathy is negatively associated with NH resident HRQoL as reported by proxies. Depression and cognitive functioning do not moderate this association. NH residents do not self-report a relationship between apathy and HRQoL. More research is needed to understand caregiver and NH resident attitudes and underlying assumptions regarding apathy and HRQoL.
从居民和代理两个角度探讨冷漠与健康相关生活质量（HRQoL）之间的关系，以及认知和抑郁是否会调节这种关系。
对一项关于疗养院抑郁护理计划效果的集群随机试验的基线数据进行二次分析。对于 HRQoL，使用视觉模拟量表（VAS）和欧洲生活质量（EQ-5D）的荷兰语版本对 521 名疗养院居民进行评估，并由专业护理人员从疗养院居民的角度（居民-代理）和从他们自己的角度（代理-代理）进行报告。为三个角度计算了效用得分（U）。使用 10 项冷漠评估量表、康奈尔痴呆抑郁量表和标准化的简易精神状态检查分别测量冷漠、抑郁和认知。
调整了疗养院单位内聚类的混合模型显示，冷漠与 HRQoL 呈负相关，从居民-代理角度来看（EQ-5D VAS：估计效应，-0.31，P<0.001；EQ-5D 效用：-0.30，P<0.001），从代理-代理角度来看（VAS：-0.29，P<0.001；U：-0.03，P<0.001），但从居民-居民角度来看没有（VAS：-0.05，P=0.423；U：-0.08，P=0.161）。控制抑郁和认知及其与冷漠的交互项并没有改变结果。
冷漠与代理报告的疗养院居民 HRQoL 呈负相关。抑郁和认知功能不会调节这种关系。疗养院居民不会自我报告冷漠与 HRQoL 之间存在关系。需要进一步研究以了解护理人员和疗养院居民对冷漠和 HRQoL 的态度和潜在假设。
