School of Occupational Therapy, College of Medicine, National Taiwan University, Taipei, Taiwan.
Division of Occupational Therapy, Department of Physical Medicine and Rehabilitation, National Taiwan University Hospital, Taipei, Taiwan.
Disabil Rehabil. 2020 Aug;42(16):2325-2333. doi: 10.1080/09638288.2018.1559888. Epub 2019 Feb 11.
The purpose of this study was to identify determinants within the International Classification of Functioning, Disability and Health as a conceptual framework regarding the quality of life of older long-term care facility residents. A questionnaire-based cross-sectional design was conducted. All participants ( = 210) completed a questionnaire that included the Sheltered Care Environmental Scale, the Beck Depression Inventory, the Short Physical Performance Battery, the Mini-Mental State Examination, the World Health Organization Disability Assessment Schedule, and the World Health Organization Quality of Life Scale. The outcome was assessed using mixed-design multiple regression with a covariance model and hierarchical regression. Personal factors, environmental factors, body function and structures, and activity and participation explained 35.9%, 18.5%, 25.2%, and 52.1% of the variability in quality of life, respectively. The hierarchical model included 10 variables and explained 84.3% of the total variability in quality of life. Activity and participation showed high explanatory power for the quality of life of older long-term care facility residents. The influence of activity and participation in the older population is an important issue, although these factors remain relatively unexplored. This exploratory study used the International Classification of Functioning, Disability and Health as a conceptual framework to provide a more sophisticated understanding of quality of life.Implications for rehabilitationAlthough the viewpoint of quality of life involves many more factors than an understanding of an individual disease or disability condition, activity and participation were found to be the most important factors.Simple clinical measures, such as activity limitations and participation restrictions, can be used as clinical markers of quality of life, thus enabling rehabilitation professionals to determine the quality of life of older people in institutions.The conceptual framework of determinants of quality of life that this study reports may be helpful for rehabilitation professionals to explore with patients to implement interventions.
本研究旨在确定国际功能、残疾和健康分类中的决定因素，作为老年人长期护理机构居民生活质量的概念框架。采用基于问卷的横断面设计。所有参与者（n=210）完成了一份问卷，其中包括庇护环境量表、贝克抑郁量表、简短体能表现测试、简易精神状态检查、世界卫生组织残疾评估量表和世界卫生组织生活质量量表。使用协方差模型和层次回归的混合设计多回归来评估结果。个人因素、环境因素、身体功能和结构以及活动和参与分别解释了生活质量的 35.9%、18.5%、25.2%和 52.1%。层次模型包含 10 个变量，解释了生活质量总变异性的 84.3%。活动和参与对老年人长期护理机构居民的生活质量具有较高的解释力。尽管这些因素仍未得到充分探索，但活动和参与对老年人的影响是一个重要问题。本探索性研究使用国际功能、残疾和健康分类作为概念框架，提供了对生活质量更复杂的理解。康复的意义尽管生活质量的观点涉及比个体疾病或残疾状况更多的因素，但发现活动和参与是最重要的因素。简单的临床测量，如活动受限和参与受限，可以作为生活质量的临床标志物，从而使康复专业人员能够确定机构中老年人的生活质量。本研究报告的生活质量决定因素的概念框架可能有助于康复专业人员与患者一起探讨实施干预措施。
