Hlongwane Naomi, Ned Lieketseng
Division of Disability and Rehabilitation Studies, Department of Global Health, Faculty of Medicine and Heatlh Sciences, Stellenbosch University, Cape Town, South Africa
Division of Disability and Rehabilitation Studies, Department of Global Health, Faculty of Medicine and Heatlh Sciences, Stellenbosch University, Cape Town, South Africa.
BMJ Open. 2025 May 11;15(5):e099448. doi: 10.1136/bmjopen-2025-099448.
The increasing demand for long-term care (LTC) services in resource-constrained settings has highlighted significant gaps in both the quality of care and the quality of life (QoL) for older adults. The objective of this study is to examine the lived experiences of QoL among older individuals in LTC facilities.
Using an institutional ethnographic approach, we conducted indepth interviews with 20 residents, aged 62-98 years, across five LTC facilities in Gauteng, South Africa. Indexing and mapping were used to identify emergent categories. The authors used reflexive methods, and member checking was conducted.
Analysis revealed seven interconnected dimensions of QoL: health and physical well-being, social connectedness and companionship, spiritual fulfilment and faith, independence and autonomy, dignity and respect, emotional well-being and acceptance and adaptation. These aspects are closely linked to institutional factors such as staff capacity, resource allocation and care policies. Participants emphasised the importance of meaningful social interactions, spiritual practices, autonomy and dignity in enhancing their QoL.
The study underscores the complex relationship between institutional care practices and the QoL of older adults in resource-constrained environments. Findings advocate for culturally sensitive, person-centred care strategies to improve the multifaceted QoL of LTC residents, offering valuable insights for policy reforms and interventions in similar resource-constrained settings.
在资源有限的环境中，对长期护理（LTC）服务的需求不断增加，这凸显了老年人护理质量和生活质量（QoL）方面的显著差距。本研究的目的是考察长期护理机构中老年人的生活质量体验。
我们采用机构民族志方法，对南非豪登省五家长期护理机构的20名年龄在62至98岁之间的居民进行了深入访谈。使用索引和映射来识别新出现的类别。作者采用了反思性方法，并进行了成员核对。
分析揭示了生活质量的七个相互关联的维度：健康与身体福祉、社会联系与陪伴、精神满足与信仰、独立与自主、尊严与尊重、情绪福祉以及接纳与适应。这些方面与诸如工作人员能力、资源分配和护理政策等机构因素密切相关。参与者强调了有意义的社会互动、精神实践、自主和尊严对提高他们生活质量的重要性。
该研究强调了在资源有限的环境中，机构护理实践与老年人生活质量之间的复杂关系。研究结果倡导采用文化敏感、以人为本的护理策略，以改善长期护理居民多方面的生活质量，为类似资源有限环境中的政策改革和干预措施提供了有价值的见解。
