Sørensen Torgeir, Bergh Sverre, Hestad Knut Asbjørn, Feiring Ingvild Hjorth, Danbolt Lars Johan, Lichtwarck Bjørn
Innlandet Hospital Trust, Brumunddal, Norway.
Front Psychol. 2025 Aug 14;16:1633401. doi: 10.3389/fpsyg.2025.1633401. eCollection 2025.
Meaning in life is considered an underestimated asset for people's well-being, particularly among individuals with dementia residing in nursing homes. However, knowledge on meaning in life in this target group is scarce, among other reasons because an instrument specifically developed and adapted to assess meaning in life in this population has been missing. Although existential experiences are known to affect well-being in older adults, few tools exist to assess meaning in life in individuals with dementia. This study aims to validate the newly developed Meaning in Life in Persons with Dementia Questionnaire (MIND) for use in nursing home residents.
We included 116 participants with dementia from 34 nursing homes in Eastern Norway. Descriptive statistics, reliability tests, confirmative factor analysis, and multiple regression for evaluation of validity.
Both meaningfulness (α 0.86) and crisis of meaning (α 0.92) had acceptable internal consistency. As expected, the two constructs were also highly significant and negatively correlated (-0.59). Confirmatory factor analysis showed that all goodness of fit-values were clearly on the right side of the limits for a two-factor solution (CFI 0.999). When testing for construct validity, in multivariate linear regression analysis meaningfulness was significantly associated with higher QoL-AD scores (Standardized = 0.346), while crisis of meaning showed a negative but non-significant trend. Severity of depression symptoms assessed by the Cornell Scale for Depression in Dementia (CSDD) and quality of life measured by the Quality of Life in Late-Stage Dementia scale (QUALID) were not associated with meaningfulness or crisis of meaning. Lack of significant associations may be due to low statistical power and measurement differences dependent on self-report and proxy-report.
Despite sample limitations, our findings suggest that the MIND questionnaire is a psychometrically sound instrument for assessing meaning in life among nursing home residents with dementia. Its integration into clinical practice may support more individualized, person-centered care. Future research should explore its utility in diverse cultural and care settings, as well as its longitudinal sensitivity to change.
生活意义被认为是人们幸福感中一项被低估的资产，尤其是在居住在养老院的痴呆症患者中。然而，关于这个目标群体生活意义的知识却很匮乏，部分原因是一直缺少专门为评估这一人群的生活意义而开发和改编的工具。尽管已知生存体验会影响老年人的幸福感，但用于评估痴呆症患者生活意义的工具却很少。本研究旨在验证新开发的痴呆症患者生活意义问卷（MIND）在养老院居民中的适用性。
我们纳入了来自挪威东部34家养老院的116名痴呆症患者。进行描述性统计、信度测试、验证性因素分析以及用于评估效度的多元回归分析。
意义感（α = 0.86）和意义危机（α = 0.92）均具有可接受的内部一致性。正如预期的那样，这两个构念也具有高度显著性且呈负相关（-0.59）。验证性因素分析表明，所有拟合优度值显然都在双因素解决方案的限值右侧（CFI = 0.999）。在测试结构效度时，在多元线性回归分析中，意义感与较高的QoL-AD得分显著相关（标准化系数 = 0.346），而意义危机则呈现出负向但不显著的趋势。用痴呆症抑郁康奈尔量表（CSDD）评估的抑郁症状严重程度以及用晚期痴呆症生活质量量表（QUALID）测量的生活质量与意义感或意义危机均无关联。缺乏显著关联可能是由于统计功效较低以及依赖自我报告和代理报告的测量差异所致。
尽管存在样本局限性，但我们的研究结果表明，MIND问卷是一种在心理测量学上可靠的工具，可用于评估养老院痴呆症居民的生活意义。将其纳入临床实践可能有助于提供更个性化、以患者为中心的护理。未来的研究应探索其在不同文化和护理环境中的效用，以及其对变化的纵向敏感性。
