Measuring the quality of life in mild to very severe dementia: Testing the inter-rater and intra-rater reliability of the German version of the QUALIDEM

2014 ◽  
Vol 26 (5) ◽  
pp. 825-836 ◽  
Author(s):  
Martin Nikolaus Dichter ◽  
Christian G. G. Schwab ◽  
Gabriele Meyer ◽  
Sabine Bartholomeyczik ◽  
Olga Dortmann ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Negative Affect ◽  
Social Isolation ◽  
Social Relations ◽  
Rater Agreement ◽  
Severe Dementia ◽  
Rater Reliability ◽  
Single Measure ◽  
Care Relationship

ABSTRACTBackground:Quality of life (Qol) is an increasingly used outcome measure in dementia research. The QUALIDEM is a dementia-specific and proxy-rated Qol instrument. We aimed to determine the inter-rater and intra-rater reliability in residents with dementia in German nursing homes.Methods:The QUALIDEM consists of nine subscales that were applied to a sample of 108 people with mild to severe dementia and six consecutive subscales that were applied to a sample of 53 people with very severe dementia. The proxy raters were 49 registered nurses and nursing assistants. Inter-rater and intra-rater reliability scores were calculated on the subscale and item level.Results:None of the QUALIDEM subscales showed strong inter-rater reliability based on the single-measure Intra-Class Correlation Coefficient (ICC) for absolute agreement ≥ 0.70. Based on the average-measure ICC for four raters, eight subscales for people with mild to severe dementia (care relationship, positive affect, negative affect, restless tense behavior, social relations, social isolation, feeling at home and having something to do) and five subscales for very severe dementia (care relationship, negative affect, restless tense behavior, social relations and social isolation) yielded a strong inter-rater agreement (ICC: 0.72–0.86). All of the QUALIDEM subscales, regardless of dementia severity, showed strong intra-rater agreement. The ICC values ranged between 0.70 and 0.79 for people with mild to severe dementia and between 0.75 and 0.87 for people with very severe dementia.Conclusions:This study demonstrated insufficient inter-rater reliability and sufficient intra-rater reliability for all subscales of both versions of the German QUALIDEM. The degree of inter-rater reliability can be improved by collaborative Qol rating by more than one nurse. The development of a measurement manual with accurate item definitions and a standardized education program for proxy raters is recommended.

scholarly journals Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study

2016 ◽  
Vol 42 (3-4) ◽  
pp. 186-197 ◽  
Author(s):  
Maartje S. Klapwijk ◽  
Monique A.A. Caljouw ◽  
Marjoleine J.C. Pieper ◽  
Jenny T. van der Steen ◽  
Wilco P. Achterberg
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Long Term Care ◽  
Neuropsychiatric Symptoms ◽  
Pulmonary Diseases ◽  
Severe Dementia ◽  
Cross Sectional ◽  
Term Care

Background: To determine which characteristics are associated with quality of life (QOL) in residents with moderate to very severe dementia in long-term care facilities (LTCFs). Material and Methods: This was a cross-sectional analysis of a cluster randomized controlled study in 12 Dutch LTCFs that enrolled 288 residents, with moderate to severe dementia assessed with the Reisberg Global Deterioration Scale (Reisberg GDS) and QOL with the QUALIDEM. Characteristics that were hypothesized to be associated with the six domains of QOL (applicable to very severe dementia) included demographic variables, activities of daily living (Katz ADL), cognitive performance (Cognitive Performance Scale; CPS), pain (Pain Assessment Checklist for Seniors with Limited Ability to Communicate; PACSLAC-D), neuropsychiatric symptoms (Neuropsychiatric Inventory-Nursing Home Version; NPI-NH) and comorbidities. Results: Multivariate logistic regression modelling showed associations with age in the domain Social isolation [odds ratio, OR, 0.95 (95% confidence interval, CI, 0.91-0.99)], ADL level in the domain Positive affect [OR 0.89 (95% CI 0.83-0.95)] and the domain Social relations [OR 0.87 (95% CI 0.81-0.93)], severity of dementia in the domain Social relations [OR 0.28 (95% CI 0.12-0.62)] and in the domain Social isolation [OR 2.10 (95% CI 1.17-3.78)], psychiatric disorders in the domain Positive affect [OR 0.39 (95% CI 0.17-0.87)] and pulmonary diseases in the domain Negative affect [OR 0.14 (95% CI 0.03-0.61)] of the QUALIDEM. Neuropsychiatric symptoms were independently associated with all six domains of the QUALIDEM [OR 0.93 (95% CI 0.90-0.96) to OR 0.97 (95% CI 0.95-0.99)]. Pain was associated with the domains Care relationship [OR 0.92 (95% CI 0.84-1.00)] and Negative affect [OR 0.92 (95% CI 0.85-1.00)]. Conclusion: QOL in dementia is independently associated with age, ADL, dementia severity, pain, psychiatric disorders, pulmonary diseases and neuropsychiatric symptoms. It is possible to detect persons with dementia at risk for a lower QOL. This information is important for developing personalized interventions to improve QOL in persons with dementia in LTCFs.

scholarly journals Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Kathrin Schmüdderich ◽  
Daniela Holle ◽  
Armin Ströbel ◽  
Bernhard Holle ◽  
Rebecca Palm
Keyword(s):  
Quality Of Life ◽  
Nursing Homes ◽  
Positive Affect ◽  
Social Isolation ◽  
Social Relations ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Short Version ◽  
Linear Regression Models

Abstract Background Severe agitation and its relation to single dimensions of quality of life are not well understood. The aim of this study was to gain more knowledge about severe agitation and to examine the relationships between the severity of agitation and single dimensions of quality of life among residents with dementia living in German nursing homes. Methods This exploratory secondary analysis included data from 1947 residents of 66 German nursing homes from the DemenzMonitor study. The construct of agitation was defined as a composite score of the items agitation/aggression, irritability/lability and disinhibition from the Neuropsychiatric Inventory Questionnaire (NPI-Q); the resident was classified as severely agitated if at least one of these symptoms was rated as ‘severe’. The single dimensions of quality of life were measured with the short version of the QUALIDEM instrument. To avoid selection bias, two controls with mild or no agitation were selected for each resident with severe agitation using propensity score matching. Mixed linear regression models were then generated to determine the differences in the dimensions of quality of life for the severity of agitation and the defining items. Results For four out of five dimensions of quality of life of the short version of QUALIDEM, residents with severe agitation had significantly lower values than residents without severe agitation. Converted to scale size, the greatest difference between both groups was found in the dimension social isolation with 23.0% (-2.07 (95% CI: -2.57, -1.57)). Further differences were found in the dimensions restless tense behaviour with 16.9% (-1.52 (95% CI: -2.04, -1.00)), positive affect with 14.0% (-1.68 (95% CI: -2.28, -1.09)) and social relations with 12.4% (-1.12 (95% CI: -1.54, -0.71)). Conclusions Severe agitation is a relevant phenomenon among nursing home residents with dementia and is associated with lower values of quality of life in the dimensions social isolation, restless tense behaviour, positive affect and social relations from the QUALIDEM instrument. Therefore, more attention should be paid to severe agitation in nursing practice and research. Moreover, care strategies used to reduce severe agitation should be considered in terms of their impact on the dimensions of quality of life.

KUALITAS HIDUP PASIEN STROKE DI POLIKLINIK RAWAT JALAN RUMAH SAKIT SWASTA YOGYAKARTA

2019 ◽  
Vol 7 (3) ◽  
pp. 232-237
Author(s):  
Hana Larasati ◽  
Theresia Titin Marlina
Keyword(s):  
Quality Of Life ◽  
Social Relations ◽  
Hemorrhagic Stroke ◽  
Poor Quality ◽  
Social Dimension ◽  
Stroke Patients ◽  
Sampling System ◽  
Post Stroke ◽  
Psychological Dimension

Background: stroke is a disorder of nervous system function that occurs suddenly and is caused by brain bleeding disorders that can affect the quality of life physical dimensions, social dimensions, psychological dimensions, environmental dimensions. Based on the result of Lumbu study (2015) the number of samples were 71 people collected data using the (WHOQOL-BREF). There were 56 people (78,9%) had the poor quality of life of post stroke. The mean of post-stroke quality of life domain was physical domain (45,27%), psychological domain (49,87%), social relations domain (48,15%) and environmental domain (50.01%). Objective: the purpose of the study was know the quality of life of the stroke patients in Outpatient Polyclinic of Private Hospital in Yogyakarta. Methods: used descriptive quantitative by using questionnaire test of purposive sampling system based on patients who have been affected of ischemic or hemorrhagic stroke before, number 30 respondents. Result: quality of life of stroke patient of medium physical dimension (67%), psychological dimension (71%), social dimension (67%), dimension good environment (63%). Conclusion: the quality of life of stroke patients of physical dimension, psychological dimension, and moderate social dimension, while the quality of life of stroke patients were good environmental dimension.   Keywords: Hemorrhagic stroke, ischemic stroke, quality of life

Impact of Social Isolation Strategies Due to COVID-19 on Mental Health and Quality of Life in Brazil

2020 ◽  
Author(s):  
Luciano Magalhães Vitorino ◽  
Gerson Hiroshi Yoshinari Júnior ◽  
Gabriela Gonzaga ◽  
Isabela Faria Dias ◽  
Isabela Marum Góes Ribeiro ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Social Isolation

scholarly journals Three Strategies for Describing Social Interactions of Adolescents in a Multicultural Environment—Indicators for the Quality of Life Research

2021 ◽  
Vol 18 (15) ◽  
pp. 8166
Author(s):  
Alicja Szerląg ◽  
Arkadiusz Urbanek ◽  
Kamila Gandecka
Keyword(s):  
Quality Of Life ◽  
Social Interactions ◽  
Social Relationships ◽  
Social Relations ◽  
Living Environment ◽  
Life Assessment ◽  
Multicultural Environment ◽  
Multicultural Community ◽  
The Social

Background: The analysis has involved social interactions in a multicultural environment. The social context has been defined by the Vilnius region (Lithuania), where national, religious, and cultural differences exist across generations (multicultural community). The space of “social relationships”, as one of the modules of the WHO quality of life assessment, has been studied. An innovation of the research has been related to the analysis of the phenomenon of community of nationalities and cultures as a predictor of quality of life (QoL). The social motive of the research has been the historical continuity (for centuries) of the construction of the Vilnius cultural borderland. Here, the local community evolves from a group of many cultures to an intercultural community. Interpreting the data, therefore, requires a long perspective (a few generations) to understand the quality of relationships. We see social interactions and strategies for building them as a potential for social QoL in multicultural environments. Methods: The research has been conducted on a sample of 374 respondents, including Poles (172), Lithuanians (133), and Russians (69). A diagnostic poll has been used. The respondents were adolescents (15–16 years). The research answers the question: What variables form the interaction strategies of adolescents in a multicultural environment? The findings relate to interpreting the social interactions of adolescents within the boundaries of their living environment. The description of the social relations of adolescents provides an opportunity to implement the findings for further research on QoL. Results: An innovative outcome of the research is the analysis of 3 interaction strategies (attachment to national identification, intercultural dialogue, and multicultural community building) as a background for interpreting QoL in a multicultural environment. Their understanding is a useful knowledge for QoL researchers. The data analysis has taken into account cultural and generational (historical) sensitivities. Therefore, the team studying the data has consisted of researchers and residents of the Vilnius region. We used the interaction strategies of adolescents to describe the category of “social relationships” in nationally and culturally diverse settings.

scholarly journals A preliminary psychometric evaluation of Music in Dementia Assessment Scales (MiDAS)

2014 ◽  
Vol 26 (6) ◽  
pp. 1011-1019 ◽  
Author(s):  
Orii McDermott ◽  
Vasiliki Orgeta ◽  
Hanne Mette Ridder ◽  
Martin Orrell
Keyword(s):  
Quality Of Life ◽  
Music Therapy ◽  
Sample Size ◽  
Psychometric Properties ◽  
Care Home ◽  
Psychometric Evaluation ◽  
Small Sample ◽  
Rater Reliability ◽  
Assessment Scales

ABSTRACTBackground:Music in Dementia Assessment Scales (MiDAS), an observational outcome measure for music therapy with people with moderate to severe dementia, was developed from qualitative data of focus groups and interviews. Expert and peer consultations were conducted at each stage of the scale development to maximize its content validity. This study aimed to evaluate the psychometric properties of MiDAS.Methods:Care home residents with dementia attended weekly group music therapy for up to ten sessions. Music therapists and care home staff were requested to complete weekly MiDAS ratings. The Quality of Life Scale (QoL-AD) was completed at three time-points.Results:A total of 629 (staff = 306, therapist = 323) MiDAS forms were completed. The statistical analysis revealed that MiDAS has high therapist inter-rater reliability, low staff inter-rater reliability, adequate staff test-retest reliability, adequate concurrent validity, and good construct validity. High factor loadings between the five MiDAS Visual Analogue Scale (VAS) items, levels of Interest, Response, Initiation, Involvement, and Enjoyment, were found.Conclusions:This study indicates that MiDAS has good psychometric properties despite the small sample size. Future research with a larger sample size could provide a more in-depth psychometric evaluation, including further exploration of the underlying factors. MiDAS provides a measure of engagement with musical experience and offers insight into who is likely to benefit on other outcomes such as quality of life or reduction in psychiatric symptoms.

scholarly journals Tailoring interventions for social isolation among older persons during the COVID-19 pandemic: challenges and pathways to healthcare equity

2021 ◽  
Vol 20 (1) ◽  
Author(s):  
Lise Dassieu ◽  
Nadia Sourial
Keyword(s):  
Quality Of Life ◽  
Older Adults ◽  
Social Isolation ◽  
Older Persons ◽  
Vulnerable Population ◽  
Subjective Experiences ◽  
Main Text ◽  
Healthcare Equity ◽  
Structural Inequities

Abstract Background Social isolation among older adults raises major issues for equity in healthcare in the context of the COVID-19 pandemic. Main text This commentary describes current challenges in preventing social isolation among older adults and proposes pathways to develop inclusive approaches to intervention in this vulnerable population. Building interventions that take account of structural inequities among older persons, as well as their subjective experiences, expectations and perspectives, appears fundamental to improve their health and quality of life in pandemic and post-pandemic contexts. Conclusions We argue that equity-based and person-centered approaches are critical to counter the negative outcomes of social isolation in the vulnerable older population.

Determinants of Quality of Life during the COVID-19 pandemic: An analysis of a large sample of Brazilian Health Professionals

2021 ◽  
Author(s):  
Jonas Jardim de Paula ◽  
Danielle de Souza Costa ◽  
Antônio Geraldo Silva ◽  
Débora Marques de Miranda ◽  
Leandro Malloy-Diniz
Keyword(s):  
Quality Of Life ◽  
Mental Health ◽  
Risk Factors ◽  
Health Care ◽  
Social Relations ◽  
Health Professionals ◽  
World Health ◽  
Large Sample ◽  
Explained Variance

Quality of Life (QoL) is a multidimensional estimate of biopsychosocial health and wellbeing.1 The COVID-19 pandemic led to an abrupt change in our lifestyle, demanding resilience and coping mechanisms2. Health care providers are in the frontline of COVID-19 patients’ diagnosis, treatment, and rehabilitation, and there is a well-documented impact of this context on their physical and mental health2. This might impact their wellbeing and reduce their quality of life. In this research letter, we investigated which factors are associated with QoL in Brazilian healthcare professionals. We aim to investigate both protective and risk factors for the four main aspects of QoL: physical, psychological, social relations, and environment. We assessed 97.771 Brazilian adults, most (92.3%) health professionals of different professions from all the five-country regions. All included individuals agreed in a written consent to participate. Participants showed an average of 35.45 years old (±9.49) and were predominantly female (80%). They answered an online questionnaire about sociodemographic aspects, measures of mental health, and quality of life in the first semester of 2020. A detailed description of the sample and procedures can be found elsewhere3. All participants answered the WHOQoL-BREF, a standardized tool for QoL assessment developed by the World Health Organization. Stepwise linear regression analysis was used to assess the role of sociodemographic factors, previously diagnosed mental disorders, COVID-19 related symptoms as well a series of specific questions regarding participants worries and perceptions about the pandemic, including the protective behaviors' adoption (social distancing, usage of masks and sanitizer, among others). A full list of variables (64 in total) is available on the SAMBE webpage (http://abpbrasil.org.br/pcabp/). Since we have a large sample size our statistical power is about 99% (alpha=0.01) to detect small effect sizes. To simplify our results and allow a more direct application to real-life settings we only included significant predictors which showed at least 1% of adjusted explained variance in the stepwise models. The stepwise regression model was summarized in the figure below. All regression models were significant (p<0.001) as well all the predictors reported in the Figure. Total explained variance was 26% for Physical QoL, 27% for Psychological, 13% for Social Relations, and 19% for Environmental. A history of previous depression, presence of Headache, and the perception of worsening in home relationships were risk factors for lower QoL in all four domains. Our results suggest a multidimensional pattern of determinants of QoL in health care professionals in the early days of the pandemic. Interesting features emerged as predictors of QoL such as changes in home relationships, worsening in work productivity, and mental health. Expected and new predictors may shed light on which factors should be considered in interventions aiming at the development of mitigation of impact QoL in these populations.

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