scholarly journals Concordance of Self- and Informant-Rated Depressive Symptoms in Nursing Home Residents with Dementia: Cross-Sectional Findings

Author(s):  
Julie Lorraine O'Sullivan ◽  
Roxana Schweighart ◽  
Sonia Lech ◽  
Eva-Marie Kessler ◽  
Christina Tegeler-Nonnen ◽  
...  

Abstract Background: Depression is highly prevalent in nursing home residents living with moderate to severe dementia. However, assessing depressive symptoms in residents with dementia can be challenging and may vary by rater perspective. We aimed to investigate the concordance of, and factors associated with self- and informant-rated depressive symptoms in nursing home residents with dementia.Methods: Cross-sectional data was collected from N=162 nursing home residents with dementia (age: 53-100; 74% women). Self-ratings were assessed with the Geriatric Depression Scale, while the Subscale D of the Neuropsychiatric Inventory was used for informant-ratings. Cohen’s Kappa was calculated to determine concordance of both measures and of each with antidepressant medication. Associations with sociodemographic variables, self- and informant-rated quality of life, dementia stage, neuropsychiatric symptoms, functional status and antidepressant medication were analysed with multivariate linear mixed models.Results: Concordance between self- and informant-rated depressive symptoms was minimal (Cohen’s Kappa=.22, p=.02). Self-reported depression was negatively associated with self-rated quality of life (β=-.37; 95%CI: -.48 to .26, p<.001), informant-rated quality of life (β=-.31; 95%CI: -51 to .10, p=.003) and functional status (β=-.15; 95%CI: -.27 to .03, p=.02), whilst informant-rated depression revealed negative associations with informant-rated quality of life (β=-.32; 95%CI: -.54 to .11, p=.003) and dementia stage (β=-.27; 95%CI: -.50 to .03, p=.028). No concordance was found with antidepressant medication.Conclusions: In line with our expectations, low agreement and unique association patterns were found for both measures. These findings indicate that both instruments address different aspects of depression und underline the need for comprehensive approaches when it comes to detecting signs of clinically relevant depressive symptoms in dementia. Trial registration: The trial was registered with the ISRCTN registry (Trial registration number: ISRCTN98947160)

2017 ◽  
Vol 7 (1) ◽  
pp. 109-121 ◽  
Author(s):  
Hanne Marie Rostad ◽  
Martine T.E. Puts ◽  
Milada Cvancarova Småstuen ◽  
Ellen Karine Grov ◽  
Inger Utne ◽  
...  

Background/Aims: Many variables influence the quality of life in older adults with dementia. We aim to quantify how the relationship between pain and quality of life in nursing home residents with severe dementia can be explained by neuropsychiatric symptoms, depressive symptoms, and activities of daily living. Methods: This article presents cross-sectional baseline data from a cluster randomised controlled trial. Results: The total and direct effects of pain on quality of life were statistically significant. Both neuropsychiatric and depressive symptoms partially mediated the relationship between pain and quality of life. Activities of daily living acted as a mediator only when modelled together with depressive symptoms. Conclusion: Pain, neuropsychiatric symptoms, and depressive symptoms appear to be important factors that influence the quality of life for nursing home residents with severe dementia. Therefore, multidimensional interventions may be beneficial for maintaining or improving quality of life in this population.


2019 ◽  
Vol 29 (1) ◽  
pp. 91-97 ◽  
Author(s):  
A. Brandauer ◽  
S. Berger ◽  
N. Freywald ◽  
I. Gnass ◽  
J. Osterbrink ◽  
...  

Abstract Aim Quality of life is an essential outcome parameter in geriatric research and presents an important indicator for the evaluation of care treatments. The present study analyses potential impact factors on health-related quality of life (HRQOL) of nursing home residents (NHR) who are in pain. Methods Data came from the cRCT ‘PIASMA’. Statistical analyses of 146 respondents were carried out by multiple linear regressions based on the EQ-5D index (Euroquol Quality of Life) as dependent variable. Potential impact factors were applied and categorised in five blocks: pain intensity and interference (according to the Brief Pain Inventory), intervention effect, sex and age, pain-related diagnoses, and scales regarding depressive symptoms and cognitive impairment (based on the Geriatric Depression Scale and the Mini-Mental State Examination). Results On average, residents showed a pain intensity of 18.49, a pain interference of 29.61, a MMSE score of 22.84, a GDS score of 5.65 and an EQ-5D index of 0.52. Residents with more diagnoses, more depressive symptoms, and a higher pain interference showed a significantly reduced HRQOL. Conclusion Findings underline the importance of identifying and applying treatment options for both pain (especially interference) and depressive disorders to maintain HRQOL of NHR.


2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Sarah Raes ◽  
Sophie Vandepitte ◽  
Delphine De Smedt ◽  
Herlinde Wynendaele ◽  
Yannai DeJonghe ◽  
...  

Abstract Background Knowledge about the relationship between the residents’ Quality of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes. Methods The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question. Results The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P <  0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes. Conclusion Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.


PLoS ONE ◽  
2019 ◽  
Vol 14 (12) ◽  
pp. e0223704 ◽  
Author(s):  
Marinda Henskens ◽  
Ilse M. Nauta ◽  
Susan Vrijkotte ◽  
Katja T. Drost ◽  
Maarten V. Milders ◽  
...  

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0245478
Author(s):  
Leonard Turnier ◽  
Michelle Eakin ◽  
Han Woo ◽  
Mark Dransfield ◽  
Trisha Parekh ◽  
...  

Background The purpose of this study was to explore the association between perceived social support and COPD outcomes and to determine whether the associations are mediated by depressive symptoms. Methods Subjects with COPD who were enrolled as part of SPIROMICS were included in this analysis. Questionnaires relating to quality of life, symptom burden, and functional status were administered at annual clinic visits for over a 3 year period. In both cross-sectional and longitudinal analyses, we examined the association of social support as measured by the FACIT-F with COPD outcomes. Cross sectional analyses used multivariable linear or logistic regression, adjusting for covariates. For longitudinal analyses, generalized linear mixed models with random intercepts were used. Models were adjusted with and without depressive symptoms and mediation analyses performed. Results Of the 1831 subjects with COPD, 1779 completed the FACIT- F questionnaire. In adjusted cross-sectional analysis without depressive symptoms, higher perceived social support was associated with better quality of life, well-being, 6 minute walk distance, and less dyspnea. When also adjusting for depressive symptoms, all associations between social support and COPD outcomes were attenuated and no longer statistically significant. Mediation analysis suggested that depressive symptoms explained the majority (> = 85%) of the association between social support and measured COPD outcomes. Results of the longitudinal analysis were consistent with the cross-sectional analyses. There was no association between social support and odds of exacerbations. Conclusion Higher social support was associated with better COPD outcomes across several measures of morbidity including quality of life, respiratory symptoms, and functional status. In addition, these associations were largely attenuated when accounting for depressive symptoms suggesting that the beneficial association of social support with COPD outcomes may be largely mediated by the association between social support and depression. Trial registration SPIROMICS was approved by Institutional Review Boards at each center and all participants provided written informed consent (clinicaltrials.gov: NCT01969344).


2020 ◽  
Author(s):  
Sarah Raes ◽  
Sophie Vandepitte ◽  
Delphine De Smedt ◽  
Herlinde Wynendaele ◽  
Yannai DeJonghe ◽  
...  

Abstract Background: Knowledge about the relationship between the residents’ Quality Of Life (QOL) and the nursing home price is currently lacking. Therefore, this study investigates the relationship between 11 dimensions of QOL and nursing homes price in Flemish nursing homes.Methods: The data used in this cross-sectional study were collected by the Flemish government from years 2014 to 2017 and originates from 659 Flemish nursing homes. From 2014 to 2016, data on the QOL of 21,756 residents was assessed with the InterRAI instrument. This instrument contains 11 QOL dimensions. Multiple linear regression analyses were conducted to examine the research question.Results: The multiple linear regressions indicated that a 10 euro increase in the daily nursing home price is associated with a significant decrease (P < 0.001) of 0.1 in 5 dimensions of QOL (access to services, comfort and environment, food and meals, respect, and safety and security). Hence, our results indicate that the association between price and QOL is very small. When conducting a subgroup analysis based on ownership type, the earlier found results remained only statistically significant for private nursing homes.Conclusion: Our findings show that nursing home price is of limited importance with respect to resident QOL. Contrary to popular belief, our study demonstrates a limited negative effect of price on QOL. Further research that includes other indicators of QOL is needed to allow policymakers and nursing home managers to improve nursing home residents’ QOL.


1988 ◽  
Vol 7 (3) ◽  
pp. 367-388 ◽  
Author(s):  
Joan Retsinas ◽  
Patricia Garrity

The sarse literature on blind nursing home residents describes them as isolated, withdrawn, and dependent. We introduce a model that links blindness to immobility, isolation, dependence, loss of affect, and disinterest in the outside world. Using data from one nursing home, we compared the functional status and mobility of residents who were blind before admission with that of residents who became blind after admission. The results suggest that preadmission blind residents' dependence, isolation, and immobility were attributed not solely to their blindness, but to their severe nonvisual disabilities, including hearing impairments. Postadmission blind residents, however, did suffer because of their blindness. To improve blind residents' quality of life, we offer practical suggestions for training nursing home staff.


2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 89-89
Author(s):  
Minhong Lee ◽  
Kyeongmo Kim ◽  
Sok An

Abstract Background and Purpose: Addressing issues of quality of life of nursing home residents based on the human rights-based approach has been a top priority in the long-term care system in Korea but no study has yet examined the relationship between self-determination of nursing home residents and their quality of life. This study aimed to examine whether greater levels of self-determination in the provision of daily care were associated with higher levels of quality of life of the residents. Methods: We collected data from 332 residents (+65) at 20 nursing homes in a metropolitan city. We measured residents’ right to self-determination using the autonomy scale of the Client-centered Care Questionnaire. We also included quality of life, socio-economic characteristics, ADLs, depressive symptoms, and social networks. We ran multiple regression analysis using SPSS 26.0. Results: The findings of this study revealed that greater levels of residents’ right to self-determination were associated with higher levels of quality of life (β =-.425, p &lt;.0001). Older residents who were higher levels of depressive symptoms were likely to have lower levels of quality of life (β = -.265, p &lt; .001). Conclusions and Implications: This study adds to the growing literature on the ways nursing home residents’ self-determination contributes to their quality of life. More opportunities for self-determination in their treatment should be given to promote recovery and to encourage participation in the decision-making process. Nursing practitioners and policymakers in Korea should develop programs and/or services that enhance residents’ self-determination to improve their quality of life.


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