【作者】 高洁；

【导师】 王克芳；

【作者基本信息】 山东大学 ， 护理学， 2017， 硕士

【摘要】 研究目的:对养老机构老年人生活质量量表进行修订及验证,并描述养老机构老年人生活质量现状,分析生活质量的影响因素,为有针对性的提高这一人群生活质量的干预提供理论依据。研究方法:采用横断面研究设计,于2016年5月至9月选取济南市33家养老机构老人进行问卷调查,共发放376份问卷,有效回收371份。调查内容包括:老人及机构一般资料问卷、视力、听力、咀嚼、营养、睡眠、尿失禁、日常生活活动能力、衰弱、抑郁、焦虑、孤独、社会支持、社会活动参与,以及老人的生活质量。使用AMOS19.0进行养老机构老年人生活质量量表的验证性因子分析,采用SPSS19.0进行养老机构老年人生活质量量表信度及效标效度检验,以及生活质量的影响因素分析。具体包括:描述性分析、独立样本t检验、方差分析、卡方检验、pearson相关、spearman相关、多元线性回归分析、多因素logistic回归分析、结构方程模型等。结果:1.养老机构老年人生活质量量表修订版经验证性因子分析后,最终量表由9个维度、38个条目组成。总量表总Cronbach’s α系数为0.891,各维度的Cronbach’sα系数分别在0.661～0.897之间。验证性因子分析中,具体的拟合指标为χ2=990.365,χ2/df =1.590,NFI=0.859,NNFI=0.934,IFI=0.943,CFI=0.942,RMSEA=0.040。效标效度分析,养老机构老年人生活质量量表总分及各维度均分均与EQ-VAS显著相关;除家庭亲密度及人际关系和谐性维度与EQ-5D效应值相关性不显著外,其他各维度及总分均与EQ-5D效应值显著相关。2.养老机构老年人生活质量现状:在养老机构老年人生活质量量表中,在自主决策领域老人的得分最高,在活动参与性领域的得分最低;健康相关生活质量(EQ-5D)中,老人在日常活动能力维度出现问题的比例最大(60.1%),其次为行动能力(56.3%);老人自评健康状况(EQ-VAS)得分为66.08±22.34。3.多元线性回归分析结果显示:个体因素中,年龄、性别、衰弱、睡眠、抑郁、孤独、焦虑、社会网络、社会活动参与、子女相聚频率;以及机构因素中,附属于医院、室外活动场所是机构老年人生活质量的预测因素;睡眠、疾病指数、焦虑、社会活动参与是老人自评健康状况(EQ-VAS)的预测因素。多因素logistic回归分析结果显示,年龄、衰弱、日常生活活动能力、社会活动参与、居住安排是老人健康相关生活质量(EQ-5D)的预测因素。结论:1.养老机构老年人生活质量量表具有较好的信度和效度。2.养老机构老年人生活质量较低。3.养老机构老年人生活质量受到个体因素和机构因素的影响,机构工作人员应识别其中的危险人群,尽早采取针对性的措施,从而提高老人的生活质量。更多还原

【Abstract】 Objectives To confirm the construct validity of the revised quality of life scale for residents in long-term care facilities,and to describe the actuality of quality of life(QOL)of the residents,as well as to explore the related factors that might affect the QOL of the elderly in long-term care facilities.Methods The research was conducted among the elderly in long-term care facilities in the city of Jinan from May to September in 2016,with the cross-sectional questionnaire investigation.In all mails out 376 questionnaires,acquires 371 effective questionnaires.The contents of investigation were:the general information of the elderly and the facility,vision,hearing,mastication,nutrition,sleep,urine incontinence,ability of daily living(ADL),frail,depression,anxiety,loneliness,social support,social activity participation,and their QOL.The construct validity of the QOL scale was conducted with Amos 19.0,the reliability analysis and criterion validity analysis of the QOL scale,as well as the analysis of associated factors of QOL were conducted with SPSS 19.0.The statistics included:the descriptive statistics,independent sample t test,analysis of variance(ANOVA),Chi-squared test,Pearson correlation,Spearman correlation,multiple linear regression,binary logistic regression,structural equations modeling.Results1.With construct validity analysis,the revised quality of life scale for residents in long-term care facilities was composed of 38 items,belonging to nine dimensions.The Cronhbch’s alpha coefficient of the scale was 0.891 with those of nine dimensions between 0.661 to 0.897.The confirmatory factor analysis results showed χ2=990.365,χ2/df=1.590,NFI=0.859,NNFI=0.934,IFI=0.943,CFI=0.942,RMSEA=0.040.The criterion validity analysis results showed that the 9 dimension were associated with EQ-VAS score,and 7 dimension were correlated with EQ-5D utility.2.The present situation of the QOL:the elderly had the highest score in autonomy dimension,and the lowest score in security dimension.With the health-related quality of life(HRQOL),most residents had problems in usual activity(60.1%),followed by the mobility(56.3%).The mean score of their self-rated health on EQ-VAS was 66.08±22.34。3.Multiple linear regression showed:among individual factors,age,gender,frail,sleep,depression,loneliness,anxiety,social network,social activity participation,the frequency of children visits;and attach to hospitals,outdoor living space among facility factors predicted the residents’ quality of life.Sleep,comorbidities,anxiety,and social activity participation were related to their self-rated health status(EQ-VAS).Binary logistic regression showed that age,frail,activity of daily living,social activity participation and living-room arrangement were associated with residents’ health-related quality of life(EQ-5D).Conclusions1.Quality of life scale for residents in long-term care facilities was proved to have good psychometric characteristics and can be applied in the long-term care facilities context.2.Residents in long-term care facilities had low quality of life.3.The quality of life among residents in long-term care facilities were influenced by individual-and facility-factors.The staff were suggested to recognize the influence factors and provide better prevention for the elderly.更多还原