| Objectives: To evaluate the status and dynamic development of quality of life in institutional residents, to get the information about those who have left nursing homes, and to explore related factors on the basis of epidemiological study.Methods:1. Cross-sectional study of quality of lifePeople aged 60 and over from 15 Nursing Homes in Xi'an were selected as our study's subjects by simple random clustering sampling method. SF-36 short form scale, and a self-developed questionnaire including demo-social characteristics,diseases suffered,reasons for dwelling,satisfaction to available services from the institution were used to assess quality of life and collect data about general information and living situation.Data was analyzed by SPSS 13.0. t-test,χ~2 analysis, multi-linear regression analysis methods were used to describe the status of quality of life in Nusing homes and explore its related factors.2.①case control study: on the basis of 2008's investigation, the basic data in 2006 was divided into two groups. Case-control study was applied to compare the difference of quality of life between case and control groups.②In addition, we explored the reasons why some people chose to leave the nursing homes.③On the basis of the investigation in 2008, the elderly having been stayed in the nursing homes since 2006 were observed to explore the dynamic development of quality of life.Data was analyzed by SPSS 13.0 with t-test,χ~2 test .OR value and 95% confidence index were caculated.Results: 380 and 209 valid questionnaires were collected in cross-sectional study of quality of life and reasons why some elderly have left, respectively.1. the whole situation was at a median or lower level. The status in high, middle, and low level was 38.7%, 55.8%, 5.5% respectively.2. 12 items including having disease or not,cerebrovascular disease, having exercise or not, having some kinds of interest or not, satisfaction about his or her own and the children's life,inter-personal relationship,vehicles,life events about health deterioraration, unhappy experiences and positive events were found to be related to quality of life.3. RE and having religion belief or not were found to be related to the elderly's leaving or stay in nursing homes. Having a lower REscore(OR=0.621, 95%CI=0.396~0.973) was negatively related to leaving nursing homes. Howecer,having no religional belief (OR=2.030, 95% CI=1.154~3.569) was positively associated with leaving the nursing homes. The elderly who have left were mainly be brought back home by their children and death, an the the cause of death were dominated by cerebrovascular and heart diseases.4. The quality of life among the elderly in nursing homes was found to have a declined tendency in physical health situation, while there was increased tendency in mental health situation. Conclusion: The quality of life of the elderly in institutional environment in Xi'an is not optimistic. 61.3% of the population was at medium or lower level. But our study would provide some proofs about how to improve quality of life of the elderly in nursing homes. Measurement should be concerned on the following items: cultivating and maintaining some kinds of interests, reasonable exercise, advancing communication between each other, treatment and daily nursing for common diseases, especially cerebrovascular diseases. In addition, improving institutional services, promoting soft and hard ware construction, training and educating the attendents for the old may also open a positive way to improve the quality of life of this special population. If the above advices can be carried out, it will finally help to achieve the goal of healthy ageing.
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