The Trajectories And Predictors Of Quality Of Life Of The Elderly In Nursing Home

Objectives To explore the heterogeneous trajectories of health related quality of life and specific quality of life of the elderly in nursing homes,and analyze its baseline predictive factors.Methods The research was conducted among the elderly in 26 nursing homes in Jinan from June in 2016 to September in 2017.With the purposive sampling,296 elders were surveyed and followed up twice.The cognitive status,self-care ability of daily life,physical activity,nutritional status,frailty,severity of urinary incontinence,anxiety and depression,social networks and health related quality of life and specific quality of life of the elderly were assessed by the standardized scale.We collected the demographic sociological characteristics of the elderly with self-prepared general information questionnaire.The data analysis was conducted in SPSS21.0and Mplus7.0,including descriptive analysis,chi-square test,student-t test,repeated measure analysis of variance,one-way ANOVA,Latent Class Growth Analysis and Logistic regression.Results1.The EQ-5D index of the elders showed a downtrend overall during one year,and appeared 3 trajectories:decline with high level,maintain with intermediate level and maintain with low level.There are 37.6%,41.6%,20.8%elders in decline with high level,maintain with Intermediate level and maintain with low level,respectively.2.The specific quality of life remained stable overall during one year,and appeared 3 trajectories:maintain with high level,maintain with intermediate level and maintain with low level.There are 34.0%,53.2%,12.8%elders in maintain with high level,maintain with intermediate level and maintain with low level,respectively.3.The multiple logistic regression showed that baseline pain,nutrition status,activity of daily life,and physical function were the independent predictors of the heterogeneous trajectories of the EQ-5D index.4.The Ordered logistic regression showed that baseline frailty,quality of sleeping,depress and family network were the independent predictors of the heterogeneous trajectories of specific quality of life in nursing homes.The poorer nutrition status,frailty,activity of daily life,suspicious or having sleep disorders,and more serious depress,the more elders showed maintain with intermediate level and maintain with low level of specific quality of life during 1 year.Conclusion:1.The elderly in nursing homes showed the heterogeneous trajectories of health related quality of life.There were just 37.6%elders in high level at baseline,which prompted the bad situation of health related quality of life of them in nursing homes.2.The elderly in nursing homes showed the heterogeneous trajectories of specific quality of life,and almost of the elders showed the trajectories of maintain with intermediate level and maintain with low level,which means that the poor specific quality of life of elders in nursing homes.3.The baseline pain,nutrition status,activity of daily life and physical function were the independent predictors of the heterogeneous trajectories of health related quality of life.And frailty,quality of sleeping,depress and family network were the independent predictors of the heterogeneous trajectories of specific quality of life in nursing homes.