Influence Of Informal Care On The Quality Of Life In The Elderly

ObjectiveThis study was to describe the level of sense of the situation of informal care satisfaction for the elderly and explore its influencing factors by using self-made informal care satisfaction questionnaire.Then,we investigated the impact of informal care satisfaction on quality of life in the elderly by establishing a structural equation model between them and introducing two mediating variables of frailty and depressive factors.Our aim is to guide informal care and provide the basis for building a perfect community-home pension system,then promote the quality of life of the elderly.MethodsA questionnaire survey was carried out in 210 elderly people over 60 years of age from Qingdao community during August 2017 to April 2018.The questionnaires include:general data questionnaire,informal care satisfaction questionnaire,frailty phenotype,depression scale for the elderly,and the Mos 36-item Short Form Health Survey(SF-36).Statistical software SPSS 23.0 was employed for data analysis.Descriptive analysis,t test,one-way ANOVA,Pearson correlation analysis,multiple linear regression analysis and hierarchical regression analysis were included.Statistical software AMOS23.0 was used to analyze structural equation model.Results1.The average score of informal care satisfaction for the elderly in Qingdao was(3.19±0.50),the average score of daily life care was(3.15±0.73),and the score of psychological support guidance was(3.12±0.62).The score of disease-related nursing was(3.02±0.58).The total score of frailty phenotype was(1.47±1.36),in which 66 cases(31.4%)were non-frailty,98 cases(46.7%)were pre-frailty,46 cases(21.9%)were frailty;The total score of depression was(10.81±5.84),and that of non-depression was 165(69.0%).There were 57 cases of mild depression(27.2%)and 8 cases of severe depression(3.8%).The total score of quality of life was(104.88 ±20.58).2.Multiple stepwise regression analysis showed that monthly income(?= 0.205,P=0.005),place of residence of the child(?=-0.449,P<0.001),duration of the spouse's care(?= 0.223,P=0.002),and average number of days in hospital(?=-0.231,P= 0.002)were the factors of satisfaction of the informal care of the elderly;The number of chronic diseases(?=-0.386,P<0.001),the duration of the spouse's care(?= 0.404,P<0.001)and the times(?=-0.190,P=0.021)of hospitalizations were the factors of quality of life.3.Correlation analysis showed that daily life care was positively related to psychological support(r = 0.450,P<0.01)and disease-related care(r= 0.403,P<0.01)and quality of life(r= 0.496,P<0.01),while negatively related to frailty(r=-0.329,P<0.01)and depression(r=-0.222,P<0.01).Psychological support was positively related to disease-related care(r= 0.358,P<0.01)and quality of life(r= 0.546,P<0.01),and negatively related to frailty(r=-0.311,P<0.01)and depression(r=-0.01,P<0.01).Disease-related care was positively related to quality of life(r= 0.500,P < 0.01),and negatively related to frailty(r= 0.375,P < 0.01)and depression(r= 0.281,P < 0.01).Frailty was positively related to depression(r= 0.384,P<0.01)and negatively related to quality of life(r= 0.572,P<0.01),while depression was negatively related to quality of life(r= 0.573,P<0.01).4.The structural equation model showed that daily life care(?=-0.212,P<0.001)and disease-related care(?=-0.288,P < 0.001)had a direct negative effect on frailty.Psychological support(?=-0.361,P<0.001)and disease-related care(?=-0.154,P<0.001)had a direct negative effect on depression.Frailty(?=-0.263,P < 0.001)and depression(?=-0.329,P<0.001)had a direct negative effect on quality of life.Daily life care(?= 0.193,P < 0.001),psychological support(?= 0.165,P < 0.001)and disease-related care(?= 0.187,P<0.001)had a direct positive effect on quality of life;The three dimensions of informal care can directly affect the quality of life,but also indirectly affect the quality of life through frailty and depression.The intermediate effects are 0.056,0.119 and 0.127 respectively.The Bootstrap method was used to test the mediating effect.The result showed that the mediating effect was significant.Conclusion1.The informal care satisfaction of the elderly in Qingdao is to be improved which only get the basic level.The incidence of frailty and depression is higher than other cities.The quality of life in the elderly is generally better,but it still needs to be improved comparedwith the norm of the domestic age group.2.Monthly income,place of residence of the child,duration of the spouse's care,and average number of days in hospital were the factors of satisfaction of the informal care in the elderly;The number of chronic diseases,the duration of the spouse's care and the times of hospitalizations were the factors of quality of life.3.There was a correlation between informal care satisfaction,frailty,depression and quality of life in the elderly.The better the score of informal care,the higher the level of quality of life;the higher the score of frailty and depression,the lower the level of quality of life.4.Informal care can not only directly affect the quality of life,but also indirectly affect the quality of life through the intermediary of frailty and depression.