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Health and Quality of Life Outcomes

, 2:10

First Online: 19 February 2004Received: 09 December 2003Accepted: 19 February 2004

Abstract

BackgroundIn patients with very severe dementia self-rating of quality of life usually is not possible and appropriate instruments for proxy-ratings are not available. The aim of this project is to develop an instrument of clinical proxy-ratings for this population.

MethodsUsing electronic instruments, physicians and nurses recorded patient behaviour and changes of behaviour over a period of one year. Based on these data a list of 65 items was generated and subsequently allocated to 14 categories. This list was tested in 217 patients 61–105 yrs with dementia diagnosed according to ICD-10 by both physicians and nurses. The severity of dementia was assessed by means of the Global Deterioration Scale GDS and the Brief Cognitive Rating Scale BCRS. The Spitzer-Index proxy-rating was used as a global quality of life measure. Activity of daily living was rated using the Barthel Index.

ResultsA factor analysis of the original 65 items revealed 5 factors communication, negative affect, bodily contact, aggression, and mobility. By stepwise removing items we obtained satisfactory internal consistencies of the factors both for nurses- and physicians- ratings. The factors were generally unrelated. The validity of the instrument was proven by correlations of the factors communication and mobility with the Brief Cognitive Rating Scale BCRS and the Barthel-Index.

ConclusionThe results demonstrate the reliability and validity of the Vienna List as a proxy rating measurement of quality of life in patients with severe dementia. The psychometric properties of the scale have to be proved in further studies.

Keywordswell-being quality of life old-old severe dementia  Download fulltext PDF



Autor: Franz Porzsolt - Marina Kojer - Martina Schmidl - Elfriede R Greimel - Jörg Sigle - Joerg Richter - Martin Eisemann

Fuente: https://link.springer.com/



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