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Activities of daily living, life orientation, and health-related quality of life among older people in nursing homes: a national cross-sectional study in China

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Abstract

Purpose

This study aimed to explore the current status of activities of daily living (ADLs), life orientation, and health-related quality of life (HRQoL) among older people in nursing homes and to further examine the mediating role of life orientation in the impact of ADLs on HRQoL.

Methods

A national cross-sectional study was conducted among older people aged 60 and above in nursing homes by the randomly stratified cluster sampling method. The status of ADLs, life orientation and HRQoL were measured using an ADL scale, a life orientation scale and the SF-12v2 scale, respectively. Multiple linear regression models were used to identify explanatory factors associated with ADLs, life orientation, and HRQoL. The potential mediating role of life orientation in the relationship between ADL and HRQoL was explored by mediation analysis.

Results

The overall prevalence of ADL disability was 52.67%, and 84.37% of older people in nursing homes had a negative life orientation. The mean scores of physical health and mental health among older people in nursing homes were 45.44 ± 6.46 and 42.67 ± 8.48, respectively. Some sociodemographic characteristics were associated with poor physical health and mental health. After adjustments were made for covariates, the life orientation score mediated 13.81% of the total effect of the ADL score on physical component score of HRQoL and mediated 45.33% of the mental component score of HRQoL.

Conclusion

A sizeable proportion of older people had ADL disability and negative life orientation, and HRQoL was poor among older Chinese people in nursing homes. Life orientation partially mediates the relationship between ADLs and HRQoL.

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Acknowledgements

We wish to thank the participants, advisors, management staff of nursing homes, and collaborators of this study for their valuable contributions.

Funding

This study was funded by the Social Sciences Foundation of Liaoning Province (No. L18ATJ001).

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Authors and Affiliations

  1. School of Public Health, China Medical University, 77 Puhe Road, Shenyang North New Area, Shenyang, Shenyang, Liaoning Province, 110122, People’s Republic of China

    Junling Li, Xueying Xu, Jinbin Sun, Weijie Cai, Tiantian Qin, Mingcheng Wu & Hongbo Liu

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  1. Junling Li
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  2. Xueying Xu
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  7. Hongbo Liu
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Contributions

All authors contributed to the study conception and design. Material preparation, data collection, and analysis were performed by JL, JS, WC, TQ, and MW. The first draft of the manuscript was written by JL, and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

Corresponding author

Correspondence to Hongbo Liu.

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Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Individual privacy was not involved in our questionnaire. The study protocol was in accordance with the ethical standards and was approved by the Ethics Committee of China Medical University (CMU6206-1004).

Informed consent

Considering the age of the participants and the lack of written ability, we obtained oral consent from the older adult participants, meanwhile we obtained written informed consent about the process from our study nursing home. Besides, our investigators would provide information to the older adults orally and make them fully aware of the purpose of our study, and those who did not agree to be investigated were excluded.

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Li, J., Xu, X., Sun, J. et al. Activities of daily living, life orientation, and health-related quality of life among older people in nursing homes: a national cross-sectional study in China. Qual Life Res 29, 2949–2960 (2020). https://doi.org/10.1007/s11136-020-02571-w

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