Dementia, pain, depression, behavioral disturbances, and ADLs: toward a comprehensive conceptualization of quality of life in long-term care.
OBJECTIVE
Quality of life in long-term care settings is a multidimensional construct that includes functional, cognitive, behavioral, and psychological variables. Quality of life variables have been found to be related to one another, but directional influences have not been tested.


METHODS
The purpose of this study was to develop and compare two competing path models composed of quality of life variables, including dementia, pain, behavioral disturbances, and ADLs.


RESULTS
Path analytic results revealed that cognitive, emotional, and behavioral variables interact with one another to predict patients' activities of daily living. Pain levels did not influence activities of daily living directly, but rather influenced behavioral disturbances and depression, which in turn influenced activities of daily living.


CONCLUSIONS
These preliminary findings suggest that in order to assist long-term care residents in improving their activities of daily living, decreasing pain is likely to yield the greatest overall improvements. Future research on the relationships between quality of life variables is recommended to further develop multidimensional treatment models for healthcare providers in long-term care.
University of North Texas Health Science Center, Fort Worth, Texas 76107, USA. dcipher@hsc.unt.edu
Daisha J
DJ
Cipher
P Andrew
PA
Clifford
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D001519:Behavior; D002908:Chronic Disease; D003704:Dementia / Q000523:psychology*; D003863:Depression / Q000523:psychology*; D005260:Female; D006801:Humans; D008134:Long-Term Care; D008297:Male; D008960:Models, Psychological; D059408:Pain Management; D011569:Psychiatric Status Rating Scales; D011788:Quality of Life