title: Does the care dependency of nursing home residents influence their health-related quality of life?-A cross-sectional study.
abstract: BACKGROUND
  Studies on health-related quality of life (HRQOL) are missing for nursing home residents independent from their health conditions or interventions after admission. Our aim was to analyse if the care dependency of nursing home residents influence their HRQOL and to describe HRQOL of nursing home residents at the time of admission.
  
  
  METHODS
  Eleven German nursing homes were randomly selected for a cross-sectional multicentre study from April 2008 until December 2009. HRQOL was measured with the Nottingham Health Profile (NHP) in the six domains "Physical Mobility", "Energy", "Pain", "Social Isolation", "Emotional Reaction" and "Sleep". Domain scores range from zero (good subjective health status) to 100 (poor subjective health status). Care dependency was evaluated using the Care Dependency Scale, age, sex, cognitive status and diseases were documented by the research assistants. Multivariate regression analysis was performed to quantify the influence of care dependency on HRQOL.
  
  
  RESULTS
  120 residents were included in total. HRQOL was mostly reduced in the domains "Physical Mobility" and "Energy" (mean scores >43.0), while impairment differences in the domains "Pain", "Social Isolation", "Emotional Reaction" and "Sleep" were only moderate (≤25.0). HRQOL was not influenced by the age. Women (n = 85) had a significantly poorer HRQOL in the domain "Pain" than men (mean score women: 29.5 ± 31.5; males: 14.9 ± 17.2; p = 0.011). Care dependency had an influence on the domain "Sleep" (ß = -0.195, p = 0.031), while the other domains were not influenced by care dependency. Residents with a low care dependency scored significantly lower (better HRQOL) in the domain "Sleep" than residents with a high care dependency (mean score 15.3; SD ± 19.0 versus mean score 32.8 SD ± 33.2; p < 0.02).
  
  
  CONCLUSIONS
  The level of care dependency has no influence on the HRQOL from the nursing home residents' perspective apart from the domain "Sleep". High care dependency residents have a lower HRQOL in the domain "Sleep" compared to moderate and low care dependency residents. We found a significantly lower HRQOL in women compared to men in the domain "Pain".
authors.affiliation: Department of Nursing Science, Charité- Universitätsmedizin Berlin, Augustenburgerplatz 1, Berlin 13353, Germany.
authors.forename: Manuela
authors.initials: M
authors.lastname: Tabali
authors.forename: Thomas
authors.initials: T
authors.lastname: Ostermann
authors.forename: Elke
authors.initials: E
authors.lastname: Jeschke
authors.forename: Theo
authors.initials: T
authors.lastname: Dassen
authors.forename: Cornelia
authors.initials: C
authors.lastname: Heinze
mesh_terms: D000369:Aged, 80 and over; D003858:Dependency, Psychological; D005260:Female; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data*; D011788:Quality of Life / Q000523:psychology*; D012648:Self Care / Q000706:statistics & numerical data; D012737:Sex Factors; D011795:Surveys and Questionnaires