Psychometric properties of the geriatric quality of life-dementia in older adults with dementia or mild cognitive impairment living in nursing homes

BACKGROUND: Given the theoretical and methodological limitations, there is insufficient knowledge about the psychometric properties and internal structure of quality of life (QOL) measurements for patients with dementia living in nursing homes. The present study aimed to confirm the validity and reliability of the Geriatric Quality of Life-Dementia scale (GQOL-D) to measure the QOL of patients with dementia in nursing homes and analyze their QOL based on the validated GQOL-D factor structure. METHODS: The GQOL-D was used to assess QOL. A convenience sampling method was used to recruit patients with dementia or mild cognitive impairment from six nursing homes in two cities. In order to confirm the validity and factor structure of the scale, both exploratory factor analysis and confirmatory factor analysis were employed. An independent t-test and a one-way analysis of variance were performed to examine the difference in the QOL across general characteristics. RESULTS: The original factor model was not appropriate to assess the QOL of dementia patients living in nursing homes because the models did not show adequate fit indices. The results support a two-factor structure: environmental and personal factors. Our findings suggest that the internal consistency and construct validity of the proposed two-factor model are adequate, and the GQOL-D is a useful tool for assessing the QOL of dementia patients living in nursing homes. CONCLUSIONS: This factor structure model of environmental and personal aspects is a useful theoretical framework for designing and evaluating interventions for people with dementia and providing integrated person-centered care for people with dementia in nursing homes.