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Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis

BACKGROUND: Severe agitation and its relation to single dimensions of quality of life are not well understood. The aim of this study was to gain more knowledge about severe agitation and to examine the relationships between the severity of agitation and single dimensions of quality of life among res...

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Autores principales: Schmüdderich, Kathrin, Holle, Daniela, Ströbel, Armin, Holle, Bernhard, Palm, Rebecca
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042694/
https://www.ncbi.nlm.nih.gov/pubmed/33849487
http://dx.doi.org/10.1186/s12888-021-03167-5
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author Schmüdderich, Kathrin
Holle, Daniela
Ströbel, Armin
Holle, Bernhard
Palm, Rebecca
author_facet Schmüdderich, Kathrin
Holle, Daniela
Ströbel, Armin
Holle, Bernhard
Palm, Rebecca
author_sort Schmüdderich, Kathrin
collection PubMed
description BACKGROUND: Severe agitation and its relation to single dimensions of quality of life are not well understood. The aim of this study was to gain more knowledge about severe agitation and to examine the relationships between the severity of agitation and single dimensions of quality of life among residents with dementia living in German nursing homes. METHODS: This exploratory secondary analysis included data from 1947 residents of 66 German nursing homes from the DemenzMonitor study. The construct of agitation was defined as a composite score of the items agitation/aggression, irritability/lability and disinhibition from the Neuropsychiatric Inventory Questionnaire (NPI-Q); the resident was classified as severely agitated if at least one of these symptoms was rated as ‘severe’. The single dimensions of quality of life were measured with the short version of the QUALIDEM instrument. To avoid selection bias, two controls with mild or no agitation were selected for each resident with severe agitation using propensity score matching. Mixed linear regression models were then generated to determine the differences in the dimensions of quality of life for the severity of agitation and the defining items. RESULTS: For four out of five dimensions of quality of life of the short version of QUALIDEM, residents with severe agitation had significantly lower values than residents without severe agitation. Converted to scale size, the greatest difference between both groups was found in the dimension social isolation with 23.0% (-2.07 (95% CI: -2.57, -1.57)). Further differences were found in the dimensions restless tense behaviour with 16.9% (-1.52 (95% CI: -2.04, -1.00)), positive affect with 14.0% (-1.68 (95% CI: -2.28, -1.09)) and social relations with 12.4% (-1.12 (95% CI: -1.54, -0.71)). CONCLUSIONS: Severe agitation is a relevant phenomenon among nursing home residents with dementia and is associated with lower values of quality of life in the dimensions social isolation, restless tense behaviour, positive affect and social relations from the QUALIDEM instrument. Therefore, more attention should be paid to severe agitation in nursing practice and research. Moreover, care strategies used to reduce severe agitation should be considered in terms of their impact on the dimensions of quality of life. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at (10.1186/s12888-021-03167-5).
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spelling pubmed-80426942021-04-14 Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis Schmüdderich, Kathrin Holle, Daniela Ströbel, Armin Holle, Bernhard Palm, Rebecca BMC Psychiatry Research Article BACKGROUND: Severe agitation and its relation to single dimensions of quality of life are not well understood. The aim of this study was to gain more knowledge about severe agitation and to examine the relationships between the severity of agitation and single dimensions of quality of life among residents with dementia living in German nursing homes. METHODS: This exploratory secondary analysis included data from 1947 residents of 66 German nursing homes from the DemenzMonitor study. The construct of agitation was defined as a composite score of the items agitation/aggression, irritability/lability and disinhibition from the Neuropsychiatric Inventory Questionnaire (NPI-Q); the resident was classified as severely agitated if at least one of these symptoms was rated as ‘severe’. The single dimensions of quality of life were measured with the short version of the QUALIDEM instrument. To avoid selection bias, two controls with mild or no agitation were selected for each resident with severe agitation using propensity score matching. Mixed linear regression models were then generated to determine the differences in the dimensions of quality of life for the severity of agitation and the defining items. RESULTS: For four out of five dimensions of quality of life of the short version of QUALIDEM, residents with severe agitation had significantly lower values than residents without severe agitation. Converted to scale size, the greatest difference between both groups was found in the dimension social isolation with 23.0% (-2.07 (95% CI: -2.57, -1.57)). Further differences were found in the dimensions restless tense behaviour with 16.9% (-1.52 (95% CI: -2.04, -1.00)), positive affect with 14.0% (-1.68 (95% CI: -2.28, -1.09)) and social relations with 12.4% (-1.12 (95% CI: -1.54, -0.71)). CONCLUSIONS: Severe agitation is a relevant phenomenon among nursing home residents with dementia and is associated with lower values of quality of life in the dimensions social isolation, restless tense behaviour, positive affect and social relations from the QUALIDEM instrument. Therefore, more attention should be paid to severe agitation in nursing practice and research. Moreover, care strategies used to reduce severe agitation should be considered in terms of their impact on the dimensions of quality of life. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at (10.1186/s12888-021-03167-5). BioMed Central 2021-04-13 /pmc/articles/PMC8042694/ /pubmed/33849487 http://dx.doi.org/10.1186/s12888-021-03167-5 Text en © The Author(s) 2021 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Research Article
Schmüdderich, Kathrin
Holle, Daniela
Ströbel, Armin
Holle, Bernhard
Palm, Rebecca
Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis
title Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis
title_full Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis
title_fullStr Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis
title_full_unstemmed Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis
title_short Relationship between the severity of agitation and quality of life in residents with dementia living in German nursing homes - a secondary data analysis
title_sort relationship between the severity of agitation and quality of life in residents with dementia living in german nursing homes - a secondary data analysis
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8042694/
https://www.ncbi.nlm.nih.gov/pubmed/33849487
http://dx.doi.org/10.1186/s12888-021-03167-5
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