Quality of Life of People with Dementia in Nursing Homes in the Netherlands: the Influence of the Intra-, Interpersonal and Organizational level
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This research aimed to investigate factors influencing quality of life (QoL) of people with dementia (PwD) living in nursing homes (NH) in the Netherlands. The factors were identified using the Socio-Ecological Model (SEM), which allowed to look at factors from different levels simultaneously. Moreover, the current study examined the influence of the location of the NH on QoL and as such contributed to the research gap. Additionally, it was examined whether amount of visits by family carer (FC) influenced QoL, and whether this relationship was moderated by rural NHs. Data collected by Trimbos Institute (2019-2020) was used to test hypotheses. Four datasets (PwD, FC, NH’s manager and care staff) were merged into one dataset. Only suitable data was used which resulted in a subset for the current study (N = 261). A multi-level regression analysis tested the predictors of QoL. Moreover, an interaction effect between amount of visits by FC and location of the NHs is included. Results from the multi-level regression analysis showed that independency on activities of daily living, amount of visits by FC, perceptions of the caregiving role by FC, small scale care, facility size and location of the NH did not significantly influence QoL of PwD. Additionally, no support was found for the interaction effect. Although relationships were congruent with previous research, no significant effects were found. Possible explanations for the unexpected outcomes were addressed. This study contributed to the research field by using an holistic approach. Future researchers are advised to expand on research on QoL according to the SEM. Moreover, it is advised to revise research design methods. Finally, as previous research identified differences in QoL of PwD by NHs’ location, it is advised that policy makers and health care professionals reconsider health care policies.