Assessing the well-being of residents in nursing facilities

A scoping review of well-being measures: conceptualisation and scales for overall well-being

This study aims to identify the conceptualisation of overall well-being used for well-being assessment through a review of the characteristics and key components and/or dimensions of well-being scales as presented in current literature. Scopus and Web of Science were searched, and thematic analysis was conducted inductively to analyse the identified components within scales, as well as the types of well-being these scales measure. 107 peer-reviewed articles from 2003 to 2022 were included, and 69 well-being scales were identified covering nine areas of well-being. Four final themes were identified as the foundational dimensions of overall well-being: hedonic; eudaimonic; physical health; and generic happiness. Notably, these 69 scales are mainly validated and adopted in the Western context. '4 + N' frameworks of overall well-being are recommended for assessing overall well-being. This review provides researchers with a synthesis of what types of well-being have been measured and which measures have been used to assess these types of well-being for which research participants. Non-Western-based well-being research is called for that incorporates a broader range of research participants and cultural contexts in contributing to a more inclusive understanding of well-being.

Cognitive, physical and emotional determinants of activities of daily living in nursing home residents-a cross-sectional study within the PROCARE-project

BACKGROUND

Interdependencies of health, fitness, cognition, and emotion can promote or inhibit mobility. This study aimed to analyse pathways and interactions between individual subjective and objective physical performance, cognition, and emotions with activities of daily living (ADLs) as mobility indicators in multimorbid nursing home residents.

METHODS

The study included n = 448 (77.1% females, age = 84.1 ± 7.8 years) nursing home residents. To describe the participant's demographics, frailty, number of falls, and participating institutions' socioeconomic status (SES) were assessed. ADLs were measured with the Barthel Index (BI; dependent variable). Independent variables included objective physical performance, subjective physical performance, cognition, and emotions. A structural equation model (SEM) with maximum likelihood estimation was conducted with AMOS. Direct and indirect effects were estimated using standardized coefficients (significance level of 0.05).

RESULTS

Indices showed (Chi2(148) = 217, PCMIN/DF = 1.47; p < .001; Comparative Fit Index = .940; Tucker Lewes Index = .902, RMSEA = .033) that the model fitted the data adequately. While there was no direct association between emotions, subjective physical performance, and ADLs, objective physical performance and cognition predicted higher ADLs (p < .01). Emotions had a strong relationship with subjective physical performance, and cognition had a moderate relationship with objective physical performance.

DISCUSSION AND CONCLUSION

Objective performance and cognition predicted higher functional status, as expressed by higher BI scores. ADLs, such as mobility, dressing, or handling tasks, require motor and cognitive performance. Subjective performance is an important predictor of ADLs and is only partly explained by objective performance, but to a large extent also by emotions. Therefore, future interventions for nursing home residents should take a holistic approach that focuses not only on promoting objective physical and cognitive performance but also on emotions and perceived physical performance.

TRIAL REGISTRATION

Trial registration number: DRKS00014957.