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HEALTH RELATED QUALITY OF LIFE AMONG NURSERY HOME RESIDENTS IN TURKEY. Nezih DAGDEVIREN, Zekeriya AKTURK, Ela EKER, Figen OLUC Trakya University Faculty of Medicine, Department of Family Medicine, Edirne, TURKEY. Background. Life expectancy is increasing 1990 2000 ♂ 63 66
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HEALTH RELATED QUALITY OF LIFE AMONG NURSERY HOME RESIDENTS IN TURKEY Nezih DAGDEVIREN, Zekeriya AKTURK, Ela EKER, Figen OLUC Trakya University Faculty of Medicine, Department of Family Medicine, Edirne, TURKEY
Background • Life expectancy is increasing 1990 2000 ♂ 63 66 ♀ 68 71 Ministry of Health of Turkey(http://www.saglik.gov.tr/sb/extras/istatistikler/apk_2002/s_011.htm)
Core families are preferred 1968 1997 59.7 % 89.1 % • Population is aging 1985 2000 2025(exp) Pop. >65 4.2 % 7.8 % 13.0 % Serim Timur, 1972 http://aile.gov.tr/Arastirma15.htm http://www.aksiyon.com.tr/detay.php?id=11354
Rest homes are becoming a part of modern Turkish life !
Aim • To evaluate; • Demographic characteristics and • Health Related Quality of Life of rest home residents in Edirne
Methods • Setting: • Edirne is a city with 150.000 inhabitants • Located at the Western border • One nursery home with 102 residents • Subjects: • All residents of the nursery home in Edirne • Inclusion criteria: • All residents were pre- tested with MMS • Residents with MMS> 23 were invited • Data available: 85 persons
Methods • Research type: • Cross-sectional • Descriptive and analytic study • Research tool: • A questionnaire with demographic issues • RAND SF-36 Turkish version
Findings • Mean age: • 74.21 8.12 years (min: 51, max. 96) • Sex: • 68 (80%) males and 17 (20%) females • Social security status: • 61.2 % covered • 38.8 % uncovered (Current data for whole Turkey: 85 % covered) Ministry of Health Turkey Health Project General Coordination Unit. Health Services Utilization Survey in Turkey 1995
Marital status Married: 6 Single: 23 Divorced: 15 Widowed: 41 Educational Status Illiterate: 26 Literate: 18 0-5 years: 27 6-8 years: 5 > 9 years: 9 Findings (cont.)
Findings (cont.) • Duration of stay in the nursery home: Median 5 years • Being visited by relatives: • No: 38 44,7 % • Yes: 47 55,3 % • Being supported by family • No: 58 68,2 % • Yes: 27 31,8 %
Mean SF-36 scores Subscale Score Physical functioning 59,58±34,16 Role limitations due to physical health 70.00±44.29 Role limitations due to emotional health 68.63±45.82 Bodily pain 68.41±32.31 Social functioning78.97±22.67 Mental health 63.15±19.37 Vitality48.52±11.41 General health perception 53.71±19.66
Education vs. SF36 subscale scores • One-way Anova: Illiter. Liter. 0-5 6-8 >=9 F p Vitality 45.4 51.7 48.0 48.0 53.3 1.27 0.29 Mental health 60.2 76.9 60.0 60.0 58.2 3.20 0.02 General health 45.0 65.6 53.1 55.0 56.1 3.28 0.02 • Kruskal-Wallis: Illiter. Liter. 0-5 6-8 >=9 χ2 p Phys. func. 50 85 80 85 50 8.34 0.08 Role lim.PH 100 100 100 100 100 5.74 0.22 Role lim EH 100 100 100 100 100 5.20 0.27 Bodily pain 45 95 80 100 100 11.90 0.02 Social func. 81.3 100 75 87.5 87.5 3.15 0.53
Presence of Social Security vs. SF36 subscale scores • One-way Anova: Mean S.S. (+) S.S. (-) F p Vitality 49.2 47.4 0.50 0.48 Mental health 62.2 64.7 0.35 0.55 General health 57.2 48.2 4.43 0.04 • Kruskal-Wallis: Median S.S. (+) S.S. (-) χ2 p Phys. func. 80 52.5 1.98 0.16 Role lim.PH 100 100 4.34 0.04 Role lim EH 100 100 4.11 0.04 Bodily pain 57.5 80 2.53 0.11 Social func. 87.5 87.5 0.18 0.67
no significant difference in the SF-36 subscale scores with regard to: • age, • sex, • marital status, • family support, and • having visitors
Conclusion • Turkish rest home consumers are relatively young • USA: 33 % of men, 56 % of female residents are >85 years • Male/female: 80/20 • USA: 26/74 Rhoades JA, Krauss NA. Nursinghome trends, 1987 and 1996. Rockville(MD): Agency for Health Care Policyand Research; 1999. MEPS ChartbookNo. 3. AHCPR Pub. No. 99-0032. http://www.opm.state.ct.us/pdpd4/ltc/researcher/brief2.pdf
Lack of social security is high (39%) • USA: 19 % • Are the Turkish family bonds loosening ? • Only half of the residents are visited by their relatives; the ratio of feeling supported is even less. State of Connecticut NursingFacility Registry, September 30, 1996.
High social functioning vs. low vitality scores • Rest home is efficient as a social environment, BUT • What can be done to increase physical well being?
Literature search could not reveal any logical explanation on the significance of the multivariate statistics. • The relationship between education as well as social security and some subscales of SF-36 needs further clarification.