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Broj 2 Zagreb UDC 61 • AMCREF 74 (2) 113-208 (2020) ISSN 1330-0164 AMC65-1 korice.indd 1 31.3.2011 15:24:09 ACTA MEDICA CROATICA GLASILO AKADEMIJE MEDICINSKIH ZNANOSTI HRVATSKE Journal of the Academy of Medical Sciences of Croatia Urednik – Editor-in-Chief PETAR KES Pomoćnik urednika – Editorial Assistant ILIJA KUZMAN Tajnik – Secretary NIKOLA JANKOVIĆ Tehnička urednica – Technical Editor DUNJA BERITIĆ-STAHULJAK Urednički odbor – Section Editors Iva Alajbeg, Marko Banić, Nikolina Bašić Jukić, Josip Čulig, Iva Dekaris, Marko Duvnjak, Josip Djelmiš, Alenka Gagro, Josipa Kern, Dragutin Košuta, Ratko Matijević, Jasminka Peršec, Sanjin Rački, Zvonko Rumboldt, Adriana Vince Predsjednik Uredničkog savjeta – Chief Council JASNA LIPOZENČIĆ Počasna urednica – Honorary Editor NASTJA KUČIŠEC TEPEŠ Urednički savjet – Editorial Council Mladen Belicza (Zagreb), Theodor Dürrigl (Zagreb), Davorin Djanić (Slavonski Brod), Željko Grabarević (Zagreb), Olga Jelić (Slavonski Brod), Tatjana Jeren (Zagreb), Vjekoslav Jerolimov (Zagreb), Anica Jušić (Zagreb), Eduard Klain (Zagreb), Vasilije Nikolić (Zagreb), M. William Novick (Memphis), Vlado Oberiter (Zagreb), Mladen Pavlović (Zagreb), Momir H. Polenaković (Skopje), Kristina Potočki (Zagreb), Senija Rašić (Sarajevo), Željko Reiner (Zagreb), Johannes Ring (München), Daniel Rukavina (Rijeka), Antun Tucak (Osijek), Ivan Urlić (Split), Melita Valentić-Peruzović (Zagreb), John Wallwork (Cambridge), Ljiljana Zergollern-Čupak (Zagreb), Željko Zupančić (Zagreb) Lektor – Language Editor Antonija Redovniković Omotna stranica – Cover designed Ivan Picelj Adresa Uredništva – Address of the Editorial Board ACTA MEDICA CROATICA Akademija medicinskih znanosti Hrvatske Praška 2/III, 10000 Zagreb, Hrvatska Tel/fax: +385 1 46 40 589; E-mail: [email protected] Web: www.amzh.hr Časopis se tiska četiri puta godišnje. Prigodno se mogu publicirati tematski brojevi i suplementi. The Journal is published four times a year. Conveniently may be publish supplements. Naručuje se neposredno od Uredništva. Godišnja pretplata u zemlji iznosi za ustanove 350 kn, za pojedince 150 kn, a uplaćuje se na račun IBAN: HR5423600001101481831 pri Zagrebačkoj banci. Orders can be placed directly to our Editorial Offi ce. The annual subscription outside Croatia is US $150 to be paid to our bank account Akademija medicinskih znanosti Hrvatske, Privredna banka Zagreb d.d., Radnicka cesta 50, 10000 Zagreb, Croatia, SWIFT PBZGHR2X IBAN: HR6323400091110089793 (for Acta Medica Croatica). Tisak – Print: Gradska tiskara Osijek d.d., 31000 Osijek, Croatia Tiska se u 500 primjeraka - Printed in 500 copies Tiskanje časopisa potpomognuto je fi nancijskim sredstvima Ministarstva znanosti i tehnologije RH. The printing of the Journal is subsidized by the Ministry of Science and Technology of the Republic of Croatia acta medica croatica Časopis Akademije medicinskih znanosti Hrvatske Acta Med Croatica • Vol. 74 Br. 2 • Str. 113-208 • Zagreb, lipanj 2020. The Journal of the Academy of Medical Sciences of Croatia Indexed/abstracted in: SCOPUS Biosis Previews Cancerlit Embase/Excerpta Medica Health Planning and Administration Toxline EBSCO Acta Med Croatica, 74 (2020) 115-124 Original Paper SELF-ASSESSED QUALITY OF LIFE (QOL) OF RESIDENTS RECEIVING LEVEL 2 AND LEVEL 3 SOCIAL SERVICES IN COUNTY-OWNED NURSING HOMES IN THE CITY OF ZAGREB ZRINKA MACH1*, NADA TOMASOVIĆ MRČELA1,2,3* and BRANKO KOLARIĆ2,4,5 1Alma Mater Europaea – ECM, Slovenia; 2Department of Public Health Gerontology, Andrija Štampar Teaching Institute of Public Health, Zagreb, Croatia; 3University Department of Health Studies, University of Split, Split, Croatia; 4School of Medicine, University of Rijeka, Rijeka, Croatia; 5Academy of Medical Sciences of Croatia, Zagreb, Croatia * These authors contributed equally to the paper. The aim was to analyze whether there is signifi cant difference in self-assessment of the examined domains of the quality of life in residents receiving level 2 and level 3 social services in county-owned nursing homes in the City of Zagreb. This analytical cross-sectional survey was conducted successively (2018-2019) in 3 county-owned nursing homes in Zagreb including residents from nursing homes with levels 2 and 3 social services. The Quality of Life Scales for Nursing Home Residents 2001 test was used to examine the self-assessed quality of life in 92 residents aged ≥65, while Barthel Index modifi ed by Shah, Vanclay and Cooper (MBI) was used to assess their functional independence. General sociodemographic variables were used including the level of social services provided. Study results showed that the self-assessed domains of functional competence (Z=5.050), privacy (Z=4.687), meaningful activity (Z=4.632), interpersonal relationships (Z=3.394), autonomy (Z=3.352) and individuality (Z=3.755) (p<0.001 all) were signifi cantly higher among residents receiving level 2 versus level 3 social services. Self-assessed quality of life (N=92) showed the lowest level in the domain of food enjoyment (Me=11.40; IQR=9.02-11.40). In conclusion, difference in the examined domains of self-assessed quality of life between level 2 and level 3 users of social services in nursing homes guides the gerontologic multidisciplinary team in selecting interventions that can contribute to improving the quality of life of the elderly, especially the functionally dependent ones who need help of others in all areas of functioning (level 3 social services). The self-assessed quality of life of residents receiving level 2 and level 3 social services showed the lowest level in the domain of food enjoyment, which indicates the need for interventions in the implementation gerontologic nutritional standards and menus in nursing homes. Key words: functional independence, nursing homes, quality of life self-assessment, the elderly Address for correspondence: Zrinka Mach, MSc, mag. soc. geront. Alma Mater Europaea – ECM Slovenia Slovenska 17 2000 Maribor, Slovenia E-mail: [email protected] INTRODUCTION ability of the elderly to perform basic activities of daily living (ADL) in their home is a signifi cant predictor of Th ere are numerous specifi c qualities in the elderly their dependence on someone else’s care, placement in population, which undoubtedly aff ect the self-assess- the nursing home, and death (6,7). ment of their quality of life (QOL) (1). Resources pro- vided by society for the elderly who are functionally Changes resulting from moving into a nursing home disabled or who are unable to live independently (2), are noticed in social interactions and adaptation to do- namely home care and residential care, are particularly mains that include privacy, dignity and independence important. Loss of functional independence is a factor (8). Satisfaction with the examined domains of elderly associated with greater dependency of the elderly on people’s quality of life is connected with age, gender, help from others and on health care (3), and is one of number of health problems, and level of functional in- the main reasons for leaving their homes (4,5). Th e in- dependence (9-11). Personal perception of the QOL 115 Z. Mach, N. Tomasović Mrčela, B. Kolarić Self-assessed quality of life (QOL) of residents receiving level 2 and level 3 social services in county-owned nursing homes in the City of Zagreb • Acta Med Croatica, 74 (2020) 115-124 of the elderly is also infl uenced by cultural context, on minimum conditions for the provision of social personal goals, social network, interpersonal relation- services by the Ministry of Demographics, Family, ships (12-14), and many other factors. Youth and Social Policy (26). Th e phenomenon of aging is undoubtedly connected Th erefore, the main aim was to investigate whether to the QOL of the elderly individual, and research in- there is a signifi cant diff erence in the self-reported dicates the importance of age structure factors or gen- domains of the QOL of benefi ciaries receiving level 2 der diff erentiation as, for example, in nursing homes, versus level 3 social services in county-owned nursing men and younger old people oft en report better health homes in the City of Zagreb. and quality of life (15). Likewise, the results of some studies showed positive correlation between QOL and Our research covered self-assessment of the QOL of increasing age, and older age was associated with bet- nursing home residents who are partially dependent ter self-assessment of QOL in elderly day care centre on the help of another person to take care of their ba- (16). Research indicates that lower levels of functional sic needs (level 2) versus those who are functionally independence for elderly are associated with poorer dependent on another person to take care of all their self-assessment of their QOL (10,11). On the other needs (level 3). Th is would improve and balance the hand, it has been noticed that elderly people with low- quality of care in nursing homes for the elderly with er levels of functional independence who lived in their diff erent needs. homes rated their QOL better than elderly nursing home residents with higher levels of functional inde- PARTICIPANTS AND METHODS pendence (17). Analytical cross-sectional survey study was carried out Likewise, research on the QOL of elderly people in successively in 3 county-owned nursing homes in Za- nursing homes around the world indicates that wom- greb (Dubrava, Ksaver and Sv. Josip Nursing Homes) en have lower QOL than men (15,18,19). Th is may be in the period from 2018 to 2019. Th is survey
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