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The association of perceived conflict with sadness for long-term care residents with moderate and severe dementia / H. M. O'Rourke; K. D. Fraser; W. Duggleby; N. Keating; Norah Keating
Swansea University Author: Norah, Keating
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Objectives: Research into the lived experiences of long-term care residents with dementia hasidentified perceived conflict, and its impact on sadness, as priorities for quality of life from theperspectives of people with dementia. However, whether and to what extent perceived conflictand sadness are...
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Objectives: Research into the lived experiences of long-term care residents with dementia hasidentified perceived conflict, and its impact on sadness, as priorities for quality of life from theperspectives of people with dementia. However, whether and to what extent perceived conflictand sadness are associated has not been previously tested in this population. This study tested theassociations between perceived conflicts with staff, family or friends and co-residents and theirexperience of sadness, and whether cognitive impairment or functional dependence modifiedthese associations.Methods: The study design was cross-sectional, correlational retrospective. Participants were5001 residents of 613 long-term care facilities in Ontario, Canada with moderate and severedementia. Clinical administrative data collected from 2012 to 2013 using the Resident AssessmentInstrument 2.0 were used to measure the person’s perception of conflicts with family/friends,staff, or co-residents, as well as verbal and non-verbal indicators of sadness. Hypotheses weretested using logistic regression, with cluster correction.Results: Sadness (adjusting for age, sex, family/friend contact, pain, cognitive impairment, andfunctional dependence) was positively associated with perceived conflicts with family or friends(OR 1.91; 95% CI 1.26–2.88; p¼0.002) and staff (OR 1.51; 95% CI 1.07–2.13; p¼0.020). Theseassociations did not differ depending on the level of cognitive impairment or functionaldependence. The association between co-resident conflict and sadness was statisticallysignificant for people with moderate (OR 2.02; 95% CI 1.45–2.82; p<0.001) but not for thosewith severe dementia (OR 1.18; 95% CI 0.72–1.91; p¼0.511).Conclusion: Long-term care residents with dementia who perceive conflict with others requiresupport to maintain high quality relationships, particularly with family and friends. Future researchshould rigorously assess the modifiability of perceived conflict for people with moderate andsevere dementia, and whether interventions to ameliorate perceived conflict result in decreasedsadness and improved quality of life.
relationships, mood, dementia, quality of life, Resident Assessment Instrument
College of Human and Health Sciences