Individual and institutional factors associated with the quality of life of portuguese older adults living in nursing homes

Abstract

Methods: This cross-sectional study involved 22 nursing homes from the central region of Portugal and a total of 213 institutionalized older adults aged 60 or older without cognitive impairment, selected through random cluster sampling. Participants were interviewed using a structured questionnaire to collect data on sociodemographic, lifestyle behaviours, and information related to their nursing home experience. Institutional characteristics were reported by the Technical Director of each nursing home. Multiple linear regression models were conducted to identify individual and institutional characteristics associated with QoL, controlling for potential confounders. QoL was assessed using the Portuguese version of the WHOQOL-OLD scale. Results: The mean age of participants was 84.8 years, with 67.1% being female. The average WHOQOL-OLD total score was 63.3 on a 0-100 scale. Higher levels of loneliness were associated with a decrease in the QoL score (β = −0.790; 95% confidence intervals [CI]: −0.981; −0.599). Collaborating in the institution chores (β = 7.669; 95% CI: 3.220; 12.118), monthly visits (β = 7.099; 95% CI: 2.450; 11.748), and the existence of outdoor spaces (β = 6.519; 95% CI: 2.459; 10.579) were positively associated with participants' QoL. Conclusion: QoL in nursing homes is shaped by both individual and institutional factors. Loneliness, participation in chores, family visits, and access to outdoor spaces significantly impact well-being, emphasizing the need for targeted interventions and policies to enhance the lives of institutionalized older adults.