China has 9 million elderly individuals with dementia, which places it first in the world. Although family care remains the major source of support for people with dementia, residential care has become an indispensable choice in recent years. The biggest concern is the quality of life of the elderly with cognitive impairment or dementia (QOL-ECI) in residential care facilities (RCFs). Previous studies have explored many individual-level factors associated with QOL-ECI; however, less discussion has been conducted on how to improve it from an organizational-level perspective. China serves as a good research setting for this issue. The present study aims to establish an organizational-level framework to investigate QOL-ECI in RCFs. The Person-centered Care (PCC) Approach serves as an organizational strategy, and the High Commitment Work System (HCWS) is used as a human resource management practice. The study exposes the QOL-ECI status of RCFs in Xi’an China; and examines the relationship between PCC/HCWS and QOL-ECI respectively and jointly. A quantitative research method, survey in particular has been designed to achieve the research objectives, and has been conducted in two phases. Phase one of the study aims to validate a Chinese Version of the Person-centered care Assessment Tool (P-CATC), which is designed to measure the extent to which formal caregivers rate their facility as being person-centered. The resulting 24-item P-CAT-C is validated among a sample of full-time employees (n=330) in all 34 RCFs in urban Xi’an, a city in China. Phase two is a survey conducted among the same 34 RCFs. Full-time employees (n=330) evaluated the HCWS level for each RCF; residents with cognitive impairment (n=307) and their respective personal care workers (n=207) were invited to evaluate QOL-ECI. Hierarchical Linear Modeling (HLM) has been adopted to test the hypothesis. In phase one study, Confirmatory Factor Analysis (CFA) shows that a three-factor 15-item solution of the P-CAT-C provided adequate fit indices to the data (χ2 = 145.69, df = 81, p< 0.001, CFI = 0.93, TLI=0.91; RMSEA = 0.05). The internal consistency coefficient (Cronbach’s α=0.68) is satisfactory. The inter scale correlation shows good construct validity. The result of Phase two study shows that the total mean patient-rated QOL-ECI score is 36.06 (SD=8.16) and the caregiver-rated score is 34.09 (SD=6.88). Using caregiver-rated QOL-ECI as the dependent variable, the HLM regression analysis shows that PCC and HCWS are statistically significant with QOL-ECI respectively, and that the HCWS has a positive moderate effect on the relationship between PCC and QOL-ECI. Using patient-rated QOL-ECI as the dependent variable, the hypotheses are partially supported. This study is among the first to report the QOL-ECI status of RCFs in China. It initially demonstrates that PCC and HCWS are positively associated with QOL-ECI both respectively and jointly. It also primarily establishes an organizational-level framework to examine QOL-ECI. This will generate valuable implications and insight into research, practice and policy-making. Finally, this study further develops the PCC theory from an organizational perspective, and contributes to both management and social work literature by first adopting the HCWS for service organizations for the elderly. / published_or_final_version / Social Work and Social Administration / Doctoral / Doctor of Philosophy

Thesis (M. Med. Sc.)--University of Hong Kong, 2007.

Thesis (M.A.)--Eastern Illinois University, 2005. / Includes bibliographical references (leaves 46-52).

Thesis (M.A.)--Eastern Illinois University, 2005. / Includes bibliographical references (leaves 46-52). Also available online (PDF file) by a subscription to the set or by purchasing the individual file.

Thesis (M.A.)--Eastern Illinois University, 2005. / Includes bibliographical references (leaves 46-52).

Thesis (Ph. D.)--University of North Texas, Aug., 2009. / Title from title page display. Includes bibliographical references.

Thesis (Ph. D.)--University of North Texas, Aug., 2009. / Title from title page display. Includes bibliographical references.

The purpose of the study was to validate the use of the Geriatric Functional Rating Scale (GFRS) in assessing cognitively impaired individuals 65 years of age and older to determine the need for institutionalization. The population of interest consisted of individuals 65 years of age and older exhibiting cognitive impairment and residing in Delaware County, Indiana. A nonrandomized two-group experimental design was utilized for the study. Eighty subjects were selected from two subpopulations consisting of 40 institutionalized and 40 noninstitutionalized elderly.Two geriatric assessment tools were used for the study, the Mental Status Questionnaire (MSQ) and the Geriatric Functional Rating Scale (GFRS). The hypothesis for the study stated that the mean GFRS score of the noninstitutionalized subjects, the control group, would be significantly greater than the mean score of the institutionalized subjects, the experimental group.The MSQ scores as well as the means and standard deviations for the seven subscales of the GFRS were reported for the two groups. A one-tailed t-test was used to test the hypothesis. A decision with regard to the hypothesis was made at the .05 level.Findings of the study included the following:1. The subjects ranged in age from 65 to 92 years, were 90 percent female, and predominantly Protestant, 88 percent.2. The MSQ scores for the combined groups ranged from minimal cognitive impairment, 71 percent, to severe cognitive impairment, four percent.3. The total mean score on the GFRS for the institutionalized group was 6.8 indicating a need for institutionalization.4. The total score on the GFRS of the noninstitutionalized was over 10 times higher at 70.7.5. The noninstitutionalized group scored significantly higher in the GFRS (p<.00) than the institutionalized counterparts.In conclusion, the research supports the use of the Geriatric Functional Rating Scale in assessing the need for institutionalization in cognitively impaired individuals, 65 years of age and older in Delaware County, Indiana. / Department of Educational Administration and Supervision

A growing body of research suggests that substantial variability exists among cognitive abilities within individuals. This within-person variability, across cognitive domains is termed dispersion. The present study examined 304 non-demented, older adults to investigate the relationship between aging and the dispersion of cognitive functions in both a quantitative (overall levels of dispersion) and qualitative manner (patterns of dispersion). Quantitatively, higher levels of dispersion were observed in older-old adults and those identified as having suffered cognitive decline, suggesting that dispersion level may serve as a marker of cognitive integrity. Qualitatively, three distinct dispersion profiles were identified through clustering methods and found to be related to demographic, health and performance characteristics of the individuals displaying the particular profile patterns, suggesting that the patterns of dispersion may be a meaningful indicator of individual differences.

Thesis (Ph.D.)--York University, 2006. Graduate Programme in Psychology. / Typescript. Includes bibliographical references (leaves 122-152). Also available on the Internet. MODE OF ACCESS via web browser by entering the following URL: http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&res_dat=xri:pqdiss&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&rft_dat=xri:pqdiss:NR29500