A research report submitted to the Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, in partial fulfilment of the requirements for the degree of Master of Science in Physiotherapy Johannesburg 2017 / BACKGROUND: Global life expectancy is on the rise and it is contributing to the growth of the population proportion of the elderly. More and more elderly are getting institutionalised. Functional status decline has been found to influence institutionalisation in the elderly while health-related quality of life seems to be better among the community dwelling elderly compared to the institutionalised elderly. As a result, there is increased interest on the functional status and health-related quality of life (QoL) of the institutionalised elderly. OBJECTIVES: The objectives of the study were:  to determine the demographic profile of the institutionalised elderly in Alexandra, Orange Grove and Yeoville areas of Johannesburg.  to determine the health-related quality of life and functional status of the institutionalised elderly in Alexandra, Orange Grove and Yeoville areas of Johannesburg.  to determine the relationship between functional status and health-related QoL of the institutionalised elderly in selected Johannesburg areas.  to determine the predictors of functional status and health-related QoL of the institutionalised elderly in selected Johannesburg areas. METHOD: The study utilised a cross-sectional, quantitative descriptive design. Functional status was assessed using the Physical Self Maintenance Scale (PSMS) and the Instrumental Activities of Daily Living (IADL) scale while health-related QoL was assessed using the EQ-5D-5L. The functional status and health-related QoL of the participants were assessed as a onetime event over 11 weeks. The calculated sample size was 137 participants but only 116 residents met the inclusion criteria. Questionnaires were administered individually on participants who met the study inclusion criteria after obtaining consent to get activities of daily living (ADL), IADL and health-related QoL scores. Stata version 13 was used for data analysis. RESULTS: There were 105 participants, 66 (62.86%) female and 39 (37.14%) male. The mean age was 75.2 (±8.56) years and age range being 61-98 years. The median ADL score was 5. The median IADL score for female participants was 2 while the mean IADL score for male participants was 1.95±1.70. The median EQ-5D-5L index value was 0.69. Activities of daily living (r=0.685, p<0.001) and IADL (r=0.434, p<0.006 (male); r=0.369, p<0.003 (female)) were positively correlated with health-related QoL. The correlation between health-related QoL and ADL and that between QoL and IADL were strong and moderate respectively. Independent predictors of health-related QoL were race and religion. Religion was the only independent predictor of functional status (basic ADL) for both male and all participants. There was no independent predictor of functional status (IADL) for female participants. CONCLUSION: The age range of participants was a span of four decades of life beginning from the sixth decade. Females outnumbered male participants in the ratio 1.69:1. The functional status of participants was poor (IADL) to moderate (ADL). The health-related quality of life of participants was moderate. Functional status and health-related quality of life were positively associated with strong strength. Religion and race independently predicted functional status and health-related QoL. Although the data gotten from participants’ responses were sufficient for analyses, the findings from this study cannot be generalised to all the institutionalised elderly in the selected areas in Johannesburg because the number of residents who met the study inclusion criteria and participated in the study fell short of the calculated sample size. In essence, there is the need for more studies on the functional status and health-related quality of life of the institutionalised elderly. / MT2018

Objectives: To establish the health-related quality of life (HRQOL) of survivors of critical illness as a result of trauma six months after discharge from the intensive care unit (ICU) and to determine which HRQOL measurement tool is more suitable to use in this population. To relate demographic characteristics and other outcome measures to HRQOL as reported six months after ICU discharge with the Short Form-36 (SF-36) Medical Outcomes questionnaire and EQ-5D questionnaire respectively. Methods: A retrospective cross-sectional cohort study was conducted to assess HRQOL at six months after ICU discharge for survivors of trauma who were treated with mechanical ventilation. Twenty eight (n=28) subjects were recruited from two ICUs in Johannesburg, South Africa. Health-related QOL was assessed with the SF-36 English UK version and the EQ-5D questionnaires. Demographic (age, gender) and outcome measure [Acute Physiology and Chronic Health Evaluation (APACHE) II, Injury Severity Score (ISS), ICU and hospital length of stay (LOS)] information was related to HRQOL. Results: The HRQOL reported by subjects showed limitations when measured with the EQ-5D and SF-36. EQ-5D data revealed that 50% of subjects reported some problems in mobility, 35% in self-care and 67.9% in usual activities. Furthermore, 60.7% reported some problems in pain/discomfort and 7.1% reported extreme problems in this domain. With regard to the anxiety/depression domain, 46.4% reported some problems whilst 7.1% reported extreme problems. The mean score for the EQ-5D visual analogue scale (VAS) was found to be 68 (± 26.1). Statistical significance was found in the relationships between age and EQ-VAS (p = 0.05; r = -0.4) where a moderate correlation was observed, ICU length of stay (LOS) and the mobility domain (p = 0.01), hospital LOS and the mobility domain (p = 0.04), hospital LOS and the self-care domain (p = 0.04) and the APACHE II score and the usual activities domain (p = 0.05). With respect to the HRQOL as measured with the SF-36 questionnaire, subjects were found to have not achieved optimal HRQOL in any of the domains nor with regard to the summary scores. Lowest scores were found in the role physical (RP) [44.6 (± 41.6)] and role emotional (RE) [44.1 (± 45.4)] domains. The physical component summary score (PCS) [62.1(± 27.8)] was slightly higher than the mental component summary score (MCS) [58.7(± 20.1)]. Statistical significance and a strong correlation was found in the association of age and physical functioning (PF) (p = 0.00; r = -0.6). The association between age and general health (GH) (p = 0.02; r = -0.4) yielded a moderate correlation. The same can be said about the association between age and physical component summary score (PCS) (p = 0.01; r = -0.5). PF was also significantly associated with ICU (p = 0.03; r = -0.4) and hospital (p = 0.03; r = -0.4) LOS and a moderate correlation was shown between these variables. Conclusion: At six months after ICU discharge, HRQOL for these subjects was not optimal. Age, ICU and hospital LOS seemed to be associated with limitations in HRQOL related to function while severity of illness had a lesser effect. The EQ-5D questionnaire proved to be simpler and more user-friendly in ascertaining the HRQOL of trauma survivors; however the SF-36 gave more detailed information about HRQOL. Patients who experienced trauma might benefit from a rehabilitation programme after discharge from hospital to address the functional impairments in HRQOL observed with this study.

Diss. (sammanfattning) Uppsala : Univ., 2001. / Härtill 4 uppsatser.

Thesis (M.A.)--University of Hong Kong, 1996. / Includes bibliographical references (leaf 70-73).

Thesis (M.A.)--University of Hong Kong, 1996. / Includes bibliographical references (leaf 70-73). Also available in print.

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Thesis (M.N.)--University of Sydney, 2004. / Title from title screen (viewed 6 May 2008). Submitted in fulfilment of the requirements for the degree of Master of Nursing to the Dept. of Clinical Nursing, Faculty of Nursing. Includes bibliographical references. Also available in print form.

Thesis (Ph. D.)--West Virginia University, 2008. / Title from document title page. Document formatted into pages; contains xiv, 242 p. : ill. (some col.). Includes abstract. Includes bibliographical references (p. 171-183).

Thesis (M.S.)--University of Michigan, 1991.

Thesis (M.S.)--University of Michigan, 1991.