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How do Chinese patients with dementia rate their own quality of life?

Published online by Cambridge University Press:  17 September 2007

Philip Lin Kiat Yap ,
Jenny Yen Ni Goh ,
Linda Mary Henderson ,
Pei Min Han ,
Kui Shin Ong ,
Serene Si Ling Kwek ,
Elizabeth Yi Hui Ong  and
Donus Pui Kwan Loh
Philip Lin Kiat Yap*
Affiliation:
Department of Geriatric Medicine, Alexandra Hospital, Singapore
Jenny Yen Ni Goh
Affiliation:
Department of Medical Social Service, Alexandra Hospital, Singapore
Linda Mary Henderson
Affiliation:
Department of Nursing, Alexandra Hospital, Singapore
Pei Min Han
Affiliation:
Department of Occupational Therapy, Nanyang Polytechnic School of Health Sciences, Singapore
Kui Shin Ong
Affiliation:
Department of Occupational Therapy, Nanyang Polytechnic School of Health Sciences, Singapore
Serene Si Ling Kwek
Affiliation:
Department of Occupational Therapy, Nanyang Polytechnic School of Health Sciences, Singapore
Elizabeth Yi Hui Ong
Affiliation:
Department of Occupational Therapy, Nanyang Polytechnic School of Health Sciences, Singapore
Donus Pui Kwan Loh
Affiliation:
Department of Behavioral Science, Nanyang Polytechnic School of Health Sciences, Singapore
*
Correspondence should be addressed to: Dr. Yap Lin Kiat Philip, Consultant Geriatrician, Department of Geriatric Medicine, Alexandra Hospital, Singapore159964. Phone: +65 64722000; Fax: 65 63793996. Email: philip_yap@alexhosp.com.sg.
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Abstract

Objective: This study examines the psychometric properties and clinical experience in using the Mandarin translation of the Quality of Life–Alzheimer's Disease (QoL-AD) instrument in Chinese patients with dementia in Singapore.

Methods: A Mandarin version of QoL-AD was established following standard guidelines for transcultural adaptation of QoL measures. The instrument was administered to 70 patient-carer dyads; patients with severe dementia (MMSE < 10) were excluded. Reliability by internal consistency and test-retest, and construct validity by correlating the known domains of QoL-AD with validity measures for the respective domains, was performed. Guidelines for Rating Awareness Deficits (GRAD) measured patients' insight into their deficits.

Results: Three patients were not able to complete the QoL-AD. Internal consistency (Cronbach's α) was high for both patient (0.9) and carer (0.8) QoL-AD ratings, as was test-retest reliability, intraclass correlation coefficient (ICC) 0.7 and 0.8 respectively. Correlation of QoL-AD with domain measures was moderate for carer ratings (0.21 < r < 0.51) and poor for patient (−0.17 < r < 0.13). Patient self-rated QoL correlated poorly with, and was significantly higher than, carer-rated QoL. Correlation between patient and carer QoL-AD was stronger in patients with better insight (GRAD 3–4).

Conclusions: The results suggest that while the Mandarin version of QoL-AD can be used reliably in our population, patients' self perceived QoL can be different from carer ratings and from objective QoL measures. The disparity can be attributed to patients' poor insight, denial, fear of “losing face,” normalization and accommodation of standards with aging. The patients' lack of education and seclusion from Western cultural exposure are also contributory.

Keywords

dementiaquality of lifeChinesepsychometric propertiesreliabilityvalidity
Type
Research Article
Information
International Psychogeriatrics , Volume 20 , Issue 3 , June 2008 , pp. 482 - 493
Copyright
Copyright © International Psychogeriatric Association 2007

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