Behavioral and emotional quality of life of patients undergoing inpatient geriatric rehabilitation.

PURPOSE: In the context of geriatric rehabilitation, 2 quality of life (QoL) facets are of particular importance: a behavioral, more objective facet, and an emotional, more subjective facet. This study looked at changes in these 2 QoL facets during rehabilitation, their relationship to each other and potential mediating processes. DESIGN: Ninety-two geriatric patients were assessed by the geriatric assessment and a structured face-to-face interview at admission to and discharge from an inpatient geriatric rehabilitation ward. Behavioral QoL was measured in terms of independence in the activities of daily living and mobile abilities, while positive and negative affect represented emotional QoL. As potential mediators, self-perceptions of health (self-rated health, subjective pain, temporal health comparison) were assessed. Statistical analysis comprised repeated-measures (multivariate) analyses of variance as well as regression and mediation analyses based upon a fixed effects-panel model. RESULTS: All behavioral and emotional QoL indicators showed significant prepost improvements. During rehabilitation, changes in behavioral QoL were significantly related to changes in emotional QoL. Multiple regression of changes in emotional QoL on changes in behavioral QoL and in self-perceptions of health revealed, however, that only health perceptions significantly predicted emotional QoL. Mediation analysis showed that self-perceptions of health fully mediated the relationship between behavioral and emotional QoL outcomes. CONCLUSIONS: During geriatric rehabilitation, significant progress can be made regarding QoL. The results indicate that the influence of physical progress on affective improvements is conveyed through self-perceptions of health, showing the importance of self-perceptions of health for emotional QoL in geriatric rehabilitation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Subjective well-being of geriatric patients during and after inpatient geriatric rehabilitation: a biopsychosocial prediction model.

PURPOSE: The study focused on indicators of subjective well-being (SWB) and how they developed during and after geriatric rehabilitation. Furthermore, a biopsychosocial prediction model for longer-term SWB was tested. METHODS: Patients of an inpatient geriatric rehabilitation unit were assessed at admission, discharge and a three-month follow-up. Indicators of SWB comprised affect, life satisfaction, valuation of life and autonomy. Further, biomedical and psychosocial variables assessed upon admission were used to predict SWB at follow-up. Statistical analysis included repeated-measures (M)ANOVA depicting SWB development over time with Cohen's d for effect size, along with canonical correlation analyses used to test the biopsychosocial prediction model. RESULTS: 78 out of 122 patients were assessed three times. Across all measurement points, different change patterns among SWB indicators were detected: Positive affect was significantly higher at follow-up than at admission (mean difference (MD) = .28, p < .01, Cohen's d = .37). Negative affect declined during rehabilitation (MD = - .29, p < .01, Cohen's d = .40) but increased again until follow-up (MD = .31, p < .01, Cohen's d = .42). Life satisfaction and valuation of life showed no change over time, while experience of autonomy gradually worsened from admission until follow-up (MD = - .29, p < .05, Cohen's d = .32). The biopsychosocial model revealed that personality traits and control beliefs best predicted SWB at follow-up. CONCLUSIONS: Although geriatric rehabilitation has a positive effect on affect, it does not consistently improve other SWB indicators. Moreover, paying attention to psychological parameters such as personality in the daily geriatric routine could help to identify patients for whom longer-term SWB is particularly at risk.