1、本科毕业设计（论文） 外 文 翻 译 原文： Dining experience , foodservices and staffing are associated with quality of life in elderly nursing home residents Introduction Although todays nursing home residents are more functionally and cognitively impaired than they were 20 years ago (1-5), nursing homes still aim to
2、preserve and promote good quality of life for their residents, however challenging this may be. While both physical and social environmental factors, such as level of recreational activities and control over physical environment, have frequently been included in determinants of quality of life among
3、 frail elderly people (6-8), very few studies have determined whether institutional factors, such as food and nutritional services and dining experience, are associated with quality of life in LTC. Several other factors have already been identified as contributing to the quality of life of the elder
4、ly in health care institutions. For example, chronic conditions, drug consumption, functional abilities, swallowing difficulties, and nutritional status have all been linked to their quality of life (9-12). Risk of malnutrition has also been found to be associated with quality of life in older adult
5、s (10,13,14). Winzelberg et al. (9) observed a significant correlation between residents quality of life scores and their mental health status (i.e., severity of cognitive dysfunction and depression). The American Dietetic Association put forward a position paper on nutrition and aging which stipula
6、tes that, along with environmental factors, the enjoyment of food and nutritional well-being play a key part in an older adults quality of life (1). The psychological and social aspects surrounding mealtime can impact on elderly residents quality of life by influencing the pleasure of eating. Mealti
7、mes tend to give residents a sense of security, belonging, structure and order to their day. They can also give residents a sense of independence and control over daily choices (15). A potential link between residents quality of life and institutional factors, such as those related to food and dinin
8、g experience, has been indicated by some researchers (16-19). West et al. (17) found that many residents feel powerless when it comes to their surroundings, such as the liberty to choose food and dining companions. Residents in their study ranked a greater variety of foods, meals that are appetizing
9、, comfortable seating during meals, calm mealtime atmosphere and respect for food preferences as being among their top ten important food-related concerns. Similarly, Kane et al. (19) found that, when asked to rate the importance of control and choice over certain areas of their everyday nursing hom
10、e life, residents prioritized having choice and control over their food. In another study, residents quality of life seemed to improve following the introduction of a buffet-style meal service (20). This type of service included additional assistance for residents during meals and a better dining at
11、mosphere. Residents could choose from a greater variety of foods and could receive second helpings of favourite foods (20). High correlations were also found between residents quality of life and their enjoyment of food and mealtimes, and being able to receive their favourite foods (21). According t
12、o Evans et al. (22), residents could adapt better to nursing home life if their food and food service preferences were being met. Despite studies that demonstrate that food and nutrition services and dining environment are important to LTC residents, few studies have actually tested whether these fa
13、ctors are significantly related to their quality of life using a valid quality of life measurement tool. Discussion Measurement of Quality of Life Very few studies have attempted to use a single measure of quality of life for both cognitively impaired and cognitively intact seniors； yet, for researc
14、hers concerned with improving the quality of life of all LTC residents this is an extremely important issue. The QOL-D instrument was developed for use among cognitively impaired seniors, and though its internal consistency was higher in cognitively impaired residents, it did have acceptable reliabi
15、lity for use with cognitively intact residents. For cognitively impaired residents, reliability results for all three subscales were quite similar between Sloane et al.s (31) study and ours ( = .57 to .79). Unfortunately, Sloane etal. (34) did not report on the reliability of the combined QOL-D scal
16、e. Mean scores for QOL-D and its subscales were significantly higher in cognitively intact residents, which reflected their higher quality of life, especially in terms of activity levels. Two previous studies found that quality of life decreases with increasing level of cognitive impairment (9,11)；
17、however, Winzelberg et al. (9) used a modified version of the Logsdon et al.s (35) Quality of Life-Alzheimers Disease scale (QOL-AD) in their study, while Kerner et al. (11) used the Quality of Well-Being (QWB) Scale. Health and Socio-Demographics Over two-thirds of the residents in this study were
18、cognitively impaired, which is similar to percentages found by other studies with institutionalized elderly (3, 36). A significantly larger percentage of cognitively impaired residents compared to cognitively intact residents had a BMI lower than 20 (26.8% vs 9.1%). Other studies in LTC settings hav
19、e also shown that residents with dementia-related disorders are more prone to weight loss and malnutrition (3, 36). Length of stay was not significantly associated with quality of life in either cognitively intact or impaired residents, but an increase in the number of medical conditions was negativ
20、ely associated with quality of life in cognitively intact residents. There was no significant difference in types of conditions reported for cognitively intact versus impaired residents. This is somewhat surprising since different conditions should have lead to the institutionalization of both group
21、s of residents. In addition, Kempen et al. (12) also found that chronic medical conditions were negatively associated with quality of life in cognitively intact older adults in both community and institutionalized settings. Dining Experiences and Quality of Life Number of dining companions was positively associated with quality of life in
