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Factors that Influence Quality of Life from the Perspective of People with Dementia Open Access


Other title
Influencing Factor
Logistic Regression
Resident Assessment Instrument
Alzheimer Disease
Quality of Life
Systematic Review
Type of item
Degree grantor
University of Alberta
Author or creator
O'Rourke, Hannah M
Supervisor and department
Duggleby, Wendy (Faculty of Nursing)
Fraser, Kimberly D (Faculty of Nursing)
Examining committee member and department
Slaughter, Susan (Faculty of Nursing)
Molzahn, Anita (Faculty of Nursing)
Sales, Anne (School of Nursing)
Venturato, Lorraine (Faculty of Nursing)
Keating, Norah (Human Ecology)
Faculty of Nursing

Date accepted
Graduation date
Doctor of Philosophy
Degree level
Background: The prevalence of dementia, a progressive and incurable condition that affects memory and daily function, is increasing worldwide. The perspective of people with dementia can be captured to better understand which factors impact quality of life for this particular population. Such factors can then be used to guide future research to improve quality of life for people with dementia, even as troubling symptoms like memory loss progress. Purpose: The purpose of this dissertation is to identify factors that influence quality of life from the perspective of people with dementia. Methods: The dissertation consists of four related and sequential papers: (1) a conceptual paper to assess the extent to which the perspective of people with dementia has been included to assess and conceptualize quality of life in the quantitative dementia-specific literature, (2) a systematic literature review and metasynthesis of qualitative evidence to identify factors that influence quality of life according to people with dementia, (3) a methods paper describing how metasyntheses findings were applied to design a quantitative study, and (4) a cross-sectional, quantitative, correlational study to test the association between perceived conflict and sadness (a proposed influencing factor and outcome of poor quality of life, respectively). Findings and Conclusions: Two important limitations of previous research to understand quality of life from the perspective of people with dementia were identified. First, existing quantitative literature was inconsistent with a subjective definition of quality of life because researchers neglected to conceptualize quality of life from the perspective of people with dementia. Second, the body of existing qualitative research had not been considered collectively, nor had it informed quantitative research. In this dissertation, these limitations were addressed by applying knowledge from the body of qualitative research as a whole to design a quantitative study that was consistent with a subjective definition of quality of life. The findings demonstrated that people with dementia could contribute meaningfully to advance knowledge about factors that impact quality of life in this population. The four factors that influenced quality of life from the perspective of people with dementia included Relationships, Sense of Place, Wellness Perspective, and Agency in Life Today. Further exploration of the Relationships factor generated evidence in support of the proposed association between conflict and sadness, and highlighted that conflict with family and friends may have a particularly negative impact on people with moderate and severe dementia living in long-term care. The factors identified in this dissertation were each complex, but potentially modifiable and useful to generate further research questions and hypotheses that reflect the priorities of people with dementia. Given these four factors, the roles and responsibilities of health care providers may need to be re-considered in order to optimize quality of life for people with dementia.
Permission is hereby granted to the University of Alberta Libraries to reproduce single copies of this thesis and to lend or sell such copies for private, scholarly or scientific research purposes only. Where the thesis is converted to, or otherwise made available in digital form, the University of Alberta will advise potential users of the thesis of these terms. The author reserves all other publication and other rights in association with the copyright in the thesis and, except as herein before provided, neither the thesis nor any substantial portion thereof may be printed or otherwise reproduced in any material form whatsoever without the author's prior written permission.
Citation for previous publication
O'Rourke, H. M., Duggleby, W., Fraser, K. D. & Jerke, L. Factors that influence quality of life from the perspective of people with dementia: A metasynthesis. Journal of the American Geriatrics Society (in press).

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