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Objectives: To determine the relationship between quality of life (QOL) and environmental factors of temperature, noise, and lighting in nursing home residents with severe dementia., Design: Cross-sectional, observational, analytical., Setting: Eight public, long-term care nursing homes in the province of Girona, Spain., Participants: Random sample of 160 nursing home residents with severe dementia., Measurements: Functional and cognitive impairment, pain, neuropsychiatric disturbances, and QOL were determined using standardized instruments. Temperature, noise, and lighting in bedrooms, dining rooms, and living rooms were measured in the morning and afternoon using a multifunction environment meter in a standardized manner., Results: Adjusted multivariate linear regression models demonstrated that environmental measures were independently associated with QOL and related factors. High temperature in the bedroom was associated with lower QOL (standardized β = 0.184), high noise levels in the living room were associated with low behavioral signs of social interactions (β = 0.196), and low lighting levels in the bedroom were associated with number of signs of negative affective mood (β = -0.135)., Conclusion: The QOL of nursing home residents with severe dementia was related to environmental factors such as temperature, noise, and lighting. The monitoring of these environmental factors may improve these individuals' QOL., (© 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.)

Purpose: The aim of the study was to develop a cross-cultural adaptation and to evaluate the validity and reliability of a Spanish version of the Quality of Life in Late-Stage Dementia (QUALID) scale., Methods: Observational and cross-sectional validation study. The QUALID was translated according to standardised procedures. Internal consistency was assessed using Cronbach's alpha. The QUALID structure was assessed using a Principal Component Analysis (PCA). Inter-respondent (one rater asking two respondents) and inter-rater (two raters asking one respondent) reliability was assessed using the Intraclass Correlation Coefficient (ICC). The criterion validity (concurrent) was assessed by Spearman's correlation between the QUALID score and the QoL-Visual Analogue Scale (QoL-VAS) score. The construct validity (convergent) was assessed by Spearman's correlations between QUALID score and scores on the Pain-Visual Analogue Scale (Pain-VAS), on the Mini-Mental State Examination (MMSE) and on the Neuropsychiatric Inventory-Nursing Home (NPI-NH)., Results: A total of 160 elderly residents and 152 respondents at 8 long-term care centres in the province of Girona (Spain) participated in the study. Results showed satisfactory levels of internal consistency (Cronbach's alpha coefficients 0.74) and evidenced the multidimensionality of the scale. Three factors were identified (behavioural signs of discomfort, behavioural signs of social interaction and signs of negative affective mood). Acceptable inter-respondent reliability (ICC = 0.74) and high inter-rater reliability (ICC = 0.95) were found. The QUALID score was associated with the QoL-VAS score, suggesting a good concurrent criterion validity, and also with the Pain-VAS, the MMSE and the NPI-NH scores, suggesting good construct validity., Conclusions: Our evaluation of the psychometric properties of the Spanish version of the QUALID indicates that it is a reliable and valid instrument with an adequate capacity to distinguish between different clinical status.