Philadelphia Geriatric Center morale scale in a Japanese nursing home for the elderly

In Japan, nursing homes for the elderly are operated under the Elderly Persons’ Welfare Law. According to a 2002 Social Welfare Facilities Survey, 63 780 residents were living in nursing homes for the elderly in Japan. However, little information about the well-being of residents living in the homes has been reported so far. We interviewed nursing-home residents about their basic activities of daily living (ADL), cognitive impairment, depression and quality of life (QOL). Their basic ADL and cognitive impairment were assessed using the Barthel Index and Mini-Mental State Examination (MMSE). 1,2 The degree of depressive mood was assessed by a shortened version of the Geriatric Depression Scale (GDS-15). 3 QOL was evaluated by the Philadelphia Geriatric Center (PGC) morale scale. 4 Scores on the revised PGC morale scale were also calculated for comparison with previously reported results. 5 In addition, the residents were asked about their families and preference for some activities of life. Fifty residents in a municipal nursing home for the elderly were asked to participate. Data were collected from interviews with 44 residents; five of the other residents were absent at the time of interview and one declined to participate. The mean age of participants was 82.3 ± 6.2 SD, and 76.7% were female. The mean Barthel Index and MMSE scores were 18.7 ± 2.4 SD/20 and 23.2 ± 5.8 SD, respectively. The mean GDS-15 score of all patients was 6.7 ± 3.4 SD, and 47.7% of the patients scored above six. The mean score on the PGC morale scale was 12.8 ± 3.8 SD, and that on the revised PGC morale scale was 10.0 ± 3.3 SD. Table 1 shows the Pearson’s correlation coefficients among age, Barthel Index, MMSE, GDS-15 and the PGC morale scale. The PGC morale scale score correlated significantly with the Barthel Index and GDS-15 scores, but not with the MMSE score. Twenty percent of the residents had children, and 32% of them had grandchildren. Eleven percent of the interviewed residents had a living brother or sister. Only one resident had a spouse at the time of the interview. PGC morale scale scores did not differ significantly between residents who did or did not have children, grandchildren or siblings. The rates of the participants who prefer each activity and the contributions of their preferences to the PGC morale scale are shown in Table 2. Watching TV and listening to the radio were the most commonly enjoyed activities. There was no significant difference in the PGC morale scale scores between residents who enjoyed these activities and those who did not. Although the PGC morale scale has been used in many studies as an index to assess overall satisfaction of life, there are only a few articles in Japanese reporting on the PGC morale scale of residents living in nursing homes for the elderly (Asano & Tniguchi 1981; Hamada 1997; Shibuya & Mizutani 2001). The overall mean PGC morale scale score in the above three reports was 13.5 ( n = 464), being slightly higher than the results of this study. The mean score on the revised PGC morale scale was comparable to the score of 10.0 observed among the Japanese elderly living in a special nursing home, 6 but it was lower than the scores observed among community-dwelling elderly in other reports (in Maeda et al . , 5 Yasunaga et al . , 7 Nagata et al . 8 and Fukuda et al . 9