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Title: The structure of well-being in dementia
Author: Greatorex, Barry
Awarding Body: University of Leicester
Current Institution: University of Leicester
Date of Award: 2002
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The nature and structure of the concept of well-being, both in general psychological research and in relation to dementia, is reviewed. Well-being is important in understanding subjective emotional experience and life satisfaction, and central to the concept of 'quality of life'. The research between the structure of well-being in dementia and in wider research is explored, bringing together work from the United States and Tom Kitwood's theory of dementia care. The principal hypothesis investigated relates to this body of work: specifically whether 'well-being' in people-with-dementia can be understood as one- or more than one factor. Subsidiary hypotheses concerning well-being in dementia and other variables are also investigated. Seven point rating scales were used to measure indicators of well-being used in 'Dementia Care Mapping'. A pilot study was used to develop a rater's manual, to test acceptability, and to obtain feed-back for improvements in method. A reliability study measured inter-rater reliability on fifteen indicators of well-being. Further data was gathered to produce data on ratings of indicators of well-being in 102 persons with dementia. Additional data on demographic characteristics and cognitive functioning were collected. Findings indicate that indicators of well-being in people-with-dementia can be reliably measured using observation. The research findings support a two-factor model of well-being in dementia, comprising a factor of 'Social engagement/Pleasure', and a factor of 'Negative affect vs. Relaxed calm'. These factors are uncorrelated. Investigation of subsidiary hypotheses reveals evidence of a negative correlation between cognitive impairment and the 'Social engagement/Pleasure' factor, but no correlation between cognitive impairment and 'Negative Affect'. No gender differences in factor scores are found for well-being or ill-being, although gender differences for indicators of ill-being not included in the factor analysis are found. The theoretical, service, policy and clinical implications for the above findings are discussed. Suggestions for future research are made.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (D.Clin.Psy.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available