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Title: Generating a model of quality of life for older nursing home residents in the Lebanon : a grounded theory study
Author: Adra, Marina
ISNI:       0000 0004 2740 4611
Awarding Body: University of Manchester
Current Institution: University of Manchester
Date of Award: 2013
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Background: Over the past two decades, the growing number of older people in the Lebanon, the advances in medical technology, and the changing family patterns of support have combined together to increase access to long-term care facilities for older people. Lebanon, like other developing countries, still needs to define the policies and programs that will reduce the burden of an ageing population on its society and economy. Moreover, there is a need to ensure the availability of health and social services for older people and to promote the older person‟s continuing participation in a socially and economically productive life in long-term care institutions. Whilst quality of life is a meaningful expression in the Lebanon, it remains a sophisticated and complex construct and it provokes considerable debate about its constituent parts. This study contributes to the debate by presenting a model of factors determining quality of life for older people residing in two Lebanese nursing homes. This grounded theory is built on the analysis of data collected in interviews with older residents, staff members and family carers with the aim of exploring the meaning of quality of life in the nursing home setting from different contexts.Aims and Objectives: The overall aim of this study is to explore the perceptions, perspectives and meaning of quality of life for a theoretical sample of older people living in Lebanese nursing homes, care staff and family carers and to produce an explanatory theoretical model of experience using the classic approach to generating grounded theory. The research objectives were to: identify factors that older people living in nursing homes believe constitute a meaningful and good quality of life; identify the role of the staff employed by nursing homes in helping to support quality of life; and identify the meaning that families attach to quality of life and how this is constructed. Results: Constant comparative analysis of data generated from the three groups of participants led to the emergence of three interrelated sub-core categories: “maintaining self” for older residents, “maintaining identity” for staff members, and “maintaining continuity” for family carers. Each of these sub-core categories consisted of either three or four properties/phases to explain the experience of the older resident, the staff member, and the family carer in their trajectory towards achieving and sustaining quality of life. Following a theoretical integration, the three sets of sub-core categories were conceptually connected through the linking scheme of “maintaining interrelationships”. Transcending the data, and by increasing theoretical sensitivity, the core category of “relating” emerged to explain the dynamics of quality of life. “Relating” was also found to have temporal dimensions that worked on sustaining, restoring, and creating interrelationships, processes that had the „fit and grab‟ necessary to shed new light on the meaning of quality of life for all participants. Conclusion: This study is one of the few that has explicitly explored quality of life in nursing homes from the perspectives of all the key actors. As such it has made an important contribution to the literature particularly in recognising the role of “relating” and “maintaining interrelationships” in enhancing quality of life in nursing homes in the Lebanon. The contribution of the substantive grounded theory emerging from this study is not solely restricted to helping interpret the everyday experience of quality of life, but also includes implications for policy and practice.
Supervisor: Hopton, John; Keady, John Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available