Analysis of the degree of acceptance of illness among older adults living in a nursing home undergoing rehabilitation – an observational study

Figures & data

Figure 1 Recruitment process for the study group.

Table 1 The characteristics of the patients (N=96)

Baseline Characteristics	%
Gender
Female	81
Male	19
Age
Mean (SD)	78.5 (8.2)
Range	61-97
Education
Primary	30
Vocational	26
Secondary	30
Higher	14
Marital status
Single (widow(er), unmarried)	73
Married	27
Family care
Lack of care capacity	24
Incomplete	53
Full	23
Diagnosis
Fractura	29
Stroke	53
Chronic illness	18
Number of comorbidities
Mean (SD)	4.0 (1.7)
Range	1-8

Abbreviation: SD, standard deviation.

Table 2 The level of illness acceptance by patients at the initial and final assessments (Mann–Whitney test and Kruskal–Wallis test)

	AIS results
	n	AIS1	p	AIS2	p
		Mean (SD)		Mean (SD)
Gender
Female	78	16.4 (6.4)	0.799	23.9 (7.5)	0.617
Male	18	16.8 (6.6)		24.7 (7.3)
Diagnosis
Fracture	28	16.6 (5.8)		25.3 (8.3)
Stroke	51	15.8 (6.6)	0.367	22.4 (7.0)	0.070
Chronic illness	17	18.1 (6.5)		26.9 (6.1)
Education
Primary/vocational	54	16.6 (6.4)	0.653	24.5 (7.3)	0.391
Secondary/higher	42	16.2 (6.4)		23.4 (7.6)
Marital status
Single (widow(er), unmarried)	70	16.5 (6.1)	0.791	23.9 (7.2)	0.710
Married	26	16.5 (7.2)		24.4 (8.1)
Family care
Lack of care capacity	23	14.9 (5.9)		22.2 (7.3)
Incomplete	51	15.8 (5.8)	0.050	23.1 (7.7)	0.010
Full	22	16.9 (7.3)		28.0 (5.5)
State of cognitive function (MMSE1)
Dementia (MMSE <24)	56	14.9 (5.7)	0.006	22.7 (7.6)	0.012
No Dementia (MMSE ≥24)	40	18.7 (6.6)		26.0 (6.7)
Mood (GDS1)
No depression GDS ≤5	27	21.7 (5.9)	0.0001	28.7 (7.2)	0.0001
Depression GDS >5	69	14.4 (5.3)		22.2 (6.7)
Initial functional status (BI1)
Severe (0–20)	21	12.6 (4.3)		20.1 (6.5)
Moderate (21–85)	75	17.5 (6.4)	0.001	25.1 (7.3)	0.005
Slight	0	-		-

Abbreviations: AIS1, Acceptance of Illness Scale upon admission to the ward; AIS2, Acceptance of Illness Scale after 3 months; MMSE1, Mini Mental State Examination upon admission to the ward; GDS1, Geriatric Depression Scale upon admission to the ward; BI1, Barthel Index upon admission to the ward.

Table 3 Mean values for the tested parameters in the initial and final assessments

Variables	Initial data		Final data		Difference	Wilcoxon Test
	Mean	SD	Mean	SD		Z	p
MMSE	22.8	3.8	23.5	3.5	0.7	2.69	0.007
BI	40.3	19.6	64.2	19.4	23.9	8.39	<0.0001
GDS	7.4	3.1	4.8	3.0	−2.6	7.25	<0.0001
AIS	16.5	6.4	24.0	7.4	7.5	8.20	<0.0001

Abbreviations: MMSE, Mini Mental State Examination; BI, Barthel Index; GDS, Geriatric Depression Scale; AIS, Acceptance of Illness Scale.

Table 4 Comparison of selected factors between patients with a low or high level of illness acceptance after 3 months of rehabilitation

	AIS results after 3 months (AIS 2)				Mann–Whitney Test
	Low (8–19 points)		High (31–40 points)
	n	Mean (SD)	n	Mean (SD)	p
Age	25	78.4 (9.1)	20	77.0 (7.2)	0.4413
Number of comorbidities	25	4.0 (1.5)	20	4.1 (1.5)	0.8337
MMSE 1	25	21.7 (3.0)	20	24.7 (3.9)	0.0067
MMSE 2	25	22.2 (3.0)	20	25.6 (2.7)	0.0007
BI 1	25	32.4 (20.3)	20	51.0 (17.7)	0.0025
BI 2	25	49.4 (19.6)	20	81.0 (12.9)	<0.00001
GDS 1	25	9.2 (2.8)	20	4.4 (1.9)	<0.00001
GDS 2	25	7.6 (2.6)	20	1.7 (0.8)	<0.00001
AIS 1	25	10.8 (2.7)	20	23.2 (5.8)	<0.00001
Change in BI (BI2-BI1)	25	17.4 (12.7)	20	30.0 (17.9)	0.0151

Abbreviations: MMSE1, Mini Mental State Examination upon admission to the ward; MMSE2, Mini Mental State Examination after 3 months; GDS1, Geriatric Depression Scale upon admission to the ward; GDS2, Geriatric Depression Scale after 3 months; BI1, Barthel Index upon admission to the ward; BI2, Barthel Index after 3 months; AIS1, Acceptance of Illness Scale upon admission to the ward; AIS2, Acceptance of Illness Scale after 3 months.

Table 5 Comparison between patients with a low or high level of illness acceptance after 3 months of rehabilitation

	AIS results after 3 months (AIS 2)				χ^2 test
	Low (8-19 points) n=25		High (31-40 points) n=20		p
	n	%	n	%
Gender					0.6669
Female	21	56.76	16	43.24
Male	4	50.00	4	50.00
Diagnosis					0.0126
Fractura	6	42.86	8	57.14
Stroke	17	77.27	5	22.73
Chronic illness	2	22.22	7	77.78
Education					0.7608
Primary and vocational	13	56.52	10	43.48
Secondary and higher	12	54.55	10	45.45
Marital status					0.5328
Single (widow(er), unmarried)	18	58.06	13	41.94
Married	7	50.00	7	50.00
Family care					0.0121
Lack of care capacity	8	80.00	2	20.00
Incomplete	16	59.26	11	40.74
Full	1	12.50	7	87.50

Table 6 Results of the Spearman’s rank correlation for selected pairs of variables in the studied group

Pairs of variables	rho Spearman	p
AIS 1 & MMSE 1	0.25	0.0129
AIS 1 & MMSE 2	0.27	0.0066
AIS 1 & GDS 1	−0.57	<0.0001
AIS 1 & GDS 2	−0.51	<0.0001
AIS 1 & BI 1	0.31	0.0019
AIS 1 & BI 2	0.30	0.0026
AIS 1 & change BI (BI2-BI1)	0.02	0.8094
AIS 2 & MMSE 1	0.25	0.0139
AIS 2 & MMSE 2	0.32	0.0013
AIS 2 & GDS 1	−0.53	<0.0001
AIS 2 & GDS 1	−0.73	<0.0001
AIS 2 & BI 1	0.31	0.0019
AIS 2 & BI 2	0.57	<0.0001
AIS 2 & change BI (BI2-BI1)	0.32	0.0014

Abbreviations: MMSE1, Mini Mental State Examination upon admission to the ward; MMSE2, Mini Mental State Examination after 3 months; GDS1, Geriatric Depression Scale upon admission to the ward; GDS2, Geriatric Depression Scale after 3 months; BI1, Barthel Index upon admission to the ward; BI2, Barthel Index after 3 months; AIS1, Acceptance of Illness Scale upon admission to the ward; AIS2, Acceptane of Illness Scale after 3 months.