Quality of care for frail older persons in a homecare setting: what is it and how can it be measured?

2017 ◽  
Vol 30 (9) ◽  
pp. 1259-1267 ◽  
Author(s):  
Jiska Cohen-Mansfield ◽  
Adi Hannah Sela ◽  
Esther Iecovich ◽  
Hava Golander
Keyword(s):  
Factor Analysis ◽  
Quality Of Care ◽  
Migrant Workers ◽  
Older Persons ◽  
Convenience Sample ◽  
Age In Place ◽  
Frail Older Persons ◽  
The One ◽  
Main Components

ABSTRACTBackground:As more older persons opt to age in place, there is a growing trend to hire migrant workers as live-in caregivers to care for them. This raises the need to examine the quality of care they receive within this unique care setting. The objective of this pilot study was to establish the components of quality of care as provided by migrant live-in caregivers.Methods:We interviewed a convenience sample of older persons cared for by migrant live-in caregivers and their relatives. When relatives reported that older persons could not be interviewed due to advanced dementia, only relatives were interviewed. Overall, 72 older persons and 117 relatives were interviewed. We used the Quality of Care Questionnaire (QuCQ) developed for this study to examine the main components of quality of care in this population.Results:Factor analysis using older persons’ data revealed two factors. In the first factor, “caretaking,” items concerning provision of prompt care exhibited the highest loadings. Items measuring interpersonal aspects of the care dynamic had the highest loadings in the second factor, thus labeled “relationship.” The factor analysis based on relatives’ data yielded similarities and differences with the one based on older persons’ data. Yet, there were significant correlations between relative and older persons’ responses when using the older persons’ factor structure.Conclusions:According to older persons and relatives, quality of care depends on the extent to which older persons’ care-related needs, as well as social ones, are addressed. Appropriate evaluation of quality of care in the live-in setting is important for its improvement.

scholarly journals Validation and psychometric evaluation of the Dutch person-centred care of older people with cognitive impairment in acute care (POPAC) scale

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn J. Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie F. Roodbol
Keyword(s):  
Factor Analysis ◽  
Cognitive Impairment ◽  
Quality Of Care ◽  
Confirmatory Factor Analysis ◽  
Older People ◽  
Root Mean Square ◽  
Acute Care ◽  
Mean Square ◽  
Confirmatory Factor

Abstract Background Person-centred care is the preferred model for caring for people with dementia. Knowledge of the level of person-centred care is essential for improving the quality of care for patients with dementia. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale is a tool to determine the level of person-centred care. This study aimed to translate and validate the Dutch POPAC scale and evaluate its psychometric properties to enable international comparison of data and outcomes. Methods After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (n=114) and via social media (n=45) completed the POPAC scale. By performing confirmatory factor analysis, construct validity was tested. Cronbach’s alpha scale was utilized to establish internal consistency. Results The confirmatory factor analysis showed that the comparative fit index (0.89) was slightly lower than 0.9. The root mean square error of approximation (0.075, p=0.012, CI 0.057–0.092) and the standardized root mean square residual (0.063) were acceptable, with values less than 0.08. The findings revealed a three-dimensional structure. The factor loadings (0.69–0.77) indicated the items to be strongly associated with their respective factors. The results also indicated that deleting Item 5 improved the Cronbach’s alpha of the instrument as well as of the subscale ‘using cognitive assessments and care interventions’. Instead of deleting this item, we suggest rephrasing it into a positively worded item. Conclusions Our findings suggest that the Dutch POPAC scale is sufficiently valid and reliable and can be utilized for assessing person-centred care in acute care hospitals. The study enables nurses to interpret and compare person-centred care levels in wards and hospital levels nationally and internationally. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.

scholarly journals Psychometric validation of the Carers of Older People in Europe Index among family caregivers of older persons with dementia

2018 ◽  
Vol 6 ◽  
pp. 205031211879281
Author(s):  
Jill-Marit Moholt ◽  
Oddgeir Friborg ◽  
Mari Wolff Skaalvik ◽  
Nils Henriksen
Keyword(s):  
Factor Analysis ◽  
Older People ◽  
Family Caregivers ◽  
Older Persons ◽  
Negative Impact ◽  
Model Fit ◽  
Dementia Caregivers ◽  
Confirmatory Factor ◽  
Test Retest Reliability

Objectives: The Carers of Older People in Europe Index is a first-stage assessment tool to detect family caregivers in need of support. This instrument assesses caregivers’ subjective perceptions of their caregiving circumstances. The present study examines the psychometric properties of the Norwegian version of the Carers of Older People in Europe Index among family caregivers for older persons with dementia living at home. Methods: Cross-sectional survey data were collected from 430 dementia caregivers. The sample was randomly split as follows: the first half of the sample was used to identify the measurement model using an exploratory factor analysis, and the second half of the sample was used to cross-validate the model using a confirmatory factor analysis. The criterion validity and reliability (internal consistency and test–retest reliability) of the Carers of Older People in Europe Index were also examined. Results: Using an exploratory factor analysis, we extracted three factors that were consistent with previous findings: negative impact of caregiving, positive values of caregiving and quality of support. This model fit the data well using a confirmatory factor analysis. Moreover, a second-order model could replace the three-factor correlated model without sacrificing the model fit, supporting the use of a global impact of caregiving score. The three factors and the global factor correlated with the criteria measures in the expected directions. The internal consistency was assessed using Cronbach’s alpha and was good for the negative impact ( α = 0.86) and the quality of support ( α = 0.76) factors. The positive values factor was less consistent ( α = 0.64). The test–retest reliability was examined using Spearman’s rank order correlation and was good for all three factors. Conclusion: The psychometric properties of the Norwegian version of the Carers of Older People in Europe Index are good. The instrument assesses dementia caregivers’ situations across three primary factors or alternatively validly summarizes the factors in a global impact of caregiving score.

scholarly journals Severity of illness and adaptive functioning predict quality of care of children among parents with psychosis: A confirmatory factor analysis

2017 ◽  
Vol 52 (5) ◽  
pp. 435-445 ◽  
Author(s):  
Linda E Campbell ◽  
Mary-Claire Hanlon ◽  
Cherrie A Galletly ◽  
Carol Harvey ◽  
Helen Stain ◽  
...  
Keyword(s):  
Substance Abuse ◽  
Factor Analysis ◽  
Quality Of Care ◽  
Psychotic Disorders ◽  
Adaptive Functioning ◽  
Psychosocial Support ◽  
Severity Of Illness ◽  
Confirmatory Factor ◽  
Parenting Role

Objective: Parenthood is central to the personal and social identity of many people. For individuals with psychotic disorders, parenthood is often associated with formidable challenges. We aimed to identify predictors of adequate parenting among parents with psychotic disorders. Methods: Data pertaining to 234 parents with psychotic disorders living with dependent children were extracted from a population-based prevalence study, the 2010 second Australian national survey of psychosis, and analysed using confirmatory factor analysis. Parenting outcome was defined as quality of care of children, based on participant report and interviewer enquiry/exploration, and included level of participation, interest and competence in childcare during the last 12 months. Results: Five hypothesis-driven latent variables were constructed and labelled psychosocial support, illness severity, substance abuse/dependence, adaptive functioning and parenting role. Importantly, 75% of participants were not identified to have any dysfunction in the quality of care provided to their child(ren). Severity of illness and adaptive functioning were reliably associated with quality of childcare. Psychosocial support, substance abuse/dependence and parenting role had an indirect relationship to the outcome variable via their association with either severity of illness and/or adaptive functioning. Conclusion: The majority of parents in the current sample provided adequate parenting. However, greater symptom severity and poorer adaptive functioning ultimately leave parents with significant difficulties and in need of assistance to manage their parenting obligations. As symptoms and functioning can change episodically for people with psychotic illness, provision of targeted and flexible support that can deliver temporary assistance during times of need is necessary. This would maximise the quality of care provided to vulnerable children, with potential long-term benefits.

scholarly journals Theoretical Perspectives of Hospitalized Older Patients and Their Health-Related Problems and Quality of Care: Systematic Literature Review

2017 ◽  
Vol 10 (1) ◽  
pp. 215-225 ◽  
Author(s):  
Atef Hasan Khatib ◽  
Ayman M. Hamdan-Mansour ◽  
Manar Ali Bani Hani
Keyword(s):  
Quality Of Life ◽  
Health Care ◽  
Quality Of Care ◽  
Elderly Patients ◽  
Older Patients ◽  
Older Persons ◽  
Elderly Care ◽  
Quality Of Healthcare ◽  
Emotional Wellbeing

Introduction:The proportion of aged people is growing worldwide. Older persons are affected by a number of physical, psychological and social factors that influence their health and quality of life. These factors are usually multiple and are often masked by sensory and cognitive impairments.Purpose:The purpose of this study was to examine the available literature emphasizing older persons’ care, care-related problems, and older persons’ quality of healthcare. Also, the paper aimed at exploring the future direction of research needs.Results:Good quality older patients’ care involves safety, professional interventions, recognition and management of physical and emotional wellbeing. Care of older patients requires addressing the aging process itself, the expected decrease in functionality, and diminished cognitive ability. Little statistical data were found to address the quality of hospitalized elderly patients in particular as well as study on healthcare facilities and nursing homes. Literature does not provide much guidance to the effectiveness of care strategies.Conclusion:The results assert that elderly health care is a priority. However, health care systems are not specific about elderly patients’ needs, leading to low quality of elderly care. There is a need to use an integrated model of care to improve the quality of life and quality of care provided to hospitalized older patients.

scholarly journals Quality Of Care As Perceived By Patients In A Brazilian Hospital: A Non-Randomized Interventional Study

10.3823/2520 ◽  
2017 ◽  
Vol 10 ◽  
Author(s):  
Gunnar Glauco De Cunto Taets ◽  
Camila Mendonça de Moraes Lopes ◽  
Claudio Joaquim Borba-Pinheiro ◽  
Estelio Henrique Martin Dantas
Keyword(s):  
Quality Of Care ◽  
Repeated Measures ◽  
Rio De Janeiro ◽  
Nonparametric Test ◽  
Post Intervention ◽  
Convenience Sample ◽  
Quality Of Patient Care ◽  
Dependent Variables ◽  
Post Test

Objective: To assess patients’ perceptions of the quality of care delivered by staff who underwent training about humanized care in a private hospital in Rio de Janeiro, Brazil. Method: This was an exploratory study. The convenience sample consisted of 30 patients, and data were collected via pre-intervention questionnaires, followed by post-intervention questionnaires after a training sessions with 44 employees working in a cardiac intensive unit of a private general hospital in Rio de Janeiro, Brazil. Dependent variables were analyzed using McNemar’s nonparametric test for repeated measures, considered suitable because of the nominal scale. Percentage differences were calculated using the following equation: ∆%=[(post-test – pre-test)*100/test] with significance set at  <0.05. Results: Improvements were observed in quality of patient care (Δ% = 38.1%, p = 0.031) and clarification of patients’ clinical condition (Δ% = 25%, p = 0.021), in addition to perceived room temperature (Δ % = 40%, p = 0.008) and ambient noise (Δ% = 52.6%, p = 0.002). Conclusion: Quality of care improved significantly after staff training, demonstrating the essential nature of ongoing education.

scholarly journals Primary Health Care and Aging

2004 ◽  
Vol 2 (3) ◽  
pp. 99-108
Author(s):  
Martha Pelaez ◽  
Marilyn Rice
Keyword(s):  
Health Care ◽  
Quality Of Care ◽  
Primary Health Care ◽  
Older People ◽  
Older Persons ◽  
Interdisciplinary Teams ◽  
Healthy Ageing ◽  
Policy Statement ◽  
Primary Health

From 21-25 February 2000, in San Jose, Costa Rica, a WHO Consultative Group was held on the topic of Primary Health Care for Older Persons, with representatives from 13 countries from around the world, as well as Headquarters and Regional offices of WHO and the private sector. In the policy statement that emerged from the meeting four basic principles were highlighted: universal accessibility and coverage on the basis of need, community and individual involvement, intersectoral action for health, and appropriate use of cost effective technologies in relation to the available resources. Three complementary integration functions are mentioned: functional with an integrated approach to the health needs of individuals over their life course taking precedence over episodic management of disease; organizational, with a focus on how health centers should function with interdisciplinary teams; and educational which addresses the knowledge and skills and attitudes needed by health professionals that will facilitate communication, networking, advocacy and mediation of resources. The proceedings go on to outline the objectives to be included in national plans on health of older people, as well as the extended benefits and outcomes to be expected from PHC strategies for older people. In promoting quality of care for older persons, positive and negative factors are mentioned, as are strategies to: stimulate interest in geriatric care, motivate general practitioners to focus on the care of elders, encourage teamwork among PHC staff, and encourage multi-sectoral collaboration in promoting the health of older persons. An example is provided of healthy ageing from Canada. The recommendations include defining and measuring an ageing friendly health center (with specific indicators for the latter), defining the role of the PHC team in promoting healthy ageing, characteristics that programs should have to promote “age friendly” services in the primary care setting, and outcome indicators for quality of care of elders at the PHC level.

scholarly journals Validation of a tool to assess patient satisfaction, waiting times, healthcare utilization, and cost

2019 ◽  
Vol 20 ◽  
Author(s):  
Breda H. Eubank ◽  
Mark R. Lafave ◽  
Nicholas G. Mohtadi ◽  
David M. Sheps ◽  
J. Preston Wiley
Keyword(s):  
Patient Satisfaction ◽  
Quality Of Care ◽  
Continuum Of Care ◽  
Criterion Validity ◽  
Rotator Cuff Tears ◽  
Convenience Sample ◽  
Duration Of Symptoms ◽  
Ceiling Effects ◽  
Patients Experience

Abstract Aim Patients’ experience of the quality of care received throughout their continuum of care can be used to direct quality improvement efforts in areas where they are most needed. This study aims to establish validity and reliability of the Healthcare Access and Patient Satisfaction Questionnaire (HAPSQ) – a tool that collects patients’ experience that quantifies aspect of care used to make judgments about quality from the perspective of the Alberta Quality Matrix for Health (AQMH). Background The AQMH is a framework that can be used to assess and compare the quality of care in different healthcare settings. The AQMH provides a common language, understanding, and approach to assessing quality. The HAPSQ is one tool that is able to assess quality of care according to five of six AQMH’s dimensions. Methods This was a prospective methodologic study. Between March and October 2015, a convenience sample of patients presenting with chronic full-thickness rotator cuff tears was recruited prospectively from the University of Calgary Sport Medicine Centre in Calgary, Alberta, Canada. Reliability of the HAPSQ was assessed using test–retest reliability [interclass correlation coefficient (ICC)>0.70]. Validity was assessed through content validity (patient interviews, floor and ceiling effects), criterion validity (percent agreement >70%), and construct validity (hypothesis testing). Findings Reliability testing was completed on 70 patients; validity testing occurred on 96 patients. The mean duration of symptoms was three years (SD: 5.0, range: 0.1–29). Only out-of-pocket utilization possessed an ICC<0.70. Patients reported that items were relevant and appropriate to measuring quality of care. No floor or ceiling effects were present. Criterion validity was reached for all items assessed. A priori hypotheses were confirmed. The HAPSQ represents an inexpensive, reliable, and valid approach toward collecting clinical information across a patient’s continuum of care.

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