Measuring Relational Care in Nursing Homes: Psychometric Evaluation of the Relational Care Scale

2015 ◽  
Vol 23 (1) ◽  
pp. 82-95 ◽  
Author(s):  
Elizabeth Andersen ◽  
Farinaz Havaei
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Nursing Home Residents ◽  
Reliability And Validity ◽  
Psychometric Evaluation ◽  
Rural Nursing ◽  
Care Aides ◽  
Relational Care

Background and Purpose: The Relational Care Scale (RCS) is a Canadian evaluative instrument designed to measure nursing home residents’ perceptions of care aides’ relational abilities. Care aides’ abilities to be reliable and empathetic with nursing home residents are very important determinants of quality of care, but few instruments are designed specifically for residents or focus exclusively on these determinants. Initially developed and tested in metropolitan teaching-affiliated nursing homes in Ontario, we expanded testing by reevaluating the psychometric properties of the RCS in 5 rural nursing homes in British Columbia. Method: There were 62 residents living in 5 rural nursing homes who completed 3 instruments: the RCS under investigation, the Experiences in Close Relationships-Relationship Structures (ECR-RS) questionnaire to test for convergent validity, and the Lubben Social Network Scale-6 (LSNS-6) to test for discriminant validity. Results: The reliability of the RCS was strongly supported (Cronbach’s alpha = .90, item–total correlation > .77). Consistent with previous testing, a unidimensional internal structure was extracted. A moderate to strong correlation between the RCS and the Anxiety and Avoidance subscales of the ECR-RS supported convergent validity of the instrument. Last, partial support was obtained for the discriminant validity of the RCS. Conclusions: The RCS was easy to use for both residents and researchers. Expanded testing demonstrated its recurring reliability and validity.

Development of a Worry Questionnaire for Nursing Home Residents

2004 ◽  
Vol 23 (4) ◽  
pp. 359-366
Author(s):  
Emerenciana A. Hertzsprung ◽  
Candace Konnert ◽  
Jaylene Brinker
Keyword(s):  
Nursing Home ◽  
Cognitive Functioning ◽  
Internal Consistency ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Nursing Home Residents ◽  
Psychometric Evaluation ◽  
Reliability Coefficient ◽  
Test Reliability ◽  
Total Correlation

ABSTRACTThis paper describes a new measure, the Worry Questionnaire for Nursing Home Residents (WQNHR), designed to assess the frequency of specific worries. It was administered to 67 residents. Psychometric evaluation showed an average item-to-total correlation of 0.20 (range = 0.15 to 0.58), an internal consistency estimate of 0.79, and a test-re-test reliability coefficient of 0.80. The WQNHR showed good convergent validity with other measures of worry obtained from residents, good discriminant validity with measures of health, but poor discriminant validity with self-ratings of depression. Psychometric results also indicated that the WQNHR performed better for residents with higher cognitive functioning. In addition, a collateral form (WQNHR-C) was administered to family or friends; however, it was not significantly correlated with the WQNHR. Overall, the WQNHR is a promising screening instrument for assessing worry in nursing home residents.

scholarly journals Assessing quality of life in older adults: psychometric properties of the OPQoL-brief questionnaire in a nursing home population

2020 ◽  
Vol 18 (1) ◽  
Author(s):  
Gørill Haugan ◽  
Jorunn Drageset ◽  
Beate André ◽  
Kamile Kukulu ◽  
James Mugisha ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Psychometric Properties ◽  
Nursing Home Residents ◽  
Reliability And Validity ◽  
Measurement Properties ◽  
Nursing Home Population

Abstract Background Well-adapted and validated quality-of-life measurement models for the nursing home population are scarce. Therefore, the aim of this study was to test the psychometrical properties of the OPQoL-brief questionnaire among cognitively intact nursing home residents. The research question addressed evidence related to the dimensionality, reliability and construct validity, all of which considered interrelated measurement properties. Methods Cross-sectional data were collected during 2017–2018, in 27 nursing homes representing four different Norwegian municipalities, located in Western and Mid-Norway. The total sample comprised 188 of 204 (92% response rate) long-term nursing home residents who met the inclusion criteria: (1) municipality authority’s decision of long-term nursing home care; (2) residential time 3 months or longer; (3) informed consent competency recognized by responsible doctor and nurse; and (4) capable of being interviewed. Results Principal component analysis and confirmative factor analyses indicated a unidimensional solution. Five of the original 13 items showed low reliability and validity; excluding these items revealed a good model fit for the one-dimensional 8-items measurement model, showing good internal consistency and validity for these 8 items. Conclusion Five out of the 13 original items were not high-quality indicators of quality-of-life showing low reliability and validity in this nursing home population. Significant factor loadings, goodness-of-fit indices and significant correlations in the expected directions with the selected constructs (anxiety, depression, self-transcendence, meaning-in-life, nurse-patient interaction, and joy-of-life) supported the psychometric properties of the OPQoL-brief questionnaire. Exploring the essence of quality-of-life when residing in a nursing home is highly warranted, followed by development and validation of new tools assessing quality-of-life in this population. Such knowledge and well-adapted scales for the nursing home population are beneficial and important for the further development of care quality in nursing homes, and consequently for quality-of-life and wellbeing in this population.

scholarly journals Assessing the well-being of residents in nursing facilities

2021 ◽  
Author(s):  
Nadja Schott ◽  
Bettina Johnen ◽  
Thomas Jürgen Klotzbier
Keyword(s):  
Nursing Home ◽  
Convergent Validity ◽  
Assessment Tool ◽  
Nursing Home Residents ◽  
Reliability And Validity ◽  
Well Being ◽  
Nursing Home Population ◽  
Cross Sectional ◽  
Language Version ◽  
Cultural Adaption

Abstract Purpose Well-adapted and validated well-being (WB) instruments for the nursing home population are scarce. To our knowledge, the Laurens Well-Being Inventory for Gerontopsychiatry (LWIG) is a practical and reliable well-being assessment tool that has never been validated for German nursing home populations. Therefore, the purpose of our study was to (1) translate and cross-culturally adapt the LWIG to a German context and (2) test the reliability and validity of the German LWIG in a group of older nursing home residents using the Rasch model. Methods This study has a cross-sectional, descriptive study design. Cross-cultural adaption of the LWIG-GER from English to German was performed according to a standardized method. The data obtained from 104 long-term nursing home residents (57 women, 47 men) aged 60–99 years (mean 79.5, standard deviation ±9.11) were analyzed for psychometric testing (exploratory and confirmatory factor analysis, item fit, McDonald’s ω, convergent validity, and known-group validity, Rasch). Results The final LWIG-GER consists of 19 items with three subscales, including “psychological WB”, “social WB”, and “physical WB”. The LWIG-GER showed good overall reliability with McDonald’s ω of 0.83; the LWIG-GER dimensions’ scores were significantly correlated with depression, functional performance, activities, fear of falling, and education. Conclusions Our findings suggest that the German language version of the LWIG is a reliable and valid tool for measuring WB in nursing home residents. Furthermore, we propose that the LWIG-GER questionnaire can broaden and deepen our understanding of residents’ perception of quality of care and their environment.

Development and Psychometric Evaluation of the Caregiver Reciprocity Scale II

2000 ◽  
Vol 8 (2) ◽  
pp. 179-191 ◽  
Author(s):  
Ann K. Carruth ◽  
Catherine Holland ◽  
Laura Larsen
Keyword(s):  
Family Caregiving ◽  
Convergent Validity ◽  
Goodness Of Fit ◽  
Discriminant Validity ◽  
Reliability And Validity ◽  
Psychometric Evaluation ◽  
Measurement Model ◽  
Entire Family ◽  
Additional Support ◽  
Correlation Estimate

Caregiver reciprocity is the collective affective and behavioral expression of exchanges given and received between a caregiver and care receiver, and among family members. This psychometric investigation was designed to further examine the reliability and validity of the revised Caregiver Reciprocity Scale II (CRSII). Items were rewritten to reflect valued exchanges and balance among the entire family network, including spouses. An alpha of .83 for Warmth and Regard; .73 for Intrinsic Rewards of Giving; .83 for Love and Affection; and .75 for Balance Within Family Caregiving indicated acceptable internal consistency. The study, conducted with 176 spouse or adult children caregivers, provides additional support for the conceptual model of the four-factor solution. Construct validity was supported by the standardized factor loadings and goodness-of-fit indices obtained from confirmatory factor analysis. The results of the analysis of the measurement model, taken as a whole, demonstrate that the CRS II has adequate psychometric properties. Model parsimony was supported by an AGFI of .87, combined with an adjusted chisquare between 1.0 to 3.0. All but two item loadings were greater than .50. This, combined with the fact that all standardized loadings were twice the standardized errors and t-values were greater than 2.0, contributes to concluding that convergent validity was strong. Discriminant validity, evaluated by variance extracted estimates, and confidence interval (± two standard errors) around the correlation estimate between factors, was adequate. This study provided evidence to support the reliability and validity of the CRS II.

scholarly journals A tablet-based intervention for activating nursing home residents with dementia: results from a cluster-randomized controlled trial

2021 ◽  
pp. 1-13
Author(s):  
Julie L. O’Sullivan ◽  
Sonia Lech ◽  
Paul Gellert ◽  
Ulrike Grittner ◽  
Jan-Niklas Voigt-Antons ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Randomized Controlled Trial ◽  
Nursing Home ◽  
Nursing Homes ◽  
Psychotropic Medication ◽  
Controlled Trial ◽  
Nursing Home Residents ◽  
Randomized Controlled ◽  
Cluster Randomized

Abstract Objectives: To investigate global and momentary effects of a tablet-based non-pharmacological intervention for nursing home residents living with dementia. Design: Cluster-randomized controlled trial. Setting: Ten nursing homes in Germany were randomly allocated to the tablet-based intervention (TBI, 5 units) or conventional activity sessions (CAS, 5 units). Participants: N = 162 residents with dementia. Intervention: Participants received regular TBI (n = 80) with stimulating activities developed to engage people with dementia or CAS (n = 82) for 8 weeks. Measurements: Apathy Evaluation Scale (AES-I, primary outcome), Quality of Life in Alzheimer’s Disease scale, QUALIDEM scale, Neuropsychiatric Inventory, Geriatric Depression Scale, and psychotropic medication (secondary outcomes). Momentary quality of life was assessed before and after each activity session. Participants and staff were blinded until the collection of baseline data was completed. Data were analyzed with linear mixed-effects models. Results: Levels of apathy decreased slightly in both groups (mean decrease in AES-I of .61 points, 95% CI −3.54, 2.33 for TBI and .36 points, 95% CI −3.27, 2.55 for CAS). Group difference in change of apathy was not statistically significant (β = .25; 95% CI 3.89, 4.38, p = .91). This corresponds to a standardized effect size (Cohen’s d) of .02. A reduction of psychotropic medication was found for TBI compared to CAS. Further analyses revealed a post-intervention improvement in QUALIDEM scores across both groups and short-term improvements of momentary quality of life in the CAS group. Conclusions: Our findings suggest that interventions involving tailored activities have a beneficial impact on global and momentary quality of life in nursing home residents with dementia. Although we found no clear advantage of TBI compared to CAS, tablet computers can support delivery of non-pharmacological interventions in nursing homes and facilitate regular assessments of fluctuating momentary states.

scholarly journals Impact of Roommates on MDRO Spread in Nursing Homes

2020 ◽  
Vol 41 (S1) ◽  
pp. s66-s67
Author(s):  
Gabrielle M. Gussin ◽  
Ken Kleinman ◽  
Raveena D. Singh ◽  
Raheeb Saavedra ◽  
Lauren Heim ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Secondary Analysis ◽  
Nursing Home Residents ◽  
Multidrug Resistant ◽  
Healthcare Intervention ◽  
Odds Ratios ◽  
Care Needs ◽  
Environmental Cleaning ◽  
The Impact

Background: Addressing the high burden of multidrug-resistant organisms (MDROs) in nursing homes is a public health priority. High interfacility transmission may be attributed to inadequate infection prevention practices, shared living spaces, and frequent care needs. We assessed the contribution of roommates to the likelihood of MDRO carriage in nursing homes. Methods: We performed a secondary analysis of the SHIELD OC (Shared Healthcare Intervention to Eliminate Life-threatening Dissemination of MDROs in Orange County, CA) Project, a CDC-funded regional decolonization intervention to reduce MDROs among 38 regional facilities (18 nursing homes, 3 long-term acute-care hospitals, and 17 hospitals). Decolonization in participating nursing homes involved routine chlorhexidine bathing plus nasal iodophor (Monday through Friday, twice daily every other week) from April 2017 through July 2019. MDRO point-prevalence assessments involving all residents at 16 nursing homes conducted at the end of the intervention period were used to determine whether having a roommate was associated with MDRO carriage. Nares, bilateral axilla/groin, and perirectal swabs were processed for methicillin-resistant Staphylococcus aureus (MRSA), vancomycin-resistant enterococcus (VRE), extended-spectrum β-lactamase (ESBL)–producing Enterobacteriaceae, and carbapenem-resistant Enterobacteriaceae (CRE). Generalized linear mixed models assessed the impact of maximum room occupancy on MDRO prevalence when clustering by room and hallway, and adjusting for the following factors: nursing home facility, age, gender, length-of-stay at time of swabbing, bedbound status, known MDRO history, and presence of urinary or gastrointestinal devices. CRE models were not run due to low counts. Results: During the intervention phase, 1,451 residents were sampled across 16 nursing homes. Overall MDRO prevalence was 49%. In multivariable models, we detected a significant increasing association of maximum room occupants and MDRO carriage for MRSA but not other MDROs. For MRSA, the adjusted odds ratios for quadruple-, triple-, and double-occupancy rooms were 3.5, 3.6, and 2.8, respectively, compared to residents in single rooms (P = .013). For VRE, these adjusted odds ratios were 0.3, 0.3, and 0.4, respectively, compared to residents in single rooms (P = NS). For ESBL, the adjusted odds ratios were 0.9, 1.1, and 1.5, respectively, compared to residents in single rooms (P = nonsignificant). Conclusions: Nursing home residents in shared rooms were more likely to harbor MRSA, suggesting MRSA transmission between roommates. Although decolonization was previously shown to reduce MDRO prevalence by 22% in SHIELD nursing homes, this strategy did not appear to prevent all MRSA transmission between roommates. Additional efforts involving high adherence hand hygiene, environmental cleaning, and judicious use of contact precautions are likely needed to reduce transmission between roommates in nursing homes.Funding: NoneDisclosures: Gabrielle M. Gussin, Stryker (Sage Products): Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Clorox: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Medline: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes. Xttrium: Conducting studies in which contributed antiseptic product is provided to participating hospitals and nursing homes.

scholarly journals Antibiotic Susceptibility of Common Organisms Isolated from Urine Cultures of Nursing Home Residents

2020 ◽  
Vol 41 (S1) ◽  
pp. s118-s120
Author(s):  
Austin R. Penna ◽  
Taniece R. Eure Eure ◽  
Nimalie D. Stone ◽  
Grant Barney ◽  
Devra Barter ◽  
...  
Keyword(s):  
Nursing Home ◽  
Nursing Homes ◽  
Antibiotic Susceptibility ◽  
Clinical Decision Making ◽  
Service Providers ◽  
Urine Culture ◽  
Nursing Home Residents ◽  
Antibiotic Prescribing ◽  
E Coli ◽  
Susceptibility Data

Background: With the emergence of antibiotic resistant threats and the need for appropriate antibiotic use, laboratory microbiology information is important to guide clinical decision making in nursing homes, where access to such data can be limited. Susceptibility data are necessary to inform antibiotic selection and to monitor changes in resistance patterns over time. To contribute to existing data that describe antibiotic resistance among nursing home residents, we summarized antibiotic susceptibility data from organisms commonly isolated from urine cultures collected as part of the CDC multistate, Emerging Infections Program (EIP) nursing home prevalence survey. Methods: In 2017, urine culture and antibiotic susceptibility data for selected organisms were retrospectively collected from nursing home residents’ medical records by trained EIP staff. Urine culture results reported as negative (no growth) or contaminated were excluded. Susceptibility results were recorded as susceptible, non-susceptible (resistant or intermediate), or not tested. The pooled mean percentage tested and percentage non-susceptible were calculated for selected antibiotic agents and classes using available data. Susceptibility data were analyzed for organisms with ≥20 isolates. The definition for multidrug-resistance (MDR) was based on the CDC and European Centre for Disease Prevention and Control’s interim standard definitions. Data were analyzed using SAS v 9.4 software. Results: Among 161 participating nursing homes and 15,276 residents, 300 residents (2.0%) had documentation of a urine culture at the time of the survey, and 229 (76.3%) were positive. Escherichia coli, Proteus mirabilis, Klebsiella spp, and Enterococcus spp represented 73.0% of all urine isolates (N = 278). There were 215 (77.3%) isolates with reported susceptibility data (Fig. 1). Of these, data were analyzed for 187 (87.0%) (Fig. 2). All isolates tested for carbapenems were susceptible. Fluoroquinolone non-susceptibility was most prevalent among E. coli (42.9%) and P. mirabilis (55.9%). Among Klebsiella spp, the highest percentages of non-susceptibility were observed for extended-spectrum cephalosporins and folate pathway inhibitors (25.0% each). Glycopeptide non-susceptibility was 10.0% for Enterococcus spp. The percentage of isolates classified as MDR ranged from 10.1% for E. coli to 14.7% for P. mirabilis. Conclusions: Substantial levels of non-susceptibility were observed for nursing home residents’ urine isolates, with 10% to 56% reported as non-susceptible to the antibiotics assessed. Non-susceptibility was highest for fluoroquinolones, an antibiotic class commonly used in nursing homes, and ≥ 10% of selected isolates were MDR. Our findings reinforce the importance of nursing homes using susceptibility data from laboratory service providers to guide antibiotic prescribing and to monitor levels of resistance.Disclosures: NoneFunding: None

scholarly journals NCOG-70. RELIABILITY AND VALIDITY OF A NEW SELF-REPORT INDEX OF COGNITIVE CONCERNS IN BRAIN TUMOR PATIENTS

2020 ◽  
Vol 22 (Supplement_2) ◽  
pp. ii145-ii145
Author(s):  
Giuliana Zarrella ◽  
Alice Perez ◽  
Jorg Dietrich ◽  
Michael Parsons
Keyword(s):  
Brain Tumor ◽  
Verbal Memory ◽  
Cognitive Abilities ◽  
Convergent Validity ◽  
Discriminant Validity ◽  
Reliability And Validity ◽  
Cognitive Testing ◽  
Self Report ◽  
Measurement Information ◽  
Patient Reported

Abstract INTRODUCTION Subjective cognitive dysfunction is an important outcome measure in neuro-oncology and may provide additional information beyond performance-based neuropsychological testing. The Functional Assessment of Cancer Therapy-Brain (FACT-Br) is a frequently used quality of life (QoL) measure that includes indices of physical, emotional, social, and neurologic aspects of disease, but does not measure cognitive concerns. This study seeks to develop and validate an index of self-reported cognition derived from existing items on the FACT-Br. METHODS 145 patients (Mage=51.08, Medu=15.63) with heterogeneous brain tumor diagnoses completed neuropsychological evaluation including cognitive testing and self-report measures. Nine FACT-Br items regarding cognition were combined to form the Cognitive Index (CI). Reliability of the CI was measured with Cronbach’s alpha. Concurrent validity was assessed by correlating the CI with the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Abilities-8 or PROMIS Cognitive Concerns-8. Discriminant validity was assessed by correlation of the CI with other FACT-Br indices and the Beck Depression and Anxiety Inventories (BDI, BAI). RESULTS Internal consistency within the CI was high (Cronbach’s a 0.864). The CI correlated strongly with the PROMIS-Abilities (r =.680; p< 0.001) and PROMIS-Concerns (r=.780; p< 0.001) indicating high convergent validity. Moderate correlations were observed between the CI and the physical and functional subscales of the FACT (r=.453 and .555), whereas correlations with the social and emotional functioning subscales were weaker (r=.381 and .325). The FACT-Br-CI correlated strongly with BDI (r=-.622) and more weakly with the BAI (r=-.344). Consistent with prior literature, the CI showed modest correlations with neuropsychological measures, including verbal memory encoding (r=.300), verbal fluency (r=.252) and a composite measure of cognition (r=.249; all p’s< .01). CONCLUSIONS The FACT-Br-CI is a reliable and valid measure of self-reported cognition. Studies that include the FACT-Br could be retrospectively analyzed to assess self-reported cognitive outcomes, enriching the information gained from prior research.

scholarly journals Improving Quality of Life in Nursing Homes: The Structured Resident Interview Approach

2014 ◽  
Vol 2014 ◽  
pp. 1-8 ◽  
Author(s):  
Howard B. Degenholtz ◽  
Abby L. Resnick ◽  
Natalie Bulger ◽  
Lichun Chia
Keyword(s):  
Quality Of Life ◽  
Nursing Home ◽  
Nursing Homes ◽  
Planning Process ◽  
Intervention Group ◽  
Nursing Home Residents ◽  
Care Plan ◽  
Control Group ◽  
Improvement Programs

The quality of life (QOL) of the approximately 1.5 million nursing facility (NF) residents in the US is undoubtedly lower than desired by residents, families, providers, and policy makers. Although there have been important advances in defining and measuring QOL for this population, there is a need for interventions that are tied to standardized measurement and quality improvement programs. This paper describes the development and testing of a structured, tailored assessment and care planning process for improving the QOL of nursing home residents. The Quality of Life Structured Resident Interview and Care Plan (QOL.SRI/CP) builds on a decade of research on measuring QOL and is designed to be easily implemented in any US nursing home. The approach was developed through extensive and iterative pilot testing and then tested in a randomized controlled trial in three nursing homes. Residents were randomly assigned to receive the assessment alone or both the assessment and an individualized QOL care plan task. The results show that residents assigned to the intervention group experienced improved QOL at 90- and 180-day follow-up, while QOL of residents in the control group was unchanged.

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