Quality Improvement Questionnaires – Nursing Homes (QIQ-NH): validation of questionnaires for measuring quality of care in nursing homes from various perspectives
Abstract Background This study aims to describe the validation and optimization of a new instrument specifically designed to measure and improve the quality of care in nursing homes; the Quality Improvement Questionnaires for Nursing Homes (QIQ-NH). This instrument comprises several questionnaires on the perceived quality of care for various perspectives (e.g. clients, family and professional caregivers) and covers eight themes of the national quality framework for nursing home care in the Netherlands. Methods Data was collected in six nursing homes between September 2017 and June 2018, among 359 residents, 48 family caregivers and 648 professional caregivers who completed a subgroup-specific questionnaire of the QIQ-NH. The construct and criterion validity of the three questionnaires were tested with item- and scale analyses. The content validity of the questionnaires was tested in cognitive interviews with 20 participants (7 residents, 5 family caregivers, 8 professional caregivers). Results Psychometric analyses confirmed the multidimensionality and reliability of the three questionnaires, and the cognitive interviews showed various possibilities for further optimization of the instruments. The construct, criterion and content validity of the three questionnaires ranged from acceptable to good. Cronbach’s alphas were > .70 for almost all scales. More than half of the items were candidate for optimization according to the cognitive interviews, mainly due to clarity or knowledge problems, and the questionnaires of the QIQ-NH were optimized accordingly. Conclusions The Quality Improvement Questionnaires for Nursing Homes (QIQ-NH) provides a solid basis to continuously measure and improve the quality of nursing home care, by covering the national quality themes and by integrating the various perspectives of all parties involved. With real-time feedback, the instrument enables the management and care teams to select possibilities or areas for improvement and to implement and continuously monitor the effects of quality improvement strategies in nursing homes.