Field Testing, Refinement, and Psychometric Evaluation of a New Measure of Quality of Care for Assisted Living
| Autor: | Gregory F. Petroski, Marcia Flesner, Vicki S. Conn, David R. Mehr, Steven V. Owen, Marilyn Rantz, Richard W. Madsen, Mary Zwygart-Stauffacher, Myra A. Aud, Meridean Maas |
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| Rok vydání: | 2008 |
| Předmět: |
Gerontology
Psychometrics Attitude of Health Personnel Standard of Good Practice media_common.quotation_subject Nursing Methodology Research Choice Behavior Article Health Services Accessibility Statistics Nonparametric Wisconsin Quality of life (healthcare) Nursing Surveys and Questionnaires Health care Humans Medicine Quality (business) Patient participation Lighting General Nursing Quality Indicators Health Care Quality of Health Care media_common Observer Variation Medical model Missouri business.industry General Medicine Focus Groups Social engagement Focus group Nursing Homes Outcome and Process Assessment Health Care Nursing Evaluation Research Patient Participation Factor Analysis Statistical business Interior Design and Furnishings |
| Zdroj: | Journal of Nursing Measurement. 16:16-30 |
| ISSN: | 1945-7049 1061-3749 |
| DOI: | 10.1891/1061-3749.16.1.16 |
| Popis: | The number of assisted living facilities in the United States increased rapidly during the 1990s with an estimated 33,000 facilities caring for approximately 800,000 residents (NCAL, 2001). While the concept of assisted living is not new, having its roots in congregant housing in the 1960s (Pruchno & Rose, 2000), today’s assisted-living facilities provide housing and supportive services with some capacity to meet both scheduled and unscheduled health care needs of an older and more frail adult population (Allen, 1999; Brummett, 1997). Today’s assisted-living facilities also emphasize the social model of care rather than the medical model of care. Frail older adults and their families are attracted to homelike environments that do not resemble hospitals or traditional nursing homes and that stress independence, autonomy, and continuation of prior lifestyles. Quality of care or life has been only minimally addressed in the slowly growing body of research literature related to assisted-living facilities. Quality of life in assisted-living facilities has been linked to the facility’s social environment and whether that environment encourages social participation and family involvement (Mitchell & Kemp, 2000) and to positively rated resident–staff communication and staff involvement in care planning (Zimmerman et al., 2005). Surveys of resident satisfaction related to staff, direct care, services, activities, amenities, and environment in assisted-living facilities have been conducted in four states as elements of state-sponsored quality-improvement initiatives (Lowe, Lucas, Castle, Robinson, & Crystal, 2003). Quality of care in assisted living has had some exploration that resulted in a preliminary measure of quality of care in this long-term care environment (Aud, Rantz, Zwygart-Stauffacher, & Manion, 2004). The question for prospective residents, their families, and health care professionals is this: When you walk into one of these assisted-living facilities, how do you know that the care is of high quality? Although the assisted-living facility philosophy places a high value on individualized services provided to older adult residents in a homelike environment, there is great variation in operation of assisted-living facilities across the United States. This is due in part to the absence of federal regulations that delineate minimal standards of practice and by the absence of a national consensus on the definition of an assisted-living facility. Instead, several states have promulgated their own regulations for the assisted-living segment of institutional long-term care while other states have not, resulting in wide variation across states. Variation among states begins with the naming of such facilities—approximately 26 different names are in use—then continues with variations in services allowed or disallowed and in admission/discharge criteria (Mollica, 2003). Unlike federally regulated skilled nursing facilities, quality indicators have not been developed for assisted living facilities (Aud & Rantz, 2004). Consumers and health care professionals alike are perplexed by the absence of a single published standard of practice. The absence of a single standard also impedes the establishment of a reliable and valid method to measure care quality in assisted-living facilities. To rectify the absence of a reliable and valid method of care quality, Rantz and colleagues adapted her Observable Indicators of Nursing Home Care Quality Instrument (OIQ-NH; Rantz et al., 2000, 2006; Rantz & Mehr, 2001; Rantz & Zwygart-Stauffacher, 2005; Rantz, Zwygart-Stauffacher, & Flesner, 2005), creating a 34-item tool to measure assisted-living facility care quality. Two panels of experts assessed the validity of this initial adaptation. Interrater and test–retest reliability were assessed with a modest sample of 35 facilities with promising results (Aud et al., 2004). This article describes the subsequent revision and more extensive psychometric testing of the Observable Indicators of Nursing Home Care Quality–Assisted Living Version (OIQ-AL). |
| Databáze: | OpenAIRE |
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