Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study
Objectives To assess the feasibility of capturing older care home residents’ quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach’s alpha) of four QoL measures.Design Cross-sectional data collected in wave 1 of the DA...
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BMJ Publishing Group
2025-01-01
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| author | Claire Goodman Julienne Meyer Karen Spilsbury Barbara Hanratty Rachael Carroll Adam L Gordon Gizdem Akdur Anne Killett Jennifer Burton Ann-Marie Towers Stacey Rand Nick Smith Sinead Palmer Stephen Allan Lucy Anne Webster |
| author_facet | Claire Goodman Julienne Meyer Karen Spilsbury Barbara Hanratty Rachael Carroll Adam L Gordon Gizdem Akdur Anne Killett Jennifer Burton Ann-Marie Towers Stacey Rand Nick Smith Sinead Palmer Stephen Allan Lucy Anne Webster |
| author_sort | Claire Goodman |
| collection | DOAJ |
| description | Objectives To assess the feasibility of capturing older care home residents’ quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach’s alpha) of four QoL measures.Design Cross-sectional data collected in wave 1 of the DACHA (Developing resources And minimum dataset for Care Homes’ Adoption) study, a mixed-methods pilot of a prototype minimum dataset (MDS).Setting Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia. All homes used a digital record system from one of two suppliers.Participants Data were extracted from 748 residents. All permanent residents, aged 65 years or older, were eligible to participate, including those lacking capacity to consent. Temporary residents and residents in their last weeks of life were excluded.Outcome measures and analysis The English language versions of Adult Social Care Outcomes Toolkit (ASCOT)-Proxy-Resident, ICEpop CAPability measure for Older people (ICECAP-O), EQ-5D-5L proxy and the QUALIDEM were added to the digital record. As there have not been any previous studies of the structural validity of the English language version of the QUALIDEM, ordinal exploratory factor analysis (EFA) was applied for this measure only. Feasibility (% missing by software provider and measure), % floor/ceiling effects (>15% at lower/upper end of the scales), convergent or divergent construct validity (criterion of >75% of hypotheses accepted) and internal consistency (Cronbach’s alpha ≥0.7) were assessed for all four measures.Results The ordinal EFA of QUALIDEM did not replicate the findings of previous research. A six-factor (36 item) solution was proposed and used in all subsequent analyses. There were low rates of missing data (<5%) for all items, except ASCOT-Proxy-Resident Control (5.1%) and Dignity (6.2%) and QUALIDEM item 35 (5.1%). Ceiling effects were observed for the ASCOT-Proxy-Resident and two of the QUALIDEM subscales. None of the scales had floor effects. Cronbach’s alpha indicated adequate internal consistency (α ≥0.70) for the ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L proxy. There were issues with two QUALIDEM subscales. Construct validity for all measures was adequate.Conclusions The findings support the use of EQ-5D-5L, ASCOT-Proxy-Resident and the ICECAP-O in care homes for older people. The choice of measure will depend on the construct(s) of interest. More research is needed to establish the psychometric properties of the QUALIDEM in an English care home setting. |
| format | Article |
| id | doaj-art-5fdabb070f014368950d06d897496b02 |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2025-01-01 |
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| series | BMJ Open |
| spelling | doaj-art-5fdabb070f014368950d06d897496b022025-01-30T11:15:13ZengBMJ Publishing GroupBMJ Open2044-60552025-01-0115110.1136/bmjopen-2024-090684Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional studyClaire Goodman0Julienne Meyer1Karen Spilsbury2Barbara Hanratty3Rachael Carroll4Adam L Gordon5Gizdem Akdur6Anne Killett7Jennifer Burton8Ann-Marie Towers9Stacey Rand10Nick Smith11Sinead Palmer12Stephen Allan13Lucy Anne Webster14Centre for Research in Public Health and Community Care, University of Hertfordshire, Hatfield, UKCity University of London, London, UKSchool of Healthcare, University of Leeds, Leeds, UKPopulation Health Sciences Institute, University of Newcastle upon Tyne, Newcastle upon Tyne, UKAcademic Unit of Injury, Recovery and Inflammation Sciences, University of Nottingham, Nottingham, UKAcademic Centre for Healthy Ageing (ACHA), Queen Mary University of London, London, UKCentre for Research in Public health and Community Care (CRIPACC), University of Hertfordshire, Hatfield, UKSchool of Health Sciences, University of East Anglia, Norwich, UKSchool of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UKHealth and Social Care Workforce Research Unit, King`s College London, London, UKPersonal Social Services Research Unit, University of Kent, Canterbury, UKCentre for Health Services Studies, University of Kent, Canterbury, UKPersonal Social Services Research Unit, University of Kent, Canterbury, UKPersonal Social Services Research Unit, University of Kent, Canterbury, UKCentre for Health Services Studies, University of Kent, Canterbury, UKObjectives To assess the feasibility of capturing older care home residents’ quality of life (QoL) in digital social care records and the construct validity (hypothesis testing) and internal consistency (Cronbach’s alpha) of four QoL measures.Design Cross-sectional data collected in wave 1 of the DACHA (Developing resources And minimum dataset for Care Homes’ Adoption) study, a mixed-methods pilot of a prototype minimum dataset (MDS).Setting Care homes (with or without nursing) registered to provide care for older adults (>65 years) and/or those living with dementia. All homes used a digital record system from one of two suppliers.Participants Data were extracted from 748 residents. All permanent residents, aged 65 years or older, were eligible to participate, including those lacking capacity to consent. Temporary residents and residents in their last weeks of life were excluded.Outcome measures and analysis The English language versions of Adult Social Care Outcomes Toolkit (ASCOT)-Proxy-Resident, ICEpop CAPability measure for Older people (ICECAP-O), EQ-5D-5L proxy and the QUALIDEM were added to the digital record. As there have not been any previous studies of the structural validity of the English language version of the QUALIDEM, ordinal exploratory factor analysis (EFA) was applied for this measure only. Feasibility (% missing by software provider and measure), % floor/ceiling effects (>15% at lower/upper end of the scales), convergent or divergent construct validity (criterion of >75% of hypotheses accepted) and internal consistency (Cronbach’s alpha ≥0.7) were assessed for all four measures.Results The ordinal EFA of QUALIDEM did not replicate the findings of previous research. A six-factor (36 item) solution was proposed and used in all subsequent analyses. There were low rates of missing data (<5%) for all items, except ASCOT-Proxy-Resident Control (5.1%) and Dignity (6.2%) and QUALIDEM item 35 (5.1%). Ceiling effects were observed for the ASCOT-Proxy-Resident and two of the QUALIDEM subscales. None of the scales had floor effects. Cronbach’s alpha indicated adequate internal consistency (α ≥0.70) for the ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L proxy. There were issues with two QUALIDEM subscales. Construct validity for all measures was adequate.Conclusions The findings support the use of EQ-5D-5L, ASCOT-Proxy-Resident and the ICECAP-O in care homes for older people. The choice of measure will depend on the construct(s) of interest. More research is needed to establish the psychometric properties of the QUALIDEM in an English care home setting.https://bmjopen.bmj.com/content/15/1/e090684.full |
| spellingShingle | Claire Goodman Julienne Meyer Karen Spilsbury Barbara Hanratty Rachael Carroll Adam L Gordon Gizdem Akdur Anne Killett Jennifer Burton Ann-Marie Towers Stacey Rand Nick Smith Sinead Palmer Stephen Allan Lucy Anne Webster Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study BMJ Open |
| title | Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study |
| title_full | Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study |
| title_fullStr | Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study |
| title_full_unstemmed | Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study |
| title_short | Assessing the feasibility of measuring residents’ quality of life in English care homes and the construct validity and internal consistency of measures completed by staff proxy: a cross-sectional study |
| title_sort | assessing the feasibility of measuring residents quality of life in english care homes and the construct validity and internal consistency of measures completed by staff proxy a cross sectional study |
| url | https://bmjopen.bmj.com/content/15/1/e090684.full |
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