A New Measure of Nursing Home Care Quality

描述：（由申请人提供）我们建议完成我们的仪器的改进和现场测试，即养老院护理质量的可观察指标，以便其他研究人员以及潜在的消费者和监管机构可以使用它，通过对养老院的简短检查来评估护理质量。在我们初步的定性研究工作的基础上，我们确定了养老院护理质量的维度，我们从研究参与者的描述性陈述中构建了一个初始工具，可以观察到测量每个维度。该仪器已经修改了四次，每次都在该州的123家养老院进行了现场测试；初步的效度和信度测试结果令人满意。计划进行三个阶段的研究，以完成仪器的开发，供其他研究人员使用，并评估其效用和心理测量特性，作为帮助消费者和监管机构评估养老院护理质量的工具。在第一阶段，仪器将在密苏里州的250家养老院由经验丰富的卫生保健专业人员进行现场测试，以建立可靠性和推广理论估计。消费者代表和监管机构将在250家养老院中的30家进行现场测试。并发效度和已知组分析效度将使用最小数据集（MDS）质量指标（Qls）来测量。在第二阶段，该仪器将在另外两个中西部州的150家养老院进行现场测试。使用来自400家养老院的数据的两阶段因素分析将用于评估该工具的潜在结构。在第三阶段，评分指南将使用第一阶段和第二阶段的数据进行经验开发。计划对可观察指标仪器进行最后的现场测试，测试对象是决定搬进养老院的消费者。鉴于目前的人口和社会趋势，开发一种新的养老院护理质量衡量标准，可以在30分钟内轻松实施，并准确可靠地衡量质量的复杂方面，具有极其重要的意义。

DESCRIPTION: (provided by applicant) We propose to complete the refinement and field-testing of our instrument, the Observable Indicators of Nursing Home Care Quality, so that it can be used by other researchers and potentially by consumers and regulators, to assess quality of care on a brief inspection of a nursing home. Building upon our preliminary work of qualitative studies to identify the dimensions of quality of care in nursing homes, we constructed an initial instrument from the descriptive statements from study participants that were observable to measure each dimension. The instrument has been revised four times and field-tested each time in a total of 123 nursing homes in the state; preliminary validity and reliability test results are promising. Three phases of research are planned to complete the development of the instrument for use by other researchers and to assess its utility and psychometric properties as a tool to help consumers and regulators assess nursing home quality of care. During Phase One, the instrument will be field tested in 250 nursing homes in Missouri by experienced health care professionals to establish reliability and Generalizability theory estimates. Field tests with consumer representatives and regulators will be conducted in 30 of the 250 nursing homes. Concurrent validity and known groups analysis validity will be measured using the Minimum Data Set (MDS) quality indicators (Qls). During Phase Two, the instrument will be field tested in 150 nursing homes in two other Midwestern states. A two-stage factor analysis using data from the 400 nursing homes will be used to evaluate the underlying structure of the instrument. During Phase Three, scoring guidelines will be empirically developed using Phase One and Two data. A final field test is planned for the Observable Indicators instrument with consumers who are making the decision to move into a nursing home. In light of current demographic and societal trends, the development of a new measure of quality of care in nursing homes that can be easily administered in under 30 minutes and accurately and reliably measure the complex dimensions of quality is extremely relevant.