Comparison of two tools developed to assess the needs of older people with complex care needs

Abstract

Greater standardisation of assessments of older people with complex care needs is a requirement of UK policy. This study explores the practicability and validity of two assessment tools, Minimum Data Set Resident Assessment Instrument (MDS-RAI) and EASY-Care. Participants, aged 65 years or over, living in care homes or awaiting hospital discharge, were assessed using randomly allocated paired instruments. Client evaluation questionnaires on the practicability of the tools were completed. Short Form 12 (SF12) questionnaires were administered to assess participants' health status. Registered nurses undertook data collection and participated in two focus groups designed to explore the practicability of the tools. Statistical tests were applied to quantitative data to assess practicability and validity. Thematic content analysis was used to analyse focus group transcripts. In all, 238 assessments were completed. Older people and assessors generally reported that both tools were practicable, with EASY-Care preferred to MDS-RAI for practicability Downloaded from measures including ease of use, usefulness and acceptability. Focus groups illustrated the significance of professional judgement when using structured tools. Both tools were reasonable indicators of activities of daily living, but there were shortcomings in measurements of cognitive performance and depression. Both instruments require development to fully capture the older person's perspectives of needs and to test the validity of key measures.

Systematic review of EASY-care needs assessment for community-dwelling older people

“…), a consensus was reached of nine papers which were assessed to be of acceptable quality, summarised in Table 2 . Three papers (from one study) included the use of EASY-Care administered in hospital with patients no longer receiving consultant-led care [ 9 – 11 ]. The sample was predominantly from community-dwelling older people, so they were included in the review.…”

“…Due to limited evidence outside of a research context, we are unable to say whether EASY-Care is useful in practice or not. However, there is evidence that it is preferred over other accredited tools [ 11 ].…”

“…The potential benefits of using EASY-Care in practice are described [ 34 ] with a good fit to nursing practice either as a needs assessment tool [ 11 ] or as a diagnostic tool [ 17 ]. Importantly, these positive reports that justify the benefits of using EASY-Care in practice are internationally recognised, with consistent responses from participants in different countries [ 16 , 21 ].…”

The Stanmore Nursing Assessment of Psychological Status: Understanding the emotions of patients with spinal cord injury

“…However it appeared that no valid and reliable instrument had been designed and developed for nurses specifically to facilitate the assessment of psychological status in patients with SCI. In the current study we aimed to develop such an instrument on the basis of literature relating to the development of assessment instruments within health care settings, [16][17][18] a contemporary understanding of emotion, 19,20 and in accordance with established methods of scale development. 21 Plutchik's emotion theory, 19 which argues that eight primary emotions are of crucial relevance to adaptation in response to illness, strengthened the focus of our interviews on identifying core emotional and psychological states present in the patients.…”

`Introducing yourself to strangers'

“…The study also used statistical methods to analyse the assessment data collected and to assess the construct and criterion validity of the tools. The results of the full study are reported in Lambert et al (2005).…”