Measuring next of kin’s experience of participation in the care of older people in nursing homes

Abstract

Background Lack of conceptual clarity and measurement methods have led to underdeveloped efforts to measure experience of participation in care by next of kin to older people in nursing homes. Objective We sought to assess the measurement properties of items aimed at operationalizing participation in care by next of kin, applied in nursing homes. Methods A total of 37 items operationalizing participation were administered via a questionnaire to 364 next of kin of older people in nursing homes. Measurement properties were tested with factor analysis and Rasch model analysis. Results The response rate to the questionnaire was 81% (n = 260). Missing responses per item varied between <0.5% and 10%. The 37 items were found to be two-dimensional, and 19 were deleted based on conceptual reasoning and Rasch model analysis. One dimension measured communication and trust (nine items, reliability 0.87) while the other measured collaboration in care (nine items, reliability 0.91). Items successfully operationalized a quantitative continuum from lower to higher degrees of participation, and were found to generally fit well with the Rasch model requirements, without disordered thresholds or differential item functioning. Total scores could be calculated based on the bifactor subscale structure (reliability 0.92). Older people (� 65 years) reported a higher degree of communication and trust and bifactor total scores than younger people (p < 0.05 in both cases). People with a specific contact person experienced a higher degree of participation in the two subscales and the bifactor total score (p < 0.05 in all three instances).

Institucionalização De Idosos E Cuidado Familiar: Perspectivas De Profissionais De Instituições De Longa Permanência

“…Em estudo internacional que avaliou a experiência de familiares no cuidado a idosos institucionalizados, evidenciou-se que a participação da família estava relacionada à proximidade com a equipe, assim como a relação de confiança entre os mesmos, o diálogo aberto sobre o idoso, ser convidado para concluir tarefas, respeitado pelo próprio conhecimento e reconhecido pela equipe como parte do cuidado (23) . Nesta perspectiva, a comunicação da equipe com os familiares de idosos pode ser instrumento facilitador na cooperação e participação familiar, assim como barreira, quando utilizada somente para comunicar incidentes ou alterações clínicas, não valorizando a família como importante colaborador das práticas de cuidado ou tomada de decisão (24) .…”

Next of kin participation in the care of older persons in nursing homes: A pre–post non-randomised educational evaluation, using within-group and individual person-level comparisons

“…First, when focusing on the individual level of change, the intervention can be regarded as successful for CaT but not as successful for CiC. This finding was somewhat expected because it has been hypothesised that it is easier for care interventions to achieve success in improving CaT than in improving CiC [ 11 ]. Previous research has shown somewhat similar results.…”

“…The NoK-PiC scale consists of two subscales, the CaT and the CiC, which can either be used separately or combined to produce a total score. The scales meet rigorous measurement standards, having, for instance, no differential item functioning, high person separation indexes and no disordered thresholds [ 11 ]. The subscales contain nine items each, and all items are scored from 0 to 4 ( do not agree at all [= 0]; agree to a low extent [= 1]; partially agree [= 2]; agree to a high extent [= 3] and totally agree [= 4]).…”

“…The subscales contain nine items each, and all items are scored from 0 to 4 ( do not agree at all [= 0]; agree to a low extent [= 1]; partially agree [= 2]; agree to a high extent [= 3] and totally agree [= 4]). Possible scores range from 0 to 36 on each of the two subscales and from 0 to 72 on the total scale [ 11 ].…”

“…First, in terms of outcome measures, we have previously described the concepts included in the Next of Kin Participation in Care (NoK-PiC) questionnaire, which is designed to measure NoK’s participation in care in nursing homes [ 11 ]. Specifically, these concepts are trusting the staff, being present, conversations and information, relationships with the staff, completing tasks, being respected for one’s knowledge and being acknowledged as part of the care team [ 11 ]. It has been found that participation in care can be measured using the NoK-PiC scale, which includes the Communication and Trust (CaT) and Collaboration in Care (CiC) subscales.…”