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

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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).

Conclusion

Psychometric properties revealed satisfactory support for use, in nursing home settings, of the self-reported Next of Kin Participation in Care questionnaire, with a bifactor structure. Additional research is needed to evaluate the effectiveness of the scales’ abilities to identify changes after intervention.

Trial registration

The KUPA project has Clinical Trials number NCT02708498.

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Most cited references 53

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Critical Values for Yen’s Q3: Identification of Local Dependence in the Rasch Model Using Residual Correlations

Karl Christensen, Guido Makransky, Mike Horton (2016)

The assumption of local independence is central to all item response theory (IRT) models. Violations can lead to inflated estimates of reliability and problems with construct validity. For the most widely used fit statistic Q3, there are currently no well-documented suggestions of the critical values which should be used to indicate local dependence (LD), and for this reason, a variety of arbitrary rules of thumb are used. In this study, an empirical data example and Monte Carlo simulation were used to investigate the different factors that can influence the null distribution of residual correlations, with the objective of proposing guidelines that researchers and practitioners can follow when making decisions about LD during scale development and validation. A parametric bootstrapping procedure should be implemented in each separate situation to obtain the critical value of LD applicable to the data set, and provide example critical values for a number of data structure situations. The results show that for the Q3 fit statistic, no single critical value is appropriate for all situations, as the percentiles in the empirical null distribution are influenced by the number of items, the sample size, and the number of response categories. Furthermore, the results show that LD should be considered relative to the average observed residual correlation, rather than to a uniform value, as this results in more stable percentiles for the null distribution of an adjusted fit statistic.

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How much change is true change? The minimum detectable change of the Berg Balance Scale in elderly people.

Declan Donoghue, Emma Stokes (2009)

To determine the minimum detectable change at 95% confidence for the Berg Balance Scale in a group of elderly people, undergoing physiotherapy rehabilitation. Multi-centre, test-retest design. Cross-sectional sample of convenience of people over 65 years (n = 118) without a previous history of stroke, Parkinson's disease or recent hip arthroplasty. RATERS: Physiotherapists working with elderly people, drawn from the Physiotherapy Research into Older People group, ranging in experience from newly qualified to 39 years qualified. Each participant was assessed using the Berg Balance Scale and again within 48 hours by the same physiotherapist. The minimum detectable change at 95% was established. A change of 4 points is needed to be 95% confident that true change has occurred if a patient scores within 45-56 initially, 5 points if they score within 35-44, 7 points if they score within 25-34 and, finally, 5 points if their initial score is within 0-24 on the Berg Balance Scale. A clinician with a working knowledge of these minimum detectable change values can be up to 95% confident that a true change or not a true change in a patients' functional balance has occurred and can therefore alter their interventions accordingly to ensure quality, focused rehabilitation.

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Mandatory TB notification in Mysore city, India: Have we heard the private practitioner’s plea?

Sarabjit Singh Chadha, Sharath Burugina Nagaraja, Archana Trivedi … (2017)

Background The Government of India, made TB notification by private healthcare providers mandatory from May 2012 onwards. The National TB Programme developed a case based web based online reporting mechanism called NIKSHAY. However, the notification by private providers has been very low. We conducted the present study to determine the awareness, practice and anticipated enablers related to TB notification among private practitioners in Mysore city during 2014. Methods A cross-sectional study was conducted among private practitioners of Mysore city in south India. The private practitioners in the city were identified and 258 representative practitioners using probability proportional to size were interviewed using semi-structured questionnaire. Results Among the 258 study participants, only 155 (60%) respondents agreed to a detailed interview. Among those interviewed, 141 (91%) were aware that TB is a notifiable disease; however 127 (82%) of them were not aware of process of notification and NIKSHAY. Only one in six practitioners was registered in NIKSHAY, while one in three practitioners are notifying without registration. The practitioners expected certain enablers from the programme like free drugs, training to notify in NIKSHAY and timely feedback. 74 (47%) opined that notification should be backed by legal punitive measures. Conclusion The programme should develop innovative strategies that provide enablers, address concerns of practitioners while having simple mechanisms for TB notification. The programme should strengthen its inherent capacity to monitor TB notification. Electronic supplementary material The online version of this article (doi:10.1186/s12913-016-1943-z) contains supplementary material, which is available to authorized users.

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Author and article information

Contributors

Albert Westergren:

ORCID: http://orcid.org/0000-0003-4820-6203

Role: ConceptualizationRole: Formal analysisRole: InvestigationRole: SoftwareRole: ValidationRole: VisualizationRole: Writing – original draftRole: Writing – review & editing

Lina Behm: Role: Data curationRole: ValidationRole: Writing – original draftRole: Writing – review & editing

Tove Lindhardt: Role: ConceptualizationRole: ValidationRole: Writing – review & editing

Magnus Persson:

ORCID: http://orcid.org/0000-0003-1062-2789

Role: Data curationRole: Project administrationRole: ValidationRole: Writing – original draftRole: Writing – review & editing

Gerd Ahlström:

ORCID: http://orcid.org/0000-0001-6230-7583

Role: Data curationRole: Funding acquisitionRole: Project administrationRole: ResourcesRole: ValidationRole: Writing – original draftRole: Writing – review & editing

Karl Bang Christensen: Role: Editor

Journal

Journal ID (nlm-ta): PLoS One

Journal ID (iso-abbrev): PLoS ONE

Journal ID (publisher-id): plos

Journal ID (pmc): plosone

Title: PLoS ONE

Publisher: Public Library of Science (San Francisco, CA USA )

ISSN (Electronic): 1932-6203

Publication date (Electronic): 31 January 2020

Publication date Collection: 2020

Volume: 15

Issue: 1

Electronic Location Identifier: e0228379

Affiliations

[1 ] Department of Health Sciences, Faculty of Medicine, Lund University, Lund, Sweden

[2 ] Research Platform for Collaboration for Health, Faculty of Health Sciences, Kristianstad University, Kristianstad, Sweden

[3 ] Department of Internal Medicine, Copenhagen University Hospital, Herlev, Denmark

University of Copenhagen, DENMARK

Author notes

Competing Interests: The authors have declared that no competing interests exist.

* E-mail: albert.westergren@ 123456med.lu.se

Author information

Albert Westergren http://orcid.org/0000-0003-4820-6203

Magnus Persson http://orcid.org/0000-0003-1062-2789

Gerd Ahlström http://orcid.org/0000-0001-6230-7583

Article

Publisher ID: PONE-D-19-14214

DOI: 10.1371/journal.pone.0228379

PMC ID: 6994140

PubMed ID: 32004352

SO-VID: 3556e91c-49d6-459b-81a3-47c3ae46fdfb

License:

This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

History

Date received : 20 May 2019

Date accepted : 14 January 2020

Page count

Figures: 5, Tables: 4, Pages: 22

Funding

Funded by: the Swedish Research Council

Award ID: grant number 2014-2759

Award Recipient :

ORCID: http://orcid.org/0000-0001-6230-7583

Gerd Ahlström

Funded by: Vårdal Foundation

Award ID: grant number 2014-0071

Award Recipient :

ORCID: http://orcid.org/0000-0001-6230-7583

Gerd Ahlström

Funded by: the Foundation of Hedda Andersson

Award ID: (no number)

Award Recipient :

ORCID: http://orcid.org/0000-0003-4820-6203

Albert Westergren

This study is part of the KUPA project and is funded by the Swedish Research Council (grant number 2014-2759); Vårdal Foundation (grant number 2014-0071); Medical Faculty, Lund University; The Faculty of Health and Life Sciences, Linnaeus University; The City of Lund. An additional grant from the Foundation of Hedda Andersson, Lund University, made this study possible. The authors declare no conflict of interest and that the grant sponsors had no role in the study design; data collection, analyses, or interpretation; writing of the manuscript; or decision to publish the results.

Custom metadata

Data Availability Data are available from the Swedish National Data Service ( https://snd.gu.se/en/catalogue/study/snd1135), and upon request from the first author.

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

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Trial registration

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Most cited references 53

Critical Values for Yen’s Q3: Identification of Local Dependence in the Rasch Model Using Residual Correlations

How much change is true change? The minimum detectable change of the Berg Balance Scale in elderly people.

Mandatory TB notification in Mysore city, India: Have we heard the private practitioner’s plea?

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