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      Capabilities and quality of life in Dutch psycho-geriatric nursing homes: an exploratory study using a proxy version of the ICECAP-O

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          Abstract

          Purpose

          To validate the ICECAP-O capability measure in psycho-geriatric elderly in nursing homes, we compared the capability scores of restrained and unrestrained clients. Both nursing staff and family were used as proxies for assessing clients’ capabilities.

          Method

          For 122 psycho-geriatric elderly, a total of 96 nursing professionals and 68 family members completed a proxy questionnaire. We investigated the convergent and discriminant validity of the ICECAP-O and measures of care dependency, health-related quality of life, and overall quality of life. We also directly compared ICECAP-O scores of the 56 clients for whom both nursing staff and family members had completed the questionnaire.

          Results

          Convergent validity between ICECAP-O and care dependency, health-related, and overall quality of life measures could be established, as well as discriminant validity for the restrained and unrestrained groups. Nursing and family proxy ICECAP-O tariffs were not significantly correlated.

          Discussion

          ICECAP-O measures a more general concept than health-related quality of life and can differentiate between restrained and non-restrained psycho-geriatric clients. Since nurses seem to be able to assess the current quality of life of clients using the ICECAP-O more precisely than the family proxies, for now the use of nursing proxies is recommended in a nursing home setting.

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          Developing attributes for a generic quality of life measure for older people: preferences or capabilities?

          John Bond, Jane Lewis, Joanna Coast … (2006)
          Current UK policy with respect to the provision of health and social care for older people suggests that greater integration is required. Economists' attempts to assist resource allocation decisions, however, are very health focused, with concentration on the use of health-related quality of life measures. This paper reports an attempt to determine attributes for a new index clearly focusing on quality of life for older people rather than health or other influences on quality of life. In-depth interviews were conducted with 40 purposively selected informants aged 65 and over in private households to explore their views about what is important to them in terms of quality of life. Data were analysed using Framework qualitative analysis. Initial discussions tended to concentrate upon factors influencing quality of life including activities, relationships, health, wealth and surroundings. Further probing and analysis suggested five conceptual attributes: attachment, role, enjoyment, security and control. The data also suggested that the quality of informants' lives was limited by the loss of ability to pursue these attributes. So, for example, it is not poor health in itself, which reduces quality of life, but the influence of that poor health upon each informant's ability to, say, be independent, that is important. Amartya Sen's work on functioning and capability is particularly pertinent here. Using this work, it is possible to interpret the five conceptual attributes as a set of functionings-important for older people in the UK in the 21st century-but noting that it is the capacity to achieve these functionings that appears to be of importance. This suggests that further development of this measure should focus on an index of capability rather than preference-based utility.
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            An assessment of the construct validity of the descriptive system for the ICECAP capability measure for older people.

            Joanna Coast, Tim Peters, Lucy Natarajan … (2008)
            The index of capability (ICECAP) was developed using in-depth interviews with 40 older people and comprises five attributes: attachment, security, enjoyment, role and control. This paper explores the construct validity of these five capability attributes. An interview survey was conducted with individuals aged 65 and over located across the UK. Data were analysed in six categories (socio-demographic variables and general well-being, contact with others, health, nature of the locality and environment, social support and participation) using chi-squared tests (for categorical variables) or one-way analysis of variance (for continuous variables). About 315 individuals were interviewed (response rate 66%). Relationships were generally as anticipated with, for example: strong relationships between age and capability and well-being and capability, but no relationships between capability and either sex or social class; strong relationships between physical measures of health and role, enjoyment and control, and between mental health measures and attachment and enjoyment. This study provides some early evidence for the construct validity of the ICECAP measure. Where anticipated relationships were not observed this might in part be explained in that the ICECAP index asks about capability, but the factors with which associations were examined were largely and inevitably measures of function.
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              Welfarism vs. extra-welfarism.

              Rob Kammen, Werner Brouwer, Anthony Culyer … (2008)
              'Extra-welfarism' has received some attention in health economics, yet there is little consensus on what distinguishes it from more conventional 'welfarist economics'. In this paper, we seek to identify the characteristics of each in order to make a systematic comparison of the ways in which they evaluate alternative social states. The focus, though this is not intended to be exclusive, is on health. Specifically, we highlight four areas in which the two schools differ: (i) the outcomes considered relevant in an evaluation; (ii) the sources of valuation of the relevant outcomes; (iii) the basis of weighting of relevant outcomes and (iv) interpersonal comparisons. We conclude that these differences are substantive.
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                Author and article information

                Contributors
                : +31-10-4088700 , +31-10-4089094 , makai@bmg.eur.nl
                Journal
                Journal ID (nlm-ta): Qual Life Res
                Journal ID (iso-abbrev): Qual Life Res
                Title: Quality of Life Research
                Publisher: Springer Netherlands (Dordrecht )
                ISSN (Print): 0962-9343
                ISSN (Electronic): 1573-2649
                Publication date (Electronic): 6 September 2011
                Publication date PMC-release: 6 September 2011
                Publication date (Print): June 2012
                Volume: 21
                Issue: 5
                Pages: 801-812
                Affiliations
                Institute of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, The Netherlands
                Article
                Publisher ID: 9997
                DOI: 10.1007/s11136-011-9997-1
                PMC ID: 3348451
                PubMed ID: 21894489
                SO-VID: 37a4c1b7-60e4-40fa-9ac5-d0ba62e30c17
                Copyright © © The Author(s) 2011
                History
                Date accepted : 15 August 2011
                Categories
                Subject: Article
                Custom metadata
                issue-copyright-statement © Springer Science+Business Media B.V. 2012

                ScienceOpen disciplines: Public health
                Keywords: psycho-geriatric elderly,icecap-o,capabilities
                Data availability:
                ScienceOpen disciplines: Public health
                Keywords: psycho-geriatric elderly, icecap-o, capabilities

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