Department of Nursing Home Medicine, EMGO Institute for Health and Care Research, Amsterdam, The Netherlands.
Qual Life Res. 2012 May;21(4):671-84. doi: 10.1007/s11136-011-9978-4. Epub 2011 Aug 5.
Quality of care for long-term care (LTC) residents with dementia at the end-of-life is often evaluated using standardized instruments that were not developed for or thoroughly tested in this population. Given the importance of using appropriate instruments to evaluate the quality of care (QOC) and quality of dying (QOD) in LTC, we compared the validity and reliability of ten available instruments commonly used for these purposes.
We performed prospective observations and retrospective interviews and surveys of family (n = 70) and professionals (n = 103) of LTC decedents with dementia in the Netherlands.
Instruments within the constructs QOC and QOD were highly correlated, and showed moderate to high correlation with overall assessments of QOC and QOD. Prospective and retrospective ratings using the same instruments differed little. Concordance between family and professional scores was low. Cronbach's alpha was mostly adequate. The EOLD-CAD showed good fit with pre-assumed factor structures. The EOLD-SWC and FPCS appear most valid and reliable for measuring QOC, and the EOLD-CAD and MSSE for measuring QOD. The POS performed worst in this population.
Our comparative study of psychometric properties of instruments allows for informed selection of QOC and QOD measures for LTC residents with dementia.
对于生命末期患有痴呆症的长期护理（LTC）居民的护理质量，通常使用不是为该人群开发或经过充分测试的标准化工具进行评估。鉴于在 LTC 中使用适当的工具评估护理质量（QOC）和临终质量（QOD）的重要性，我们比较了十种常用于这些目的的现有工具的有效性和可靠性。
我们在荷兰对 LTC 死者的家庭（n=70）和专业人员（n=103）进行了前瞻性观察和回顾性访谈和调查。
在 QOC 和 QOD 结构内的工具高度相关，并且与 QOC 和 QOD 的总体评估呈中度至高度相关。使用相同工具进行前瞻性和回顾性评分差异不大。家庭和专业人员评分之间的一致性较低。Cronbach's alpha 大多足够。EOLD-CAD 与预先假定的因子结构拟合良好。EOLD-SWC 和 FPCS 似乎最适合测量 QOC，而 EOLD-CAD 和 MSSE 最适合测量 QOD。POS 在该人群中的表现最差。
我们对工具的心理测量特性的比较研究为痴呆症 LTC 居民的 QOC 和 QOD 测量提供了明智的选择。
