Research & Development, Tuscaloosa VA Medical Center, Alabama.
Alabama Research Institute on Aging and Psychology Department, The University of Alabama, Tuscaloosa.
Gerontologist. 2018 Mar 19;58(2):e15-e24. doi: 10.1093/geront/gnw255.
To develop a structured observational tool, the Resident-centered Assessment of Interactions with Staff and Engagement tool (RAISE), to measure 2 critical, multi-faceted, organizational-level aspects of person-centered care (PCC) in nursing homes: (a) resident engagement and (b) the quality and frequency of staff-resident interactions.
In this multi-method psychometric development study, we conducted (a) 120 hr of ethnographic observations in one nursing home and (b) a targeted literature review to enable construct development. Two constructs for which no current structured observation measures existed emerged from this phase: nursing home resident-staff engagement and interaction. We developed the preliminary RAISE to measure these constructs and used the tool in 8 nursing homes at an average of 16 times. We conducted 8 iterative psychometric testing and refinement cycles with multi-disciplinary research team members. Each cycle consisted of observations using the draft tool, results review, and tool modification.
The final RAISE included a set of coding rules and procedures enabling simultaneously efficient, non-reactive, and representative quantitative measurement of the interaction and engagement components of nursing home life for staff and residents. It comprised 8 observational variables, each represented by extensive numeric codes. Raters achieved adequate to high reliability with all variables. There is preliminary evidence of face and construct validity via expert panel review.
The RAISE represents a valuable step forward in the measurement of PCC, providing objective, reliable data based on systematic observation.
开发一种结构化观察工具，即 Resident-centered Assessment of Interactions with Staff and Engagement tool（RAISE），以衡量养老院中以患者为中心的护理（PCC）的两个关键、多方面的组织层面方面：（a）患者参与度和（b）员工与患者互动的质量和频率。
在这项多方法心理测量发展研究中，我们进行了（a）在一家养老院进行了 120 小时的民族志观察，以及（b）有针对性的文献综述，以促进概念的发展。这一阶段出现了两个目前没有结构化观察测量的概念：养老院患者-员工参与度和互动。我们开发了初步的 RAISE 来衡量这些概念，并在 8 家养老院平均使用了 16 次。我们与多学科研究团队成员一起进行了 8 轮迭代的心理测量测试和改进循环。每个周期都包括使用草案工具进行观察、结果审查和工具修改。
最终的 RAISE 包括一套编码规则和程序，使我们能够同时高效、无反应和有代表性地对员工和患者的养老院生活互动和参与部分进行定量测量。它包括 8 个观察变量，每个变量都有广泛的数字代码表示。评分员对所有变量都达到了足够高的可靠性。通过专家小组的审查，初步证明了其具有表面效度和结构效度。
RAISE 在 PCC 的测量方面代表了一个有价值的进步，提供了基于系统观察的客观、可靠的数据。
