Health and Social Care Economics Group, Caring Future Institute, College of Nursing and Health Sciences, Flinders University, Sturt North, GPO Box 2100, Adelaide, South Australia, 5001, Australia.
Registry of Senior Australians, South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia.
Health Qual Life Outcomes. 2022 Dec 1;20(1):159. doi: 10.1186/s12955-022-02065-y.
Quality of Life-Aged Care Consumers (QOL-ACC) is a new older-person-specific quality of life instrument designed for application in quality assessment and economic evaluation in aged care. The QOL-ACC was designed from its inception with older people receiving aged care services ensuring its strong content validity. Given that the QOL-ACC has already been validated in home care settings and a preference-weighted value set developed, we aimed to assess feasibility, construct validity and reliability of the QOL-ACC in residential aged care settings. METHODS: Individuals living in residential aged care facilities participated in an interviewer-facilitated survey. The survey included the QOL-ACC, QCE-ACC (quality of aged care experience measure) and two other preference-based quality of life instruments (ASCOT and EQ-5D-5L). Feasibility was assessed using missing data and ceiling/floor effects. Construct validity was assessed by exploring the relationship between the QOL-ACC and other instruments (convergent validity) and the QOL-ACC's ability to discriminate varying levels of self-rated health and quality of life. Internal consistency reliability was assessed using Cronbach's alpha (α).
Of the 200 residents (mean age, 85 ± 7.7 years) who completed the survey, 60% were female and 69% were born in Australia. One in three participating residents self-rated their health as fair/poor. The QOL-ACC had no missing data but had small floor effects (0.5%) and acceptable ceiling effects (7.5%). It demonstrated moderate correlation with ASCOT (r = 0.51, p < 0.001) and EQ-5D-5L (r = 0.52, p < 0.001) and a stronger correlation with the QCE-ACC (r = 0.57, p < 0.001). Residents with poor self-rated health and quality of life had significantly lower scores on the QOL-ACC. The internal consistency reliability of the QOL-ACC and its dimensions was good (α = 0.70-0.77).
The QOL-ACC demonstrated good feasibility, construct validity and internal consistency reliability to assess aged care-related quality of life. Moderate correlations of the QOL-ACC and other instruments provide evidence of its construct validity and signifies that the QOL-ACC adds non-redundant and non-interchangeable information beyond the existing instruments. A stronger correlation with the QCE-ACC than other instruments may indicate that quality of life is more intimately connected with the care experience than either health- or social-related quality of life in residential aged care settings.
《生活质量-老年护理消费者量表》（QOL-ACC）是一种新的专门针对老年人的生活质量量表，旨在用于老年护理的质量评估和经济评估。该量表从一开始就由接受老年护理服务的老年人参与设计，以确保其具有很强的内容有效性。鉴于 QOL-ACC 已经在家庭护理环境中得到验证并开发了偏好加权值集，我们旨在评估其在养老院环境中的可行性、结构有效性和可靠性。
居住在养老院的个人参加了访谈员协助的调查。该调查包括 QOL-ACC、QCE-ACC（老年护理体验质量测量）和另外两个基于偏好的生活质量量表（ASCOT 和 EQ-5D-5L）。通过缺失数据和天花板/地板效应评估可行性。结构有效性通过探索 QOL-ACC 与其他工具之间的关系（收敛有效性）以及 QOL-ACC 区分不同自我评估健康和生活质量水平的能力来评估。使用 Cronbach's alpha (α) 评估内部一致性可靠性。
在完成调查的 200 名居民（平均年龄 85±7.7 岁）中，有 60%为女性，69%出生于澳大利亚。三分之一的参与居民自我评估健康状况为一般/较差。QOL-ACC 没有缺失数据，但有很小的地板效应（0.5%）和可接受的天花板效应（7.5%）。它与 ASCOT（r=0.51，p<0.001）和 EQ-5D-5L（r=0.52，p<0.001）具有中度相关性，与 QCE-ACC（r=0.57，p<0.001）的相关性更强。自我评估健康状况和生活质量较差的居民在 QOL-ACC 上的得分明显较低。QOL-ACC 及其维度的内部一致性可靠性良好（α=0.70-0.77）。
QOL-ACC 表现出良好的可行性、结构有效性和内部一致性可靠性，可用于评估与老年护理相关的生活质量。QOL-ACC 与其他工具的中度相关性提供了其结构有效性的证据，并表明 QOL-ACC 提供了现有工具之外的非冗余和不可互换的信息。与其他工具相比，QOL-ACC 与 QCE-ACC 的相关性更强，这可能表明在养老院环境中，生活质量与护理体验的关系比健康或社会相关生活质量更为密切。
