Centre for Health Services Studies (CHSS), University of Kent, Kent, UK.
Personal Social Services Research Unit (PSSRU), University of Kent, Kent, UK.
Age Ageing. 2023 Sep 1;52(9). doi: 10.1093/ageing/afad168.
The adult social care outcomes toolkit (ASCOT) measures social care-related quality of life (SCRQoL) using self-completion questionnaires and interviews. Many care home residents find such methods inaccessible, leading to a reliance on proxy-reporting. This study aimed to establish the psychometric properties of the mixed-methods toolkit [ASCOT-Care Homes, 4 outcome (CH4)] for measuring SCRQoL when residents cannot self-report.
Two cross-sectional, mixed-methods studies were undertaken in care homes for older people in England between 2015 and 2020. We used the ASCOT-CH4 (observation, and interviews with residents and proxies) to collect information about SCRQoL and collected additional data on residents' needs and characteristics, and variables hypothesised to be related to SCRQoL.Hypothesis testing was applied to establish construct validity, Cronbach's alpha for internal consistency and exploratory factor analysis for structural validity.
The combined dataset included 475 residents from 54 care homes (34 nursing, 20 residential). Half had a diagnosis of dementia. Less than a third of residents were able to complete an ASCOT interview. Observations and proxy interviews informed researcher ratings, meaning there were no missing ASCOT-CH4 scores. ASCOT-CH4 was found to be a weak unidimensional scale, consistent with other ASCOT measures, with acceptable internal consistency (α = 0.77, 8 items). Construct validity was supported by the findings.
The ASCOT-CH4 is an alternative to conventional proxy-questionnaires for measuring the SCRQoL of care home residents, with good psychometric properties. A limitation is that users need a range of data collection skills. Future research should explore whether findings are replicable when data are collected by other researchers.
成人社会关怀结果工具包（ASCOT）使用自我完成的问卷和访谈来衡量与社会关怀相关的生活质量（SCRQoL）。许多养老院居民发现这些方法难以获得，因此依赖代理报告。本研究旨在为无法自我报告的居民建立混合方法工具包 [ASCOT-养老院，4 项结果（CH4）] 来衡量 SCRQoL 的心理测量特性。
2015 年至 2020 年期间，在英格兰的老年人养老院进行了两项横断面、混合方法研究。我们使用 ASCOT-CH4（观察以及对居民及其代理人的访谈）来收集关于 SCRQoL 的信息，并收集了有关居民需求和特征以及假设与 SCRQoL 相关的变量的其他数据。假设检验用于建立构念效度、内部一致性的克朗巴赫 α 和结构效度的探索性因素分析。
合并数据集包括来自 54 家养老院的 475 名居民（34 名护理，20 名住宿）。一半居民被诊断患有痴呆症。不到三分之一的居民能够完成 ASCOT 访谈。观察和代理访谈为研究人员的评估提供了信息，这意味着没有 ASCOT-CH4 缺失分数。ASCOT-CH4 是一个较弱的单维量表，与其他 ASCOT 测量方法一致，具有可接受的内部一致性（α=0.77，8 项）。研究结果支持构念效度。
ASCOT-CH4 是衡量养老院居民 SCRQoL 的替代传统代理问卷的方法，具有良好的心理测量特性。一个限制是用户需要一系列数据收集技能。未来的研究应探讨当由其他研究人员收集数据时，研究结果是否具有可复制性。
