Background: One way of measuring the quality of home care are quality indicators (QIs) derived from data collected with the Resident Assessment Instrument-Home Care (RAI-HC). In order to produce meaningful results for quality improvement and quality comparisons across home care organizations (HCOs) and over time, RAI-HC QIs must be valid and reliable. The aim of this systematic review was to identify currently existing RAI-HC QIs and to summarize the scientific knowledge on the validity and reliability of these QIs. Methods: A systematic review was performed using the electronic databases PubMed, CINAHL, Embase, PsycINFO and Cochrane Library. Studies describing the development process or the psychometric characteristics of RAI-HC QIs were eligible. The data extraction involved a general description of the included studies as well as the identified RAI-HC QIs and information on validity and reliability. The methodological quality of the identified RAI-HC QI sets was assessed using the Appraisal of Indicators through Research and Evaluation (AIRE) instrument. Results: Four studies out of 659 initial hits met the inclusion criteria. The included studies described the development and validation process of three RAI-HC QI sets comprising 48 unique RAI-HC QIs, which predominantly refer to outcome of care. Overall, the validity and reliability of the identified RAI-HC QIs were not sufficiently tested. The methodological quality of the three identified RAI-HC QI sets varied across the four AIRE instrument domains. None of the QI sets reached high methodological quality, defined as scores of 50% and higher in all four AIRE instrument domains. Conclusions: This is the first review that systematically summarized and appraised the available scientific evidence on the validity and reliability of RAI-HC QIs. It identified insufficient reporting of RAI-HC QIs validation processes and reliability as well as missing state-of-the-art methodologies. The review provides guidance as to what additional validity and reliability testing are needed to strengthen the scientific soundness of RAI-HC QIs. Considering that RAI-HC QIs are already implemented and used to measure and compare quality of home care, further investigations on RAI-HC QIs reliability and validity is recommended.

PurposeThe aims of this study were to analyze agreement on information needs within a group of early-state prostate cancer patients and to compare information preferences of patients with the view of health-care professionals about patients’ needs.MethodsSample consists of patients (n = 128) and six subgroups of health-care professionals (urologists, n = 32; nurses, n = 95; radiotherapy technologists (RTTs), n = 36; medical oncologists, n = 19; radiation oncologists, n = 12; general practitioners (GPs), n = 10). Information needs have been assessed with 92 questions concerning prostate cancer and its treatment. Respondents judged the importance of addressing each question. Within- and between-group agreements of patients and health-care professional groups were estimated with raw agreement indices as well as chance-corrected Kappa and Gwet’s AC1 measures. Finally, group-specific core items rated with high importance as well as high agreement were defined.ResultsPatients rated on average (median) half, i.e., 51 out 92 items as essential (interquartile range (IQR) = 36–66), 26 items as desired (IQR = 14–38), and 10 items as avoidable (IQR = 2–22). Within-group agreement on the presented information topics is modest for any participating group (AC1patients = 0.319; AC1professionals = 0.295–0.398). Agreement between patients and professionals is low too (AC1 = 0.282–0.329). Defining group-specific core sets of information topics results in 51 items being part of at least one core set. Concordance of the item core sets of patients and professionals is moderate with κ = 0.38–0.66, sensitivity of professionals’ core sets for patients’ preferences varies between 56 and 74 %.ConclusionsResults emphasize the need for dialogue between doctor/professional and patient in identifying the information needed by individual patients and support the importance of shared decision making.

BackgroundLow back pain (LBP) and neck pain (NP) are of considerable socioeconomic burden. Considering the escalating demand on health services that LBP and NP have globally, they represent an arguably unsustainable drain on resources with the projected increased demand secondary to an ageing population. Identifying populations at risk for LBP and NP may inform public health prevention strategies. Health professions’ (HP) students may be more susceptible due to their demographic factors and potentially risky postural demands of their education and formative clinical practice. The aim of our study was to compare self-reported LBP and NP of HP students with the general and stratified Swiss population to identify their prevalence. In addition, we compared the prevalence of LBP and NP in students studying different professions in order to identify whether susceptibilities exist.MethodsIn this cross-sectional study, self-reported LBP and NP reported by final-year HP students (n = 1848) were compared with the Swiss national population aged ≥15 years living in private households (n = 21,597). Binary regression models estimated crude prevalence and prevalence adjusted for age, gender, and education. Design-based F-Tests assessed differences between students and the Swiss population.ResultsCrude, overall four-week (4w) prevalence (mean (95% CIs)) for LBP was 61.0% (58.4–63.5) in all HP students versus 40.0% (39.2–40.9) in the Swiss population. Female HP students aged 21–30 years (63.3% (60.5–66.1)) reported higher LBP than the same-aged Swiss female population with secondary (43.7% (39.5–47.9)) or tertiary (36.6% (30.8–42.9)) education. Crude, overall 4w prevalence for NP was 59.8% (57.2–62.3) in all HP students versus 36.4% (35.6–37.3) in the Swiss population. Female health professions’ students aged 21–30 years reported higher NP (63.2% (60.4–66.0)) than the same-aged Swiss female population with secondary (36.6% (32.7–40.8)) or tertiary (35.4% (29.6–41.8)) education. The inter-professional differences shown indicate midwifery to be most susceptible to reporting both conditions.ConclusionsConsiderably higher LBP and NP were reported by final year HP students when compared with the general and stratified Swiss population. Worrying inter-professional susceptibilities were shown and reveal the need for further explanatory studies. Measures to reduce complex health problems like LBP and NP should be introduced into curricula in order to optimize the longevity of clinical careers and to protect the future HP workforce.

The Swiss version of RAI-HC provides a viable instrument for measuring quality of home care. The application of consistent assessment rules should be improved.

BackgroundThe Swiss Health Survey (SHS) provides the only source of data for monitoring overweight and obesity in the general population in Switzerland. However, this survey reports body mass index (BMI) based on self-reported height and weight, and is therefore subject to measurement errors. Moreover, it is not possible to differentiate between overall and abdominal overweight. In this study, we aimed to gain a better understanding of the need for weight management in the general population of Switzerland by exploring and comparing prevalence rates of BMI and waist circumference (WC) based on physical measurements by trained observers, based on data from the 2009 National Blood Pressure Week (NBPW).MethodsSample selection was based on a one-stage cluster design. A total of 385 pharmacies representing 3,600 subjects were randomly selected from pharmacies participating in NBPW. BMI measures based on physical weight and height (NBPW) were compared with self-reported BMI measures from the SHS. BMI and WC measurements from NBPW were then used to produce population estimates of overweight and obesity.ResultsBMI-based overall prevalence of overweight and obesity was 43.6%, which was 4.7% higher than the value based on the respective SHS data. Overweight and obesity were more common in men (54.3%) than in women (33.5%). However, the overall prevalence of increased WC in the general population was estimated to be 64.4%, with more women (68.4%) than men (60.1%) exhibiting a WC above the threshold. The prevalence of subjects requiring weight management in the Swiss population remained high, even after adjusting WC for false positive and negative cases.ConclusionsFirstly, it may be more appropriate for health promotion programs to address the wider group identified by WC, which includes subjects who need to reduce their weight, or gain no further weight. Secondly, the gender differences are reversed depending on the use of WC or BMI to identify subjects suitable for health promotion programs; more women than men are identified by WC, and more men than women using BMI. These differences should be accounted for in gender-specific health promotion programs.