Developing dimensions for a new preference-based quality of life instrument for older people receiving aged care services in the community

Abstract

Purpose To identify the salient quality of life characteristics relevant to older people in receipt of community aged care services in order to develop dimensions for a draft descriptive system for a new preference-based quality of life instrument. Methods Forty-one in-depth semi-structured interviews were undertaken with older people (65 years and over) receiving community aged care services across three Australian states to explore quality of life characteristics of importance to them. The data were analysed using framework analysis to extract broader themes which were organised into a conceptual framework. The data were then summarised into a thematic chart to develop a framework matrix which was used to interpret and synthesise the data. Care was taken throughout to retain the language that older people had adopted during the interviews to ensure that appropriate language was used when identifying and developing the quality of life dimensions. Results The analysis resulted in the identification of five salient quality of life dimensions: independence, social connections, emotional well-being, mobility, and activities. Conclusion This research finds that quality of life for older people accessing aged care services goes beyond health-related quality of life and incorporates broader aspects that transcend health. The findings represent the first stage in a multiphase project working in partnership with older people to develop a new preference-based instrument of quality of life for informing quality assessment and economic evaluation in community aged care. In future work, draft items will be developed from these dimensions and tested in face validity interviews before progressing to further psychometric testing.

The integration of mixed methods data to develop the quality of life – aged care consumers (QOL-ACC) instrument

“…walking stick or walking frame. This is because our Stage 1 in-depth qualitative interviews identified that older people who regularly use these devices considered themselves to be mobile [ 33 ]. This differentiates the QOL-ACC from other quality of life instruments developed with general adult populations, where a person using a mobility device could receive the lowest mobility score if they are not prompted to consider mobility aids when making their response.…”

“…This methodological approach ensured that the final instrument is psychometrically robust as well as meaningful, relevant and acceptable to aged care consumers and providers. The QOL-ACC items were developed from qualitative interviews with older people receiving aged care services about what was important for them to feel like they had a good quality of life [ 33 ] and are therefore based on what is most relevant and meaningful to older people themselves. The face validity interviews removed items that older people saw as ambiguous or potentially sensitive, and the low levels of missing data suggest that items were acceptable to participants.…”

“…1 ). These interviews identified what quality of life meant to older people and which factors most influenced their perceptions regarding their current quality of life [ 33 ]. The six dimensions that were identified as being most salient to older people’s quality of life were: mobility, pain management, emotional well-being, independence, social connections, and activities.…”

“…At this stage we noted that, relative to existing quality of life instruments that included these domains, older people talked very differently about mobility and pain. For example, older people who used mobility aids still considered themselves mobile and most older people did not expect to be pain free but rather spoke of managing pain [ 33 ]. In stage 2, a workshop was held with all members of the research team, as well as consumer and aged care provider representation, to review the qualitative data and to prepare draft items for each of the six dimensions, using the language, content and terminology used by the participants themselves in describing what quality of life means to them.…”

Research on the Incentive Mechanism of the Pension Service Supply Chain under Asymmetric Information

“…Suwa et al investigated and analyzed the views of Japan, Ireland, and Finland on the participation of robots in home care for the elderly by means of questionnaires [9]. Cleland et al conducted 41 in-depth, semistructured interviews with people over 65 years of age receiving community-based geriatric care in three Australian states to study the quality of community-based geriatric care [10].…”