Feasibility, understandability, and usefulness of the STEP self-rating questionnaire: results of a cross-sectional study

Abstract

The study was designed to evaluate the acceptance of the self-rated version of the Standardized Assessment of Elderly People in primary care in Europe (STEP) by patients and general practitioners, as well as the feasibility, comprehensibility, and usefulness in gaining new information. In all, 1007 of 1540 patients aged 65 and above, from 28 different Saxon general practices took part. We recognized that 96% of the patients were able to fill in the questionnaire by themselves. It took them an average of approximately 20 minutes to do so. Further analysis of 257 randomly selected patients identified 281 previously unknown problems (1.1 per patient). In the practitioners’ opinion, 16% of these problems, particularly physiological and mental ones, could lead to immediate consequences. Remarkably, newly identified psychosocial problems were not followed by any consequences. Fourteen of the 75 questionnaire items were not answered by more than 9% of the participants. Eight of the 14 frequently unanswered items were marked as difficult to understand by the patients. Altogether the self-rating version of the STEP was found to be feasible and useful. It was well accepted among patients; however, some questions need further review to improve their comprehensibility. Furthermore, it should be investigated why some identified problems do not have consequences and whether there is a need to record these issues at all.

STEP as a Useful Tool to Screen for Diabetes-Specific Health-Related Problems in Community-Based Geriatric Patients- An Exploratory Secondary Analysis of Cross-Sectional Data

“…This is an exploratory secondary analysis of data from a cross-sectional study by Frese et al (2013) investigating the feasibility and useful-ness of the self-administered version of the STEP as perceived by patients and GPs [10].…”

“…Participation was not selective regarding sex and age. For a detailed description of the original study design, especially recruitment of practices and patients please refer to Frese et al [10]. Altogether 1007 out of 1540 patients from 28 GP practices in Leipzig (urban) and southwest Saxony (rural) completed the STEP assessment (response rate 65.4 %).…”

“…STEP was thought to evaluate health problems of elderly people that are relevant, can be diagnosed with an adequate and acceptable testing procedure, are prone to treatment and cost efficient [7]. The content of the STEP questionnaire (as part of a multi-step approach) was first published by Junius et al [17] and Sandholzer et al [18] and modified for the original study [10]. 10 fields of interest are covered (personal data, diseases and medications, physical fitness and activities of daily life, social environment, general complaints, physical symptoms, mood, memory, health behaviour, and hospital treatment).…”

“…STEP contains a self-rating questionnaire as well as a structured physical examination and additional tests covering 33 health domains proven to be relevant and accessible in the primary care context [1,7]. It has been proven to be helpful to reveal so far unknown and unmentioned health problems in different European countries [8][9][10] and effective in reducing mortality and preventing nursing-home admissions [9].…”

“…However, due to time restraints CGAs are often not applied routinely in the primary care context [10,11], and efforts have been made to find more easily applicable tools as screening instruments for every-day use [11,12]. Based on the STEP, we tested a self-administered and thus easy-to-handle version of the patient self-rating questionnaire and found it to be useful and acceptable [10].…”