Using spontaneous commentary of nursing home residents to develop resident-centered measurement tools: A case study.
Lauren R Bangerter, Katherine Abbott, Allison Heid and 2 others
PMID 28579080WHAT IT FOUND
Nursing home residents' comments showed preferences were often important but blocked by barriers.
The team used 7,893 comments to revise the measure and add an 'important, but can't do' option.
Key findings
01Residents provided 7,893 spontaneous comments, and a major theme was that a preference could be important but barriers prevented fulfilling it.
02Comments led to an option to respond that a preference item was 'important, but can't do' and to questions about choice, satisfaction, and why residents changed their minds.
03From the 85-item PELI used initially, 20 items were modified and retained, 23 items were deleted, and 11 items were added.
STILL TO COME
How it was doneWhat they foundWhat it means for RNs
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What it does not show
Only 370 of 760 referred residents were included, and the sample was mostly white, female, East Coast, and English speaking. Residents who scored 13 or below on the MMSE were excluded, so the comments do not represent people with more severe cognitive impairment. Residents with life limiting illness, short stays, or less than one week at the facility were excluded, so the findings may not apply to those groups. The paper reports comments and item revisions, not whether the revised measure improves care or resident outcomes.
The easy way to misread this
Do not conclude that the revised measure is validated or that asking for comments improves care. The paper reports comments and item revisions, not tested outcomes.