Article type
Abstract
Objectives To identify and evaluate the psychometric properties of QIs for the long-term care of older adults with dementia living in integrated medical and nursing care facilities and to select QIs that perform well on psychometric properties to form a recommended set of QIs.
Methods A literature search of eight databases and reference chaining studies describing QIs for caring for older adults with dementia in integrated medical and nursing care settings. The QIs were categorized as relating to structure, process, or outcome and mapped against six care domains. The psychometric properties (acceptability, evidence base, definition, feasibility, reliability, and validity) of each QI were assessed using a 4-level rating scale: positive (+), moderate (+/-), negative (-), and unknown (×) to categorize as robust, moderate, or poor.
Results From 1678 titles and abstracts screened, 19 papers and 649 QIs were included. Structure, process and outcome QIs accounted for 31 (4.8%), 438 (67.5%), and 180 (27.7%) of all QIs, respectively. While many QIs concerned physical aspects of care(n=492,50.4%), very few concerned rehabilitation services (n=5,0.8%). 348 (53.6%) QIs were found to be appropriate, and 301 (46.4%) QIs were found to be inappropriate. A small number of positive (+) scores include reliability 101 (15.6%) and validity 316 (48.7%). The final shortlist of 29 QIs was derived from six studies.
Conclusions The 29 QIs from 6 studies can scientifically and effectively measure a specific aspect of the quality of care for older adults with dementia and provide a basis for constructing a quality assessment tool for dementia care in China. Next, we need to go further to conduct research on social psychological support services and rehabilitation QIs for older adults with dementia in medical and nursing institutions, verify the effectiveness of existing QIs, and construct a set of QI systems for dementia care in medical and nursing institutions according to China's national conditions, to provide Chinese data for the global research field of dementia care.
Methods A literature search of eight databases and reference chaining studies describing QIs for caring for older adults with dementia in integrated medical and nursing care settings. The QIs were categorized as relating to structure, process, or outcome and mapped against six care domains. The psychometric properties (acceptability, evidence base, definition, feasibility, reliability, and validity) of each QI were assessed using a 4-level rating scale: positive (+), moderate (+/-), negative (-), and unknown (×) to categorize as robust, moderate, or poor.
Results From 1678 titles and abstracts screened, 19 papers and 649 QIs were included. Structure, process and outcome QIs accounted for 31 (4.8%), 438 (67.5%), and 180 (27.7%) of all QIs, respectively. While many QIs concerned physical aspects of care(n=492,50.4%), very few concerned rehabilitation services (n=5,0.8%). 348 (53.6%) QIs were found to be appropriate, and 301 (46.4%) QIs were found to be inappropriate. A small number of positive (+) scores include reliability 101 (15.6%) and validity 316 (48.7%). The final shortlist of 29 QIs was derived from six studies.
Conclusions The 29 QIs from 6 studies can scientifically and effectively measure a specific aspect of the quality of care for older adults with dementia and provide a basis for constructing a quality assessment tool for dementia care in China. Next, we need to go further to conduct research on social psychological support services and rehabilitation QIs for older adults with dementia in medical and nursing institutions, verify the effectiveness of existing QIs, and construct a set of QI systems for dementia care in medical and nursing institutions according to China's national conditions, to provide Chinese data for the global research field of dementia care.