Questioning the Questionnaire: Methodological Challenges in Measuring Subjective Quality of Life in Nursing Homes Using Cognitive Interviewing Techniques

Community-based assessment of the dynamics of urban landscape characteristics and ecosystem services in the rainforest and guinea savanna ecoregions of Nigeria

Understanding the dynamics of urban landscapes and their impacts on ecological well-being is crucial for developing sustainable urban management strategies in times of rapid urbanisation. This study assesses the nature and drivers of the changing urban landscape and ecosystem services in cities located in the rainforest (Akure and Owerri) and guinea savannah (Makurdi and Minna) of Nigeria using a combination of remote sensing and socioeconomic techniques. Landsat 8 datasets provided spatial patterns of the normalised difference vegetation index (NDVI) and normalised difference built-up index (NDBI). A household survey involving the administration of a semi-structured questionnaire to 1552 participants was conducted. Diminishing NDVI and increasing NDBI were observed due to the rising trend of urban expansion, corroborating the perception of over 54% of the respondents who noted a decline in landscape ecological health. Residential expansion, agricultural practices, transport and infrastructural development, and fuelwood production were recognised as the principal drivers of landscape changes. Climate variability/change reportedly makes a 28.5%-34.4% (Negelkerke R2) contribution to the changing status of natural landscapes in Akure and Makurdi as modelled by multinomial logistic regression, while population growth/in-migration and economic activities reportedly account for 19.9%-36.3% in Owerri and Minna. Consequently, ecosystem services were perceived to have declined in their potential to regulate air and water pollution, reduce soil erosion and flooding, and mitigate urban heat stress, with a corresponding reduction in access to social services. We recommend that urban residents be integrated into management policies geared towards effectively developing and enforcing urban planning regulations, promoting urban afforestation, and establishing sustainable waste management systems.

The Use of an Iterative Strategy of Cognitive Interview and Expert Consultation to Revise the Quality of Life Scale for Patients with Aplastic Anemia (QLS-AA)

Background

Aplastic anemia is characterized by anemia, hemorrhage and infection, and is accompanied by a variety of complications and psychological burden. Therefore, the quality of life of AA patients is not optimistic. Our team is committed to developing an assessment tool for the quality of life of AA patients, and adopting an iterative strategy of cognitive interview and expert consultation to solve the challenges encountered in item revision.

Purpose

We aim to use the strategy of cognitive interview and expert consultation to inform revision of the QLS-AA into a user-friendly tool with unambiguous items and improve the content validity of the scale.

Methods

We used an iterative strategy of cognitive interview and expert consultation. Two rounds of cognitive interview were conducted to identify problems with item comprehension, recall and other cognitive processes. As well as, a multi-disciplinary group of expert consultation was consulted to review the rationality of item revisions.

Results

In the first round of cognitive interview, 16 participants responded to 107 items. Among them, the most common problems were "clarification" and "item duplication". Based on the results of the first round of interview, an expert consultation was organized. A total of 16 amendments were put forward by the expert and 14 were adopted. In the second round of cognitive interviews, A total of 5 participants were included and 64 items were evaluated. Two items were suggested to be revised, and the remaining items were accurately understood and recognized by all participants.

Couclusion

This study highlights the key issues to consider when incorporating patient perspectives into quality measurement. The revision of QLS-AA through the strategy of cognitive interview and expert consultation may provide valuable insights into the measurement of quality of life in aplastic patients.

Trial Registration Number

ChiCTR2100047575.

Assessing the well-being of residents in nursing facilities

Purpose

Well-adapted and validated well-being (WB) instruments for the nursing home population are scarce. To our knowledge, the Laurens Well-Being Inventory for Gerontopsychiatry (LWIG) is a practical and reliable well-being assessment tool that has never been validated for German nursing home populations. Therefore, the purpose of our study was to (1) translate and cross-culturally adapt the LWIG to a German context and (2) test the reliability and validity of the German LWIG in a group of older nursing home residents using the Rasch model.

Methods

This study has a cross-sectional, descriptive study design. Cross-cultural adaption of the LWIG-GER from English to German was performed according to a standardized method. The data obtained from 104 long-term nursing home residents (57 women, 47 men) aged 60–99 years (mean 79.5, standard deviation ±9.11) were analyzed for psychometric testing (exploratory and confirmatory factor analysis, item fit, McDonald’s ω, convergent validity, and known-group validity, Rasch).

Results

The final LWIG-GER consists of 19 items with three subscales, including “psychological WB”, “social WB”, and “physical WB”. The LWIG-GER showed good overall reliability with McDonald’s ω of 0.83; the LWIG-GER dimensions’ scores were significantly correlated with depression, functional performance, activities, fear of falling, and education.

Conclusions

Our findings suggest that the German language version of the LWIG is a reliable and valid tool for measuring WB in nursing home residents. Furthermore, we propose that the LWIG-GER questionnaire can broaden and deepen our understanding of residents’ perception of quality of care and their environment.

Disability "In-Justice": The Benefits and Challenges of "Yarning" With Young People Undergoing Diagnostic Assessment for Fetal Alcohol Spectrum Disorder in a Youth Detention Center

Undertaking research with young people presents an array of methodological challenges. We report the findings from a qualitative study that took place alongside a fetal alcohol spectrum disorder (FASD) prevalence study among detainees in Australia. Of 38 participants, 27 were Aboriginal youth. Interviews were conducted using "social yarning" and "research topic yarning," an Indigenous research method which allows for data collection in an exploratory, culturally safe way. A complex interplay emerged between social yarning and research topic yarning which provided a space to explore responsively with participants their experiences of FASD assessments. Flexibility, including language adaptation and visual descriptions about assessments, was utilized to assist participants recall and retell their experiences. There were, however, challenges in gathering data on the assessment experiences of some participants. We describe how employing a "yarning" method for collecting data could benefit children and young people undergoing neurodevelopmental assessments in the future.

Development of a quality of life questionnaire for nursing home residents in mainland China

OBJECTIVE

To develop and validate a quality of life (QOL) questionnaire for nursing home (NH) residents in mainland China.

METHODS

A cross-sectional study including a development sample (n = 176) and validation sample (n = 371) of NH residents aged 60 and older was conducted between 2015 and 2016 in Jinan, Shandong Province, China. Resident interviews, literature reviews, expert panels, and pilot studies were used to identify QOL domains and items pertinent to NH life. Exploratory and confirmatory factor analysis were used to develop and validate a QOL questionnaire. Reliability (internal consistency, spilt-half reliability, and test-retest reliability) and validity (construct and criterion validity) were evaluated for the questionnaire.

RESULTS

The self-report Chinese NH QOL questionnaire had 9 domains and 38 items including physical health (4 items), food enjoyment (6 items), security (3 items), environmental comfort (5 items), autonomy (2 items), meaningful activity (3 items), interrelationship (6 items), family relationships (3 items), and mood (6 items). The nine-factor model was confirmed with the following fit indices: χ²/df = 1.872, root mean square error of approximation = 0.049, comparative fit index = 0.913, and Tucker-Lewis index = 0.903. The 38-item NH QOL questionnaire showed satisfactory construct validity, criterion validity, internal consistency (Cronbach's alpha = 0.89, spilt-half reliability = 0.73, test-retest reliability = 0.76).

CONCLUSIONS

The NH QOL questionnaire appears to be a reliable and valid instrument and should be incorporated into a set of quality measures for use with NH residents in mainland China.