Perspectives of nursing professionals and older adults differ on aspects of care for older people after a nationwide improvement program

Quality evaluation questionnaires - nursing homes (QEQ-NH); validation of questionnaires for measuring quality of care in nursing homes from various perspectives

Background

This study aims to describe the validation and optimization of a new instrument designed to comprehensively measure and evaluate the quality of care in nursing homes; the Quality Evaluation Questionnaires for Nursing Homes (QEQ-NH). This instrument comprises several questionnaires on the perceived quality of care for various perspectives (e.g. clients, family and professional caregivers) and covers eight themes of the national quality framework for nursing home care in the Netherlands.

Methods

Data were collected in six nursing homes between September 2017 and June 2018, among 359 residents, 48 family caregivers and 648 professional caregivers who completed a subgroup-specific questionnaire of the QEQ-NH. Construct and criterion validity of the three questionnaires were tested with item- and scale analyses. Content validity of the questionnaires was tested in cognitive interviews with 20 participants (7 residents, 5 family caregivers and 8 professional caregivers).

Results

Psychometric analyses confirmed the multidimensionality and reliability of the three questionnaires, and the cognitive interviews showed various possibilities for further optimization of the instrument. Construct, criterion and content validity of the three questionnaires ranged from acceptable to good. Cronbach’s alphas were > .70 for almost all scales. More than half of the items were candidate for optimization according to the cognitive interviews, mainly due to clarity or knowledge problems, and the questionnaires of the QEQ-NH were optimized accordingly.

Conclusions

The Quality Evaluation Questionnaires for Nursing Homes (QEQ-NH) provide a solid basis to measure the quality of nursing home care, by covering the national quality themes and by integrating the various perspectives of all parties involved. With real-time feedback, the instrument provides the management and care teams with information to select possibilities or areas for improvement and to continuously monitor the effects of quality improvement in nursing homes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12913-021-06823-4.

Nurses' Experiences of Promoting Healthy Aging in the Municipality: A Qualitative Study

The purpose of this study was to describe nurses’ experiences of promoting healthy aging in municipalities. A descriptive qualitative research design based on semi-structured interviews with 13 nurses was employed. The nurses described the importance of giving older adults the possibility to live as individuals, but also that the organization matters as too does the nurses’ own desire to work professionally and with passion. Nurses in the municipality noticed that in today’s world, there is a changing perspective of older adults. They more often want to continue their previous life and care greatly about quality of life and because of this, they also expect more service from their health care. Our study suggests that nurses should be supported to specialize in elderly care and measures should be taken to reduce the gap between vision and reality when it comes to team work.