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Nursing home resident quality of life: testing for measurement equivalence across resident, family, and staff perspectives

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Abstract

Purpose

This study explores the factor structure of the interRAI self-report nursing home quality of life survey and develops a measure that will allow researchers to compare predictors of quality of life (QOL) across resident, family, and staff perspectives.

Methods

Nursing home residents (N = 319), family members (N = 397), and staff (N = 862) were surveyed about their perceptions of resident QOL. Exploratory factor analyses were conducted on a random half of the staff data. Subsequently, confirmatory factor analysis was used to test for measurement equivalence across the three perspectives.

Results

The final model had a four-factor structure (i.e., care and support, food, autonomy, and activities) across all three perspectives. Each factor had at least two items that were equivalent across all three perspectives, which suggests at least partial measurement equivalence.

Conclusion

The finding of partial measurement equivalence acknowledges there are important differences between perspectives and provides a tool that researchers can use to compare predictors of QOL, but not levels of agreement across perspectives. Targeting these four aspects is likely to have the additional benefit of improving family and staff perceptions of resident QOL in addition to the resident’s own QOL.

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Acknowledgments

This work was supported by a Partnerships for Health System Improvement Grant funded by the Canadian Institutes of Health Research (FRN # 114120) and the Nova Scotia Health Research Foundation (Matching-2011-7173) and a Nova Scotia Health Research Foundation 2013 Scotia Support Grant (PSO-Research Programs-2013-9039). John Hirdes was supported through the Ontario Home Care Research and Knowledge Exchange Chair funded by the Ontario Ministry of Health and Long-Term Care.

Conflict of interest

None.

Ethical standard

Ethics review boards of all participating universities and, where appropriate, participating nursing homes and regional health authorities approved the research; therefore, this research has been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki and its later amendments.

Author information

Authors and Affiliations

  1. Nova Scotia Centre on Aging, Mount Saint Vincent University, 166 Bedford Highway, Halifax, NS, B3M 2J6, Canada

    Judith Godin

  2. Geriatric Medicine Research, Nova Scotia Health Authority, 5955 Veteran’s Memorial Lane, Halifax, NS, B3H 2E1, Canada

    Judith Godin

  3. Department of Family Studies and Gerontology, Nova Scotia Centre on Aging, Mount Saint Vincent University, 166 Bedford Highway, Halifax, NS, B3M 2J6, Canada

    Janice Keefe

  4. Department of Psychology, Saint Mary’s University, 923 Robie Street, Halifax, NS, B3H 3C3, Canada

    E. Kevin Kelloway

  5. School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada

    John P. Hirdes

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  1. Judith Godin
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  4. John P. Hirdes
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Correspondence to Judith Godin.

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Godin, J., Keefe, J., Kelloway, E.K. et al. Nursing home resident quality of life: testing for measurement equivalence across resident, family, and staff perspectives. Qual Life Res 24, 2365–2374 (2015). https://doi.org/10.1007/s11136-015-0989-4

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