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Older people's perceptions of quality of care.
Sixma, H.J. Older people's perceptions of quality of care. Gerontology: 2001, 47(sup 1), 159
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Purpose: User views on quality of care are generally assessed by patients satisfaction questionnaires. However, doubts have been cast on the validity and reliability of such instruments. Aim of this paper are: (1) to describe the development of a new instrument measuring quality of care from the perspective of elderly people, (2) to examine the potential of the new instrument in quality assurance (QA) and quality improvement (QI) studies. Methods: A combination of qualitative and quantitative research methods was used to develop the QUOTE-Elderly instrument. Focus group discussions about older people's perceptions of quality of care preceded a postal survey, which was completed by 338 elderly people. Explorative and confirmative factor analyses and reliability analysis were applied to evaluate the taxonomy and feasibility of the instrument and the internal consistency of (sub)scales. Results: Using scale optimisation, a new self-administered questionnaire was produced, including generic quality aspects and category-specific aspects particularly relevant for elderly people. Feasibility tests of the QUOTE-Elderly, in which importance and performance ratings were combined into quality impact indices, showed considerable differences in the functioning of general practitioners, hospital consultants, home helps and home care agencies as perceived by elderly people. Conclusions: The QUOTE-Elderly is an assessment instrument for quality of care from the perspective of cognitively intact, non-constitutionalised elderly people. The instrument can be regarded as a method, more than a fixed set of items. The conceptual framework underlying the new instrument can also be applied in other, more specific groups of elderly people. (aut.ref.)
Purpose: User views on quality of care are generally assessed by patients satisfaction questionnaires. However, doubts have been cast on the validity and reliability of such instruments. Aim of this paper are: (1) to describe the development of a new instrument measuring quality of care from the perspective of elderly people, (2) to examine the potential of the new instrument in quality assurance (QA) and quality improvement (QI) studies. Methods: A combination of qualitative and quantitative research methods was used to develop the QUOTE-Elderly instrument. Focus group discussions about older people's perceptions of quality of care preceded a postal survey, which was completed by 338 elderly people. Explorative and confirmative factor analyses and reliability analysis were applied to evaluate the taxonomy and feasibility of the instrument and the internal consistency of (sub)scales. Results: Using scale optimisation, a new self-administered questionnaire was produced, including generic quality aspects and category-specific aspects particularly relevant for elderly people. Feasibility tests of the QUOTE-Elderly, in which importance and performance ratings were combined into quality impact indices, showed considerable differences in the functioning of general practitioners, hospital consultants, home helps and home care agencies as perceived by elderly people. Conclusions: The QUOTE-Elderly is an assessment instrument for quality of care from the perspective of cognitively intact, non-constitutionalised elderly people. The instrument can be regarded as a method, more than a fixed set of items. The conceptual framework underlying the new instrument can also be applied in other, more specific groups of elderly people. (aut.ref.)