McDonald, T. A., 2016
ISQua Conference, Tokyo, Japan.
Background and Aims: The goal of this research was to validate a scale for assessing 9 life quality indicators for long-term care clients with and without dementia, across ages and genders and with all types of chronic illness or disability in both residential and community care contexts. The basic elements of the assessment cover social capacity, self-efficacy, relationships, mood state and feelings of security. The Long-Term Care quality of life (LTC-Qol) scale fills a gap in reliable quality of life assessments in such contexts.
Methods: The scale was developed and refined over 7 years by researchers and expert clinicians engaged in using it. Analysis of data from repeated LTC-Qol data for 62 residential care and subsequently 108 long term community care clients. Convergent validity achieved through comparison of World Health Organisation Quality of Life scale (WHO-BREF) run concurrently with the community care cohort LTC-Qol assessments. Residential care surveys occurred twice, 3 months apart. Community care surveys and WHO-BREF were administered at four time points: On admission; one week later; three months from initial survey; and three months plus one week from initial survey. Analyses of reliability, internal consistency and validity were completed for both residential and community care clients. No cases were excluded on the basis of age, gender, culture, language, cognitive capacity, physical ability, or disease. All participants had at least 2-3 chronic conditions.
Results: Exploratory factor analysis of nine items revealed high internal consistency (79% of the variance), good test–retest reliability (96-100% of residential care cases and 83% of community care cases within the 95% confidence interval for normal distribution). Cronbach's alpha of 0.88 found for all residential care cases and 0.76 for community care cases. Validity across age, gender, and cognitive capacity of residential care participants shows no differences between males and females (P=077, t=-0.2989, df=55); and no differences in results between those with or without dementia (P=0.75, t=-0.3149, df=48). Significant pair-wise correlation was found between LTC-QOL and WHO-BREF scores for the community care cases.
Conclusions: Results establish the LTC-QoL as having good Test-Retest reliability and dimensionality. Content validity and management utility were verified by clinical experts over time. While the Internal Consistency of the LTC-Qol for community care is lower it remains within the acceptable psychometric range. The scale is an easy to use single page form, generating summary information on the life quality experienced by adults in care, and indicating aspects requiring attention from care personnel. It also provides management information on individual and care unit outcomes in supporting the social, self-efficacy, relational, mood and security pillars that, when robust, build potential for those in long-term care to experience a reasonable quality of life.
CITATION McDonald, T. (2016) Assessing the pillars of life quality for long-term care clients in residential and community contexts. ISQua 33rd International Conference, Tokyo Japan, 16-19 October.
NOTE McDonald, T. (2013) Measurement features of the long-term care quality of life (LTC-QoL) assessment scale. International Journal of Care Services Management 7(3), 76-86.2013 ISSN 1750-1679