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Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties

BACKGROUND: Person-centredness is promoted as a central feature of the long-term care of older adults. Measures are needed to assist researchers, service planners and regulators in assessing this feature of quality. However, no systematic review exists to identify potential instruments and to provid...

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Autores principales: Wilberforce, Mark, Challis, David, Davies, Linda, Kelly, Michael P., Roberts, Chris, Loynes, Nik
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782329/
https://www.ncbi.nlm.nih.gov/pubmed/26951641
http://dx.doi.org/10.1186/s12877-016-0229-y
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author Wilberforce, Mark
Challis, David
Davies, Linda
Kelly, Michael P.
Roberts, Chris
Loynes, Nik
author_facet Wilberforce, Mark
Challis, David
Davies, Linda
Kelly, Michael P.
Roberts, Chris
Loynes, Nik
author_sort Wilberforce, Mark
collection PubMed
description BACKGROUND: Person-centredness is promoted as a central feature of the long-term care of older adults. Measures are needed to assist researchers, service planners and regulators in assessing this feature of quality. However, no systematic review exists to identify potential instruments and to provide a critical appraisal of their measurement properties. METHOD: A systematic review of measures of person-centredness was undertaken. Inclusion criteria restricted references to multi-item instruments designed for older adult services, or otherwise with measurement properties tested in an older adult population. A two-stage critical appraisal was conducted. First, the methodological quality of included references was assessed using the COSMIN toolkit. Second, seven measurement properties were rated using widely-recognised thresholds of acceptability. These results were then synthesised to provide an overall appraisal of the strength of evidence for each measurement property for each instrument. RESULTS: Eleven measures tested in 22 references were included. Six instruments were designed principally for use in long-stay residential facilities, and four were for ambulatory hospital or clinic-based services. Only one measure was designed mainly for completion by users of home care services. No measure could be assessed across all seven measurement properties. Despite some instruments having promising measurement properties, this was consistently undermined by the poor methodological quality underpinning them. Testing of hypotheses to support construct validity was of particularly low quality, whilst measurement error was rarely assessed. Two measures were identified as having been the subject of the most rigorous testing. CONCLUSION: The review is unable to unequivocally recommend any measures of person-centredness for use in older adult care. Researchers are advised to improve methodological rigour when testing instruments. Efforts may be best focused on testing a narrower range of measurement properties but to a higher standard, and ensuring that translations to new languages are resisted until strong measurement properties are demonstrated in the original tongue. Limitations of the review include inevitable semantic and conceptual challenges involved in defining ‘person-centredness’. The review protocol was registered with PROSPERO (ref: CRD42014005935). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12877-016-0229-y) contains supplementary material, which is available to authorized users.
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spelling pubmed-47823292016-03-09 Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties Wilberforce, Mark Challis, David Davies, Linda Kelly, Michael P. Roberts, Chris Loynes, Nik BMC Geriatr Research Article BACKGROUND: Person-centredness is promoted as a central feature of the long-term care of older adults. Measures are needed to assist researchers, service planners and regulators in assessing this feature of quality. However, no systematic review exists to identify potential instruments and to provide a critical appraisal of their measurement properties. METHOD: A systematic review of measures of person-centredness was undertaken. Inclusion criteria restricted references to multi-item instruments designed for older adult services, or otherwise with measurement properties tested in an older adult population. A two-stage critical appraisal was conducted. First, the methodological quality of included references was assessed using the COSMIN toolkit. Second, seven measurement properties were rated using widely-recognised thresholds of acceptability. These results were then synthesised to provide an overall appraisal of the strength of evidence for each measurement property for each instrument. RESULTS: Eleven measures tested in 22 references were included. Six instruments were designed principally for use in long-stay residential facilities, and four were for ambulatory hospital or clinic-based services. Only one measure was designed mainly for completion by users of home care services. No measure could be assessed across all seven measurement properties. Despite some instruments having promising measurement properties, this was consistently undermined by the poor methodological quality underpinning them. Testing of hypotheses to support construct validity was of particularly low quality, whilst measurement error was rarely assessed. Two measures were identified as having been the subject of the most rigorous testing. CONCLUSION: The review is unable to unequivocally recommend any measures of person-centredness for use in older adult care. Researchers are advised to improve methodological rigour when testing instruments. Efforts may be best focused on testing a narrower range of measurement properties but to a higher standard, and ensuring that translations to new languages are resisted until strong measurement properties are demonstrated in the original tongue. Limitations of the review include inevitable semantic and conceptual challenges involved in defining ‘person-centredness’. The review protocol was registered with PROSPERO (ref: CRD42014005935). ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12877-016-0229-y) contains supplementary material, which is available to authorized users. BioMed Central 2016-03-07 /pmc/articles/PMC4782329/ /pubmed/26951641 http://dx.doi.org/10.1186/s12877-016-0229-y Text en © Wilberforce et al. 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Wilberforce, Mark
Challis, David
Davies, Linda
Kelly, Michael P.
Roberts, Chris
Loynes, Nik
Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties
title Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties
title_full Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties
title_fullStr Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties
title_full_unstemmed Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties
title_short Person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties
title_sort person-centredness in the care of older adults: a systematic review of questionnaire-based scales and their measurement properties
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4782329/
https://www.ncbi.nlm.nih.gov/pubmed/26951641
http://dx.doi.org/10.1186/s12877-016-0229-y
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