[Differences in subject needs between nursing home residents' and residential care professional's perspectives]

Considerable attention has been directed toward the quality of nursing home care, with a more recent focus on residents' perspectives concerning bio-psychosocial needs. Several researchers have reported professional and patients' perspectives to be consistently different regarding biopsychosocial needs. The objective of this study was to examine such differences.

A cross-sectional survey was conducted, with interviews of nursing home residents and a self-administered questionnaire for residential care professions. The data were obtained from 85 matched pairs in 6 nursing homes. The measures for subjective needs of the residents had three dimensions (physical, psychological, and social) covering 8 sub-categories. Analyses of the data offered good evidence of reliability (internal consistency) and content validity.

In an agreement statistic analysis using Cohen's kappa, the residents' and care professional perspectives significantly differed regarding subject needs. In another analysis using t-tests, measures for subject needs derived from residential care professionals were consistently greater than those with nursing home residents. This tendency was generally consistent across sub-categories by ADL levels. However, the ranking order for the 7 sub-categories for subject needs was very similar with both raters.

Assessing nursing home residents' subject needs represents an important and essential component of quality of care. However, needs assessment by the residential care profession is still its infancy and includes failure to consider the residents' perspective. The future research challenge is to find reasons for the gap in subjective thinking between the groups. In addition, researchers can perform a critical function on behalf of nursing home residents when they suggest improvements to the methodology for assessing residential care professionals views on residents' needs.