Creating a quality of life assessment measure for residents in long term care

The objectives of this study were to (1) gain an empirical understanding of how stakeholder (residents, family members, staff) groups view quality of life (QoL) for residents in long term care; (2) create a visual map of the domain of QoL and describe differences in importance of key elements; and (3) identify key elements of QoL that could be used to develop a standardized assessment instrument for use in person-centered care planning.

This is a descriptive study, using a mixed-method, qualitative/quantitative approach called "concept mapping."

The study was conducted at a 240-bed skilled nursing facility located in a major metropolitan area. It is part of a not-for-profit religiously affiliated social service organization.

A convenience sample included 3 groups of participants: staff members, family members of residents, and residents. Fifty-three people participated in the brain-storming sessions, and 45 people completed sorting and rating tasks. Sample sizes varied by group and by task.

Statements about the elements of QoL for residents in long term care were elicited during 14 brain-storming sessions. Sorting and rating activities were completed using a final list of 88 items.

A visual map was generated, with 5 clusters of elements representing 5 conceptual areas within QoL. Importance ratings of elements were similar for family members and staff members, and a set of elements rated as high in importance but requiring attention to implementation was produced.

Family members and staff produced similar conceptual models of QoL, and their views on the importance of the various elements were consistent. There was a high degree of consensus regarding elements considered least important and those considered most important. Elements considered most important addressed quality of care, autonomy and respect, and aspects of daily life, including food and sleep. There was less concern with the physical appearance of the facility, the amenities offered, and issues related to independence; however, all items scored above the mean of 2.5 on the 5-point rating scale. This project has shown that it is possible to use concept mapping methodology to obtain facility-specific information about stakeholders' QoL perceptions in the long term care setting, and that residents' views can be assessed and incorporated.