Validity, reliability, and feasibility of a quality of life questionnaire for people with dementia

Public Health and primary careGeriatrics in primary car

Development and evaluation of the content validity, practicability and feasibility of the Innovative dementia-oriented Assessment system for challenging behaviour in residents with dementia

Abstract Background One of the most difficult issues for care staff is the manifestation of challenging behaviour among residents with dementia. The first step in managing this type of behaviour is analysing its triggers. A structured assessment instrument can facilitate this process and may improve carers’ management of the situation. This paper describes the development of an instrument designed for this purpose and an evaluation of its content validity and its feasibility and practicability in nursing homes. Methods The development process and evaluation of the content validity were based on Lynn’s methodology (1998). A literature review (steps 1 + 2) provided the theoretical framework for the instrument and for item formation. Ten experts (step 3) evaluated the first version of the instrument (the Innovative dementia-oriented Assessment (IdA®)) regarding its relevance, clarity, meaningfulness and completeness; content validity indices at the scale-level (S-CVI) and item-level (I-CVI) were calculated. Health care workers (step 4) evaluated the second version in a workshop. Finally, the instrument was introduced to 17 units in 11 nursing homes in a field study (step 5), and 60 care staff members assessed its practicability and feasibility. Results The IdA® used the need-driven dementia-compromised behaviour (NDB) model as a theoretical framework. The literature review and expert-based panel supported the content validity of the IdA®. At the item level, 77% of the ratings had a CVI greater than or equal to 0.78. The majority of the question-ratings (84%, n = 154) and answer-ratings (69%, n = 122) showed valid results, with none below 0.50. The health care workers confirmed the understandability, completeness and plausibility of the IdA®. Steps 3 and 4 led to further item clarification. The carers in the study considered the instrument helpful for reflecting challenging behaviour and beneficial for the care of residents with dementia. Negative ratings referred to the time required and the lack of effect on residents´ behaviour. Conclusions There was strong evidence supporting the content validity of the IdA®. Despite the substantial length and time requirement, the instrument was considered helpful for analysing challenging behaviour. Thus, further research on the psychometric qualities, implementation aspects and effectiveness of the IdA® in understanding challenging behaviour is needed

Additional file 1: of Development and evaluation of the content validity, practicability and feasibility of the Innovative dementia-oriented Assessment system for challenging behaviour in residents with dementia

English version of IdAÂŽ (IdA-EÂŽ) (IdA_english_version.pdf). (PDF 2867 kb

Die Erfassung der Lebensqualität von Menschen mit Demenz in stationären Altenpflegeeinrichtungen in Deutschland - Studienprotokoll des Qol-Dem Projektes

Background: QUALIDEM is a standardized dementia-specific quality of life (Qol) measurement, which was developed and validated in the Netherlands. A German version has been available since 2008. This study protocol describes the design and methodology for the quality of life of people with dementia (Qol-Dem) project.Objective: This project aims to evaluate the reliability and validity of the German version of the QUALIDEM. Method: Due to the lack of both a universal definition of Qol and of standards to verify the validity of Qol measurements, this study is divided into three phases. The aim of the first theoretical phase is the development of a dementia-specific Qol model as a result of a meta-synthesis of qualitative studies. The second empirical phase consists of the three following steps: (a) an investigation of the scalability and internal consistency of the measure, (b) an evaluation of the interrater and intrarater reliability, and (c) an extensive evaluation of the validity of the QUALIDEM. The resulting Qol model (phase 1) will be used for the selection of appropriate comparators for validity testing. In the third phase, the QUALIDEM will be adapted, if necessary, based on the knowledge generated in the first two phases.Conclusion: The findings of the Qol-Dem project should deliver an accurate assessment of the psychometric properties of the German version of the QUALIDEM. The results will contribute to the further development of the instrument. Furthermore, the results will contribute to the theoretical development of the concept of Qol among people with dementia.Hintergrund: Das standardisierte demenzspezifische Lebensqualitätsinstrument QUALIDEM wurde in den Niederlanden entwickelt und validiert. Eine deutsche Übersetzung des Fragebogens liegt seit 2008 vor. Das vorliegende Studienprotokoll beschreibt Design und Methode des Quality of life of people with dementia (Qol-Dem) Projektes.Zielsetzung: Ziel dieses Projektes ist die Untersuchung der Reliabilität und Validität der deutschsprachigen QUALIDEM-Version.Methodik: Da eine allgemeingültige Definition der Lebensqualität von Menschen mit Demenz ebenso wie ein Standard zur Untersuchung der Validität von Lebensqualitätsinstrumenten fehlt, ist die Studie in drei Phasen unterteilt: Ziel der ersten theoretischen Phase ist die Entwicklung eines Modells zur Lebensqualität von Menschen mit Demenz als Ergebnis einer Meta-Synthese qualitativer Studien. Die zweite empirische Phase besteht aus drei Schritten: (a) einer Untersuchung der Skalierbarkeit und Internen Konsistenz, (b) einer Evaluation der Interrater- und Intrarater-Reliabilität und (c) einer intensiven Überprüfung der Validität des QUALIDEM. Ausgehend von dem entwickelten Lebensqualitätsmodell aus Phase 1 erfolgt die Auswahl geeigneter Vergleichskonstrukte zur Untersuchung der Validität. Basierend auf den Ergebnissen der beiden ersten Phasen erfolgt bei Bedarf eine Überarbeitung des deutschsprachigen QUALIDEM. Fazit: Insgesamt soll das Qol-Dem Projekt eine genaue Einschätzung der testtheoretischen Eigenschaften sowie einen Beitrag zur Weiterentwicklung des QUALIDEM liefern. Daneben werden die Ergebnisse zur theoretischen Weiterentwicklung des Konzeptes Lebensqualität von Menschen mit Demenz beitragen