Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England

Abstract Background To maintain good standards of care, evaluations of policy interventions or potential improvements to care are required. A number of quality of life (QoL) measures could be used but there is little evidence for England as to which measures would be appropriate. Using data from a p...

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Main Authors: Stephen Allan, Stacey Rand, Ann-Marie Towers, Kaat De Corte, Freya Tracey, Elizabeth Crellin, Therese Lloyd, Rachael E. Carroll, Sinead Palmer, Lucy Webster, Adam Gordon, Nick Smith, Gizdem Akdur, Anne Killett, Karen Spilsbury, Claire Goodman
Format: Article
Language:English
Published: BMC 2025-04-01
Series:Health and Quality of Life Outcomes
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Online Access:https://doi.org/10.1186/s12955-025-02356-0
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author Stephen Allan
Stacey Rand
Ann-Marie Towers
Kaat De Corte
Freya Tracey
Elizabeth Crellin
Therese Lloyd
Rachael E. Carroll
Sinead Palmer
Lucy Webster
Adam Gordon
Nick Smith
Gizdem Akdur
Anne Killett
Karen Spilsbury
Claire Goodman
author_facet Stephen Allan
Stacey Rand
Ann-Marie Towers
Kaat De Corte
Freya Tracey
Elizabeth Crellin
Therese Lloyd
Rachael E. Carroll
Sinead Palmer
Lucy Webster
Adam Gordon
Nick Smith
Gizdem Akdur
Anne Killett
Karen Spilsbury
Claire Goodman
author_sort Stephen Allan
collection DOAJ
description Abstract Background To maintain good standards of care, evaluations of policy interventions or potential improvements to care are required. A number of quality of life (QoL) measures could be used but there is little evidence for England as to which measures would be appropriate. Using data from a pilot Minimum Data Set (MDS) for care home residents from the Developing resources And minimum dataset for Care Homes’ Adoption (DACHA) study, we assessed the discriminant construct validity of QoL measures, using hypothesis testing to assess the factors associated with QoL. Methods Care home records for 679 residents aged over 65 from 34 care homes were available that had been linked to health records and care home provider data. In addition to data on demographics, level of needs and impairment, proxy report measures of social care-, capability- and health-related QoL of participants were completed (ASCOT-Proxy-Resident, ICECAP-O, EQ-5D-5L Proxy 2). Discriminant construct validity was assessed through testing hypotheses developed from previous research and QoL measure constructs. Multilevel regression models were analysed to understand how QoL was influenced by personal characteristics (e.g. sex, levels of functional and cognitive ability), care home level factors (type of home, level of quality) and resident use of health services (potentially avoidable emergency hospital admissions). Multiple imputation was used to address missing data. Results All three QoL measures had acceptable construct validity and captured different aspects of QoL, indicated by different factors explaining variation in each measure. All three measures were negatively associated with levels of cognitive impairment, whilst ICECAP-O and EQ-5D-5L Proxy 2 were negatively associated with low levels of functional ability. ASCOT-Proxy-Resident was positively associated with aspects of quality and care effectiveness at both resident- and care home-level. Conclusion The study found acceptable construct validity for ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L Proxy 2 in care homes, with findings suggesting the three are complementary measures based on different constructs. The study has also provided evidence to support the inclusion of these QoL measures in any future MDS.
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spelling doaj-art-e5ebcc2269b94fbb9f09c000bbea83d22025-08-20T03:08:09ZengBMCHealth and Quality of Life Outcomes1477-75252025-04-0123111210.1186/s12955-025-02356-0Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in EnglandStephen Allan0Stacey Rand1Ann-Marie Towers2Kaat De Corte3Freya Tracey4Elizabeth Crellin5Therese Lloyd6Rachael E. Carroll7Sinead Palmer8Lucy Webster9Adam Gordon10Nick Smith11Gizdem Akdur12Anne Killett13Karen Spilsbury14Claire Goodman15Personal Social Services Research Unit (PSSRU), University of KentPersonal Social Services Research Unit (PSSRU), University of KentHealth and Social Care Workforce Research Unit, King’s College LondonThe Health FoundationThe Health FoundationThe Health FoundationThe Health FoundationSchool of Medicine, University of NottinghamPersonal Social Services Research Unit (PSSRU), University of KentCentre for Health Services Studies (CHSS), University of KentQueen Mary UniversityCentre for Health Services Studies (CHSS), University of KentCentre for Research for Public Health and Community Care, University of HertfordshireSchool of Health Sciences, University of East AngliaSchool of Healthcare, Faculty of Medicine and Health, University of LeedsCentre for Research for Public Health and Community Care, University of HertfordshireAbstract Background To maintain good standards of care, evaluations of policy interventions or potential improvements to care are required. A number of quality of life (QoL) measures could be used but there is little evidence for England as to which measures would be appropriate. Using data from a pilot Minimum Data Set (MDS) for care home residents from the Developing resources And minimum dataset for Care Homes’ Adoption (DACHA) study, we assessed the discriminant construct validity of QoL measures, using hypothesis testing to assess the factors associated with QoL. Methods Care home records for 679 residents aged over 65 from 34 care homes were available that had been linked to health records and care home provider data. In addition to data on demographics, level of needs and impairment, proxy report measures of social care-, capability- and health-related QoL of participants were completed (ASCOT-Proxy-Resident, ICECAP-O, EQ-5D-5L Proxy 2). Discriminant construct validity was assessed through testing hypotheses developed from previous research and QoL measure constructs. Multilevel regression models were analysed to understand how QoL was influenced by personal characteristics (e.g. sex, levels of functional and cognitive ability), care home level factors (type of home, level of quality) and resident use of health services (potentially avoidable emergency hospital admissions). Multiple imputation was used to address missing data. Results All three QoL measures had acceptable construct validity and captured different aspects of QoL, indicated by different factors explaining variation in each measure. All three measures were negatively associated with levels of cognitive impairment, whilst ICECAP-O and EQ-5D-5L Proxy 2 were negatively associated with low levels of functional ability. ASCOT-Proxy-Resident was positively associated with aspects of quality and care effectiveness at both resident- and care home-level. Conclusion The study found acceptable construct validity for ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L Proxy 2 in care homes, with findings suggesting the three are complementary measures based on different constructs. The study has also provided evidence to support the inclusion of these QoL measures in any future MDS.https://doi.org/10.1186/s12955-025-02356-0Quality of lifeMeasurementCare homesOlder adultsEnglandValidity.
spellingShingle Stephen Allan
Stacey Rand
Ann-Marie Towers
Kaat De Corte
Freya Tracey
Elizabeth Crellin
Therese Lloyd
Rachael E. Carroll
Sinead Palmer
Lucy Webster
Adam Gordon
Nick Smith
Gizdem Akdur
Anne Killett
Karen Spilsbury
Claire Goodman
Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England
Health and Quality of Life Outcomes
Quality of life
Measurement
Care homes
Older adults
England
Validity.
title Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England
title_full Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England
title_fullStr Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England
title_full_unstemmed Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England
title_short Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England
title_sort construct validity of measures of care home resident quality of life cross sectional analysis using data from a pilot minimum data set in england
topic Quality of life
Measurement
Care homes
Older adults
England
Validity.
url https://doi.org/10.1186/s12955-025-02356-0
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