Using Proxies for Nursing Home Residents Quality of Life Final rept. (Sept 4 2003-Sept 3 2004)

摘要

The broad objective of this study is to contribute to an improved understanding of how to best use proxies when self-reported data on outcomes such as Quality of Life (QoL) cannot be obtained. The specific goals include assessing the information obtained from different types of proxies by examining the convergence of information from different sources and evaluating this approach as a means of establishing validity when a gold standard is not available. This research seeks to contribute to the understanding of the validity of proxy data and to the iterative improvement in the science of outcomes measurement by accomplishing the following specific aims: 1. To describe the extent and nature of agreement across different types of proxies reporting on the quality of life of nursing home residents. 2. To determine how characteristics of the study subjects (nursing home residents), characteristics of the proxies (family, staff), and characteristics of the questions asked affect the concordance of the data from the different proxies. Specifically: a. Whether agreement among proxies varies given the functional status and the cognitive status of residents. b. What characteristics of the proxies themselves affect agreement. c. What characteristics of the questions relate to the level of agreement across proxies. d. Whether question characteristics can be combined with subject and proxy characteristics to create a comprehensive model of agreement. 3. To explore potential means of determining when and the extent to which concordance across proxies is an indication of validity.