The main goal of this environmental scan was to identify instruments that have been developed to assess consumer satisfaction with care, services delivered, and quality of life that could be used or adapted for assisted living. Instruments used in research in assisted living facilities, nursing homes, and other long-term care settings were reviewed.
Recommendations regarding further questionnaire development in this area will be made in conjunction with the findings from the other AHRQ assisted living initiatives mentioned previously (e.g., focus groups and State monitoring assessment) and from CAHPS® programs mentioned earlier that focus on other long-term care settings.
Databases that were used for the search included the following:
Keywords used for the search could be generally grouped in four broad categories: facilities, services, assessment and research methods, and satisfaction and life style:
In addition, a list of authors' names was searched, including: M. Aud, K. Brown Wilson, K. Eckert, J. Garrard, S.M. Geron, L. Grant, C. Hawes, J. Hyde, B. Jackson, R.A. Kane, G.J. Kennedy, R. Mollica, C.D. Phillips, M. Rantz, P. Sloane, V. Tellis-Nayak, M. Wylde, and S.I. Zimmerman.
General Internet searches were conducted for organizations and services related to assisted living, including the following:
AHRQ staff provided several reference articles and reports. To gain an understanding of current research activity, project staff attended the 2004 Gerontological Society of America preconference meeting of the Assisted Living Special Interest Group and the 2004 Center for Excellence in Assisted Living Quality Summit, "Achieving Excellence," both held in Washington, DC. Project staff also conducted general searches using Google™, solicited developers for instruments, and networked by telephone with experts in the field, who then provided additional contacts. While for-profit vendors who market assisted living satisfaction instruments were contacted, some were reluctant to provide instruments or information about their products.
Instruments included in this report generally have some evidence about acceptable levels of reliability and/or construct validity. In some cases—when the subject matter was considered important and no other instrument was available—an instrument was included if it had strong face validity. Searches were limited to instruments published and/or in use between January 1990 and March 2005.
Appendix A (700 KB; PDF Help) presents the final list of instruments reviewed for this project. State mandated tools used to measure customer satisfaction with nursing home care and not referenced in the peer-reviewed literature generally are not included (Lowe, Lucas, Castle, et al., 2003; Castle, 2004b). Also excluded are instruments specifically intended to be used in non-long-term care residential settings (i.e., community, hospital, etc.). As a result, instruments developed for general purpose health care settings (e.g. Sofaer and Firminger, 2005), including home health care (e.g., Home Care Satisfaction Measure; Geron and Chasler, 1998; Geron, Smith, Tennstedt, et al., 2000) are excluded, as are instruments developed for the community-dwelling Alzheimer's population, including the Quality of Life in Dementia (QOL-D; Albert, Del Castillo-Castaneda, Sano, et al., 1996), Quality of Life in Alzheimer's Disease (QOL-AD; Logsdon, Gibbons, McCurry, and Teri, 2000), Alzheimer's Disease Related Quality of Life (ADRQL; Rabins, Kasper, Kleinman, et al., 2000), and the Dementia Quality of Life (DQoL; Brod, Stewart, and Sands, 2000). Since staffing measures are not the focus of this report, we did not systematically search for instruments on staffing; however, those that were identified using the stated search strategy were included.1 In addition, instruments in which the developer did not share the instrument with the scan team were excluded.
1 For additional details on long-term care staffing measures beyond those in this document, see the report Measuring Long-term Care Work: A Guide to Selected Instruments to Examine Direct Care Worker Experiences and Outcomes (Kiefer, Harris-Kojetin, Brannon, et al., 2005).