A novel method of proxy reporting questionnaire based measures of health-related quality of life of people with dementia in residential care: a psychometric evaluation

Sarah C Smith, AA Jolijn Hendriks, Jemma Regan, Nick Black Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK Background: In research in residential care, health-related quality of life (HRQL) is usually measured using either observational m...

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Main Authors: Smith SC, Hendriks AAJ, Regan J, Black N
Format: Article
Language:English
Published: Dove Medical Press 2018-07-01
Series:Patient Related Outcome Measures
Subjects:
Online Access:https://www.dovepress.com/a-novel-method-of-proxy-reporting-questionnaire-based-measures-of-heal-peer-reviewed-article-PROM
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author Smith SC
Hendriks AAJ
Regan J
Black N
author_facet Smith SC
Hendriks AAJ
Regan J
Black N
author_sort Smith SC
collection DOAJ
description Sarah C Smith, AA Jolijn Hendriks, Jemma Regan, Nick Black Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK Background: In research in residential care, health-related quality of life (HRQL) is usually measured using either observational methods or standardized questionnaires. DEMQOL-Proxy is a standardized questionnaire measuring HRQL of people with dementia and is usually reported by a family carer. However, not all residents have a family carer who visits often enough to act as a proxy. Objectives: We evaluated the psychometric performance of DEMQOL-Proxy when reported on behalf of people with dementia in residential care by a “trained proxy” (DEMQOL-Proxy-TP). Participants: We recruited a sample of 87 people with dementia living in care homes around the UK. Methods: We used modern psychometric methods (based on the Rasch model) to evaluate DEMQOL-Proxy-TP (on behalf of 85 residents) in a cross-sectional study. We evaluated scale-to-sample targeting, ordering of item thresholds, item fit to the model and differential item functioning (sex, age, type of dementia), local independence, unidimensionality and reliability on the full set of items (31 items) and also a smaller item set (26 items). Results: The smaller item set (DEMQOL-Proxy-TP-26) performed better than the original item set and was found to fit the model (p = 0.68). Nevertheless, 17 items were found to have disordered thresholds, and 24 pairs of items showed local dependency (residual correlations >0.3). There were also some areas where scale-to-sample targeting could be improved. Conclusion: After resolving the identified anomalies, DEMQOL-Proxy-TP can provide adequate measurement of HRQL of people with dementia living in residential care, particularly when no family carer is available. This can be interpreted at the group level but is not yet robust enough for use at the individual level. Future work will compare these results with the psychometric performance of DEMQOL-Proxy reported by family carers and DEMQOL self-reported by the residents. Keywords: dementia, DEMQOL-Proxy, health-related quality of life, Rasch Measurement Theory, trained proxy
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spelling doaj.art-225a91e3a32748c0ae53816147087bc22022-12-21T22:23:55ZengDove Medical PressPatient Related Outcome Measures1179-271X2018-07-01Volume 922123039175A novel method of proxy reporting questionnaire based measures of health-related quality of life of people with dementia in residential care: a psychometric evaluationSmith SCHendriks AAJRegan JBlack NSarah C Smith, AA Jolijn Hendriks, Jemma Regan, Nick Black Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK Background: In research in residential care, health-related quality of life (HRQL) is usually measured using either observational methods or standardized questionnaires. DEMQOL-Proxy is a standardized questionnaire measuring HRQL of people with dementia and is usually reported by a family carer. However, not all residents have a family carer who visits often enough to act as a proxy. Objectives: We evaluated the psychometric performance of DEMQOL-Proxy when reported on behalf of people with dementia in residential care by a “trained proxy” (DEMQOL-Proxy-TP). Participants: We recruited a sample of 87 people with dementia living in care homes around the UK. Methods: We used modern psychometric methods (based on the Rasch model) to evaluate DEMQOL-Proxy-TP (on behalf of 85 residents) in a cross-sectional study. We evaluated scale-to-sample targeting, ordering of item thresholds, item fit to the model and differential item functioning (sex, age, type of dementia), local independence, unidimensionality and reliability on the full set of items (31 items) and also a smaller item set (26 items). Results: The smaller item set (DEMQOL-Proxy-TP-26) performed better than the original item set and was found to fit the model (p = 0.68). Nevertheless, 17 items were found to have disordered thresholds, and 24 pairs of items showed local dependency (residual correlations >0.3). There were also some areas where scale-to-sample targeting could be improved. Conclusion: After resolving the identified anomalies, DEMQOL-Proxy-TP can provide adequate measurement of HRQL of people with dementia living in residential care, particularly when no family carer is available. This can be interpreted at the group level but is not yet robust enough for use at the individual level. Future work will compare these results with the psychometric performance of DEMQOL-Proxy reported by family carers and DEMQOL self-reported by the residents. Keywords: dementia, DEMQOL-Proxy, health-related quality of life, Rasch Measurement Theory, trained proxyhttps://www.dovepress.com/a-novel-method-of-proxy-reporting-questionnaire-based-measures-of-heal-peer-reviewed-article-PROMDementiaDEMQOL-Proxyhealth related quality of lifeRasch Measurement TheoryTrained Proxy
spellingShingle Smith SC
Hendriks AAJ
Regan J
Black N
A novel method of proxy reporting questionnaire based measures of health-related quality of life of people with dementia in residential care: a psychometric evaluation
Patient Related Outcome Measures
Dementia
DEMQOL-Proxy
health related quality of life
Rasch Measurement Theory
Trained Proxy
title A novel method of proxy reporting questionnaire based measures of health-related quality of life of people with dementia in residential care: a psychometric evaluation
title_full A novel method of proxy reporting questionnaire based measures of health-related quality of life of people with dementia in residential care: a psychometric evaluation
title_fullStr A novel method of proxy reporting questionnaire based measures of health-related quality of life of people with dementia in residential care: a psychometric evaluation
title_full_unstemmed A novel method of proxy reporting questionnaire based measures of health-related quality of life of people with dementia in residential care: a psychometric evaluation
title_short A novel method of proxy reporting questionnaire based measures of health-related quality of life of people with dementia in residential care: a psychometric evaluation
title_sort novel method of proxy reporting questionnaire based measures of health related quality of life of people with dementia in residential care a psychometric evaluation
topic Dementia
DEMQOL-Proxy
health related quality of life
Rasch Measurement Theory
Trained Proxy
url https://www.dovepress.com/a-novel-method-of-proxy-reporting-questionnaire-based-measures-of-heal-peer-reviewed-article-PROM
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