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1 Service Évaluation Qualité Accréditation et Sécurité Sanitaire, Direction de la Politique Médicale, Assistance Publique, Hôpitaux de Paris, Paris.
2 Paris-Sud Group Innovation in Mental Health Methodology, Hôpital Paul Brousse, Villejuif Cedex, France.
Background. Due to physical and psychological impairments, elderly patients residing in homes are often unable to participate in studies on satisfaction with care services. While their regular visitors provide interesting information, patientvisitor response concordance requires study. Our objective was to measure patientvisitor agreement on quality of care and accommodation.
Methods. A survey was conducted on elderly people in 13 nursing homes and their visitors. The 125 patientvisitor pairs completed the same Nursing Home Satisfaction Questionnaire (NHSQ) independently, for which reliability and internal validity have previously been explored. Satisfaction scores for room comfort, meal provision, information, and medical/nursing care were calculated. To estimate patientvisitor concordance, intraclass coefficients, a bias index, and Pearson's correlation coefficients were calculated.
Results. Patient satisfaction scores ranged from 57.8 (information) to 78.6 (room comfort), and visitor satisfaction from 67.9 (meal provision) to 85.9 (medical/nursing care). Mean visitor scores were higher for all scales, with a small-to-moderate index bias statistically significant for medical/nursing care (p <.001), information (p <.001), and meal provision (p =.006). Intraclass correlation coefficients were low for room comfort, information, and medical/nursing care scales (0.08 to 0.18), and nearly acceptable for the meal provision scale (0.46).
Conclusions. Visitors were not able to provide information on elderly patients' satisfaction with nursing home. Their assessments were milder than patient assessments. The NHSQ is reliable for use in either population, but patient and visitor assessments should not be merged in satisfaction studies.
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Journals of Gerontology Series B: Psychological Sciences and Social Sciences |