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Using qualitative methods to develop a measure of resident-to-resident elder mistreatment in nursing homes

Published online by Cambridge University Press:  14 March 2013

Mildred Ramirez*
Affiliation:
Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, New York, USA Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, 1300 York Avenue, New York, USA
Beverly Watkins
Affiliation:
Division of General Internal Medicine, Weill Cornell Medical College, 525 East 68th Street, Box #46, New York, USA
Jeanne A. Teresi
Affiliation:
Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, New York, USA Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, 1300 York Avenue, New York, USA Columbia University Stroud Center and New York State Psychiatric Institute, 100 Haven Avenue, Tower 3, 30F, New York, USA
Stephanie Silver
Affiliation:
Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, New York, USA Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, 1300 York Avenue, New York, USA
Gail Sukha
Affiliation:
Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, New York, USA
Gabriel Bortagis
Affiliation:
Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, New York, USA
Kimberly Van Haitsma
Affiliation:
Polisher Research Institute, Abramson Center for Jewish Life, 1425 Horsham Road, North Wales, Pennsylvania, USA
Mark S. Lachs
Affiliation:
Division of Geriatrics and Palliative Medicine, Weill Cornell Medical College, 1300 York Avenue, New York, USA
Karl Pillemer
Affiliation:
Department of Human Development, Cornell University, MVR Hall, Ithaca, New York, USA
*
Correspondence should be addressed to: Mildred Ramirez, Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, NY 10471, USA. Phone: +718-581-1140; Fax: +718-543-2477. Email: [email protected].

Abstract

Background: Despite expansion of research on elder mistreatment, limited attention has been paid to the development of improved measurement instruments. This gap is particularly notable regarding measurement of mistreatment in long-term care facilities. This paper demonstrates the value of qualitative methods used in item development of a Resident-to-Resident Elder Mistreatment (R-REM) measure for use in nursing homes and other care facilities. It describes the development strategy and the modification and refinement of items using a variety of qualitative methods.

Methods: A combination of qualitative methods was used to develop close-ended items to measure R-REM, including review by a panel of experts, focus groups, and in-depth cognitive interviews.

Results: Information gathered from the multiple methods aided in flagging problematic items, helped to highlight the nature of the problems in measures, and provided suggestions for item modification and improvement.

Conclusions: The method employed is potentially useful for future attempts to develop better measures of elder mistreatment. The employment of previously established measurement items drawn from related fields, modified through an intensive qualitative research strategy, is an effective strategy to improve elder mistreatment measurement.

Type
Special Issue Research Articles
Copyright
Copyright © International Psychogeriatric Association 2013 

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References

Bazeley, P. (2007). Qualitative Data Analysis with nVivo. Thousand Oaks, CA: Sage.Google Scholar
Burgio, L. (1997). Direct observation of behavioral disturbances of dementia and their environmental context. International Psychogeriatrics, 8, 343346. doi:10.1017/S1041610297003591.CrossRefGoogle Scholar
Burgio, L. and Leon, , , J. (1997). Using patient and proxy reports as outcome measures in Alzheimer disease research. Alzheimer Disease and Associated Disorders, 11, 179180.Google ScholarPubMed
Castle, N. (2012). Resident to resident abuse in nursing homes as reported by nurse aides. Journal of Elder Abuse and Neglect. Available online ahead of print. doi:10.1080/08946566.2012.661685.CrossRefGoogle ScholarPubMed
Cohen, M., Halevy-Levin, S., Gagin, R., Priltuzky, D. and Friedman, G. (2010). Elder abuse in long-term care residences and the risk indicators. Ageing and Society, 30, 10271040. doi:10.1017/S0144686X1000018.CrossRefGoogle Scholar
Cohen-Mansfield, J., Marx, M. S. and Rosenthal, A. S. (1989a). A description of agitation in a nursing home. Journal of Gerontology: Social Sciences, 44, S77S84. doi:10.1017/S1041610289000165.CrossRefGoogle ScholarPubMed
Cohen-Mansfield, J., Werner, P. and Marx, M. S. (1989b). An observational study of agitation in agitated nursing home residents. International Psychogeriatrics, 1, 153165.CrossRefGoogle ScholarPubMed
Cooper, C., Selwood, A. and Livingston, G. (2008). The prevalence of elder abuse and neglect: a systematic review. Age & Ageing, 37, 151160. doi:10.1093/ageing/afm194.CrossRefGoogle ScholarPubMed
Goergen, T. (2001). Stress, conflict, elder abuse and neglect in German nursing homes: a pilot study among professional caregivers. Journal of Elder Abuse and Neglect, 13, 126. doi:10.1300/J084v13n01_01.CrossRefGoogle Scholar
Golden, R. R., Teresi, J. A. and Gurland, B. J. (1984). Development of indicator scales for the Comprehensive Assessment and Referral Evaluation (CARE) interview schedule. Journal of Gerontology, 39, 138146.CrossRefGoogle ScholarPubMed
Jobe, J. B. and Herrmann, D. J. (1996). Implications of models of survey cognition for memory theory. In Herrmann, D. J., Johnson, M., McEvoy, C., Hertzog, C. and Hertel, P. (eds.), Basic and Applied Memory Research, vol. 2 (pp. 193205). Hillsdale, NJ: Erlbaum.Google Scholar
Krause, N. (2006). Use of qualitative methods to improve quantitative measures of health-related constructs. Medical Care, 44 (Suppl3), S34S38. doi:10.1097/01.mlr.0000245429.98384.23.CrossRefGoogle ScholarPubMed
Lachs, M., Bachman, R., Williams, C. S. and O'Leary, J. R. (2007). Resident-to-resident elder mistreatment and police contact in nursing homes: findings from a population-based cohort. Journal of the American Geriatrics Society, 55, 840845. doi:10.1111/j.1532-5415.2007.01195.x.CrossRefGoogle ScholarPubMed
Magaziner, J.et al. (2000). The prevalence of dementia in a statewide sample of new nursing home admissions aged 65 and older: diagnosis by expert panel. Epidemiology of dementia in nursing homes research group. Gerontologist, 40, 663672. doi:10.1093/geront/40.6.663.CrossRefGoogle Scholar
McCusker, J.et al. (2011). Use of nurse-observed symptoms of delirium in long-term care: effects on prevalence and outcomes of delirium. International Psychogeriatrics, 23, 602608. doi:10.1017/S1041610210001900.CrossRefGoogle ScholarPubMed
Morgan, D. L. (1988). Planning Focus Groups. Thousand Oaks, CA: Sage.Google Scholar
Morgan, D. L. (1998). Practical strategies for combining qualitative and quantitative methods: applications to health research. Qualitative Health Research, 8, 362376. doi:10.1177/104973239800800307.CrossRefGoogle ScholarPubMed
Morris, J. N.et al. (1990). Designing the national resident assessment instrument for nursing homes. Gerontologist, 30, 293307. doi:10.1093/geront/30.3.293.CrossRefGoogle ScholarPubMed
Nápoles-Springer, A. M., Santoyo-Olsson, J., O'Brien, H. and Stewart, A. L. (2006). Using cognitive interviews to develop surveys in diverse populations. Medical Care, 44 (Suppl 3), S21S30. doi:10.1097/01.mlr.0000245425.65905.1d.CrossRefGoogle ScholarPubMed
National Research Council (2003). Elder Mistreatment: Abuse, Neglect, and Exploitation in An Aging America. Washington, DC: The National Academy Press.Google Scholar
Pillemer, K. A. and Moore, D. W. (1989). Abuse of patients in nursing homes: findings from a survey of staff. Gerontologist, 29, 314320. doi:10.1093/geront/29.3.314.CrossRefGoogle ScholarPubMed
Pillemer, K., Mueller-Johnson, K., Mock, S., Suitor, J. and Lachs, M. S. (2006). Prevention of elder mistreatment. In Doll, L.et al. (eds.), Handbook on Injury and Violence Prevention (pp. 241254). Secaucus, NJ: Springer.Google Scholar
Pillemer, K.et al. (2012). Resident-to-resident aggression in nursing homes: results from a qualitative event reconstruction study. Gerontologist, 52, 2433. doi:10.1093/geront/gnr107.CrossRefGoogle ScholarPubMed
Ramirez, M., Teresi, J. and Holmes, D. (2006). Demoralization and attitudes toward residents among certified nurse assistants in relation to job stressors and work resources: cultural diversity in long-term care. Journal of Cultural Diversity, 13, 119125.Google ScholarPubMed
Rosen, T.et al. (2008a) Resident-to-resident aggression in long-term care facilities: insights from focus groups of nursing home residents and staff. Journal of the American Geriatrics Society, 56, 13981408. doi:10.1111/j.1532-5415.2008.01808.x.CrossRefGoogle ScholarPubMed
Rosen, T., Pillemer, K. and Lachs, M. (2008b) Resident-to-resident aggression in long- term care facilities: an understudied problem. Aggression and Violent Behavior, 13, 7787. doi:10.1016/j.avb.2007.12.001.CrossRefGoogle ScholarPubMed
Shinoda-Tagawa, T.et al. (2004). Resident-to-resident violent incidents in nursing homes. Journal of the American Medical Association, 291, 591598. doi:10.1001/jama.291.5.591.CrossRefGoogle ScholarPubMed
Sloane, P. D.et al. (2004). Effect of person-showering and the towel bath on bathing-associated aggression, agitation, and discomfort in nursing home residents with dementia: a randomized, controlled trial. Journal of the American Geriatrics Society, 52, 1795–804. doi:10.1111/j.1532-5415.2004.52501.x.CrossRefGoogle ScholarPubMed
Straus, M. A., Hamby, S. L., Boney-McCoy, S. and Sugarman, D. B. (1996). The revised conflict tactics scales (CTS2: development and preliminary psychometric data). Journal of Family Issues, 17, 283316. doi:10.1177/019251396017003001.CrossRefGoogle Scholar
Teresi, J., Morris, J., Mattis, S. and Reisberg, B. (2000). Cognitive impairment among SCU and non-SCU residents in the United States: estimates from the national institutes on aging collaborative studies of dementia special care units for Alzheimer's disease. Research and Practice in Alzheimer's Disease, 4, 117138.Google Scholar
Teresi, J., Stewart, A., Morales, L. and Stahl, S. (eds.) (2006). Measurement in a multi-ethnic society. Medical Care, 44 (Suppl. 3), S3S4. doi:10.1097/01.mlr.0000245437.46695.4a.CrossRefGoogle Scholar
Teresi, J. A.et al. (in press). Development of an instrument to measure staff-reported resident-to-resident elder mistreatment (R-REM) using item response theory and other latent variable models. The Gerontologist.Google Scholar
Tourangeau, R. (1984). Cognitive Science and Survey Methods: a cognitive perspective. In Jabine, T. B., Straf, M. L., Tanurand, J. M. and Tourangeau, R. (eds.), Cognitive Aspects of Survey Methodology: Building a Bridge Between Disciplines (pp. 73100). Washington, DC: National Academy Press.Google Scholar
Van Haitsma, K., Lawton, M. P., Kleban, M., Klapper, J. A. and Corn, J. A. (1997). Methodological aspects of the study of streams of behavior in dementing illness. Alzheimer Disease and Associated Disorder, 11, 228238.Google Scholar