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Technology and health care for the elderly medical research studies

Focus on strategic priorities that have significant social impact.

KS 2013-09

Patient- and family-reported experience and outcome measures for elderly acute care patients: A knowledge synthesis

This project reviewed evidence about the use of self-report assessment questionnaires with patients and their families in acute care settings to assess, monitor and address their quality of life concerns and health care experiences.

Research Results

Findings: A total of 186 PREM and PROM instruments were found. Only three instruments that met the inclusion criteria were identified: Quality of Dying and Death (QODD), Canadian Health Care Evaluation Project Questionnaire (CANHELP) and Canadian Health Care Evaluation Project Questionnaire - shorter version (CANHELP LITE). Quality of each instrument was appraised using EMPRO, a standardized tool for evaluating the quality of self-report health instruments. The EMPRO overall score of the three instruments ranged from 11/100 to 71/100. The CANHELP and CANHELP LITE received the highest score (71) and the QODD had the lowest (11). Thus only one PREM (CANHELP/CANHELP LITE) and no PROMs with compelling evidence of validity to support their use in this population.

Impact of findings: Project reveals the urgent need for validation studies on PROMs and PREMs to ensure that the QOL concerns and healthcare experiences of seriously ill elderly patients, and their families, can be comprehensively assessed in research, quality improvement, and program evaluation. Although this project focused specifically on acute care, our initial search strategy was more general and revealed a large number of instruments relevant to seriously ill older adults in other contexts of care. There exists a significant opportunity to use the expansive information we have collected for a more general knowledge synthesis that is not limited to acute care. This would be significant given the widespread interest in using PROMs and PREMs in other contexts of health care (e.g., residential care, and homecare).

Publications, presentations and webinars

About the Project

The needs of seriously ill elderly patients hospitalized in acute care are complex. Comprehensive assessments of their perceived health outcomes, quality of life concerns and health care experiences are critical to the provision of high quality care that addresses the needs of patients and their families.

This project identified and evaluated questionnaires designed to measure patient/family-reported outcomes (PROMs) and patient/family-reported experiences (PREMs). The purpose was to produce a comparative evaluation of PROMs and PREMs designed to provide important information from the perspective of patients and their families in order for clinicians, administrators and decision makers to ensure that the needs and concerns of seriously ill elderly patients and their families are fully understood.

For more details on the project rationale, objectives and research plan, click here.

Project Team

Principal Investigator:

Richard Sawatzky, PhD, MSc, BSc, RN -- Trinity Western University

Co-Investigators:

Stirling Bryan, PhD -- University of British Columbia

Robin Cohen, PhD, MSc, BSc -- McGill University/Jewish General Hospital

Duncan Dixon, MLIS, MEd, BA -- Trinity Western University

Anne Gadermann, PhD -- University of British Columbia/St. Paul's Hospital

Kara Schick Makaroff, PhD, RN -- University of Alberta

Kelli Stajduhar, PhD, MSN, BN, RN -- University of Victoria

Knowledge Users and Partners:

Lena Cuthbertson, MEd, OT -- B.C. Ministry of Health

Neil Hilliard, MD -- Fraser Health Authority

Judy Lett, MSc, RN -- Fraser Health Authority

Margaret McGregor, MHSc, MD -- University of British Columbia, Family Practice

Della Roberts, MSN, RN -- Fraser Health Authority

Carolyn Tayler, RN, BSN, MSN, MSA, CON(C) -- Fraser Health Authority

Project Contact: Richard Sawatzky -- rick.sawatzky@twu.ca

KS 2013-09