Measuring the ‘dose’ of person-centred care in aged care: Development of staff and family questionnaires

Aims: To develop a theoretically and psychometrically sound instrument to measure the ‘dose’ of person-centred care practice in long-term care. Background: Although person-centred care has been adopted for long-term care across the world, there is a lack of theory-based instruments to measure its impact. Two questionnaires were developed to measure person-centred care from the perspectives of staff and family based on current person-centred care frameworks: Kitwood, Nolan, and Eden Alternative. Methods: Phase I: literature review and focus groups identified potential items for the questionnaires. Phase II: academic experts, local staff, and family members of residents assessed content validity. Phase III: psychometric testing. Results: A 34-item staff questionnaire (Cronbach's Alpha = 0.942) with two factors “Making person-centredness real” and “Making the environment meaningful for life and work”. A 30-item family questionnaire (Cronbach's Alpha = 0.947), with three factors “Staff care about what is meaningful to my family member”, “Staff know and respect my family member”, and “We are all part of a family”. The factors did not directly reflect the theoretical constructs from Kitwood's and Nolan's work. Conclusion: Two instruments, capturing the ‘dose’ or active practice of delivering person-centred care, have demonstrated sound psychometric properties. The study contributes to understanding the theoretical components of person-centred care. Impact: The study addressed the lack of robust tools to measure how much person-centred care is taking place in aged care facilities. Staff and family questionnaires were produced based on strong theoretical foundations combining concepts of prominent person-centred theories and rigorous psychometric testing. The instruments can be used to determine if person-centred care makes a difference, to compare if person-centred care changes or develops over time or between facilities. Ultimately residents, families, and staff will benefit from the ability to measure how much person-centred care residents receive.