Assessing Psychometric Properties and Implementation of EQ-HWB-S in Residential Aged Care Facilities: Evidence from Italy

Principal investigator: Michela Meregaglia

Team UB/Cergas: Oriana Ciani, Francesco Malandrini, Elisabetta Notarnicola

Sponsor: EuroQol

Duration: 18 months

Abstract:

In the UE, Italy has one of the highest percentage of residents older than 65 at 24.3% (around 14 million). Of these, around 28% have long-term needs that find limited responses in the public sector. The number of beds in public aged care facilities, indeed, can satisfy only 8% of those in need. Age, as a non-modifiable factor, increases the individual risk of diseases over the course of life, eventually resulting in disability, declining physical and mental functioning and reduced quality of life (QoL). Therefore, QoL is a critically important measure in residential care for the elderly and represents a person-centered indicator of the quality of services provision. The EQ Health and Wellbeing (EQ-HWB) is a new generic measure that extends the descriptive system of EQ instruments beyond health, capturing broader aspects of well-being. Two experimental versions are currently available: a 25-item long measure and a 9-item short-version (EQ-HWB-S). Although social care was one of the settings for which the measure was specifically developed, its suitability and appropriateness for use in residential aged care need to be further explored. Moreover, as half of the residents in aged care facilities have dementia (50.7% in Italy), there is a need for proxy reporting and consequently for testing how feasible it is for proxies (e.g., family members, aged care staff) to report resident’s QoL.

This study will use a mixed-methods design incorporating survey data and semi-structured interviews to investigate feasibility, face (content) validity, convergent validity and know-group validity, and responsiveness of different versions (self-reported, interviewer-administered and proxy-reported) of the EQ-HWB-S (and of EQ-HWB, according to feasibility) in older populations living in residential aged care facilities, and to gain insights on when and under what circumstances the different administration mode should be used. Moreover, we will perform semi-structured in-person interviews with relevant stakeholders (i.e., managers, staff, caregivers) to identify key facilitators and challenges for implementing EQ-HWB-S as a routine outcome measure informing personalized care, service quality evaluation and economic evaluations in aged care facilities. The study is expected to recruit at least 6 facilities located in Northern Italy and hosting around 400 older residents. Cross-sectional data (plus a limited sample of longitudinal data) and interview data will be collected over a 6-month period after receiving approval from the Ethics Committee of Bocconi University