Abstract
PurposeTo identify the salient quality of life characteristics relevant to older people in receipt of community aged care services in order to develop dimensions for a draft descriptive system for a new preference-based quality of life instrument.MethodsForty-one in-depth semi-structured interviews were undertaken with older people (65 years and over) receiving community aged care services across three Australian states to explore quality of life characteristics of importance to them. The data were analysed using framework analysis to extract broader themes which were organised into a conceptual framework. The data were then summarised into a thematic chart to develop a framework matrix which was used to interpret and synthesise the data. Care was taken throughout to retain the language that older people had adopted during the interviews to ensure that appropriate language was used when identifying and developing the quality of life dimensions.ResultsThe analysis resulted in the identification of five salient quality of life dimensions: independence, social connections, emotional well-being, mobility, and activities.ConclusionThis research finds that quality of life for older people accessing aged care services goes beyond health-related quality of life and incorporates broader aspects that transcend health. The findings represent the first stage in a multiphase project working in partnership with older people to develop a new preference-based instrument of quality of life for informing quality assessment and economic evaluation in community aged care. In future work, draft items will be developed from these dimensions and tested in face validity interviews before progressing to further psychometric testing.
Highlights
The policy and practice landscape for the Australian aged care sector, in common with the aged care sectors of many other countries, is changing with a significant increase in1 3 Vol.:(0123456789)Quality of Life Research (2021) 30:555–565 quality improvements and ensure that resources allocated across the aged care sector are targeted to services and programmes which maximise the quality of life (QoL) of older people [6, 7, 9].Cost-utility analysis is a widely applied economic evaluation framework which synthesises costs and outcomes into a cost-utility ratio, whereby outcomes are most often assessed through the calculation of quality-adjusted lifeyears (QALYs)
If economic evaluations conducted in aged care are to accurately assess the value of competing interventions, it is important that the defining characteristics of QoL for older people are adequately captured within QALY calculations
This study has identified the key QoL dimensions articulated by older people in receipt of community aged care services about what is important to them to experience a good QoL
Summary
The policy and practice landscape for the Australian aged care sector, in common with the aged care sectors of many other countries, is changing with a significant increase in. A recent review of the development and application of generic preference-based instruments with the older population across health and social care sectors by Cleland et al [10] highlighted the EQ5D-3L [11] and EQ-5D-5L [12] as the most widely used measures applied with the older population to date. This paper reports on the first stage of our multiphase research project to develop an older person-specific preferencebased QoL measure for application in aged care This phase involved identifying the salient QoL dimensions relevant to older people in receipt of community aged care services to develop the draft descriptive system for the measure
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