Abstract
BackgroundData quality is of special concern when it comes to survey research in nursing homes. Very little is known about specifics of cognitively impaired elderly in responding to survey questions. This study examines effects of cognitive impairment, age, gender, and interview duration on the data quality in a sample of 659 nursing home residents (NHR).MethodsWithin a cross-sectional design, survey methodology was used to evaluate the pain situation in 13 nursing homes. Residents were stratified into NHR with no/mild (Mini-Mental State Examination MMSE: 18–30) and NHR with moderate (MMSE: 10–17) cognitive impairment. Data quality is measured by item nonresponse (INR). Correlation analyses, ANCOVA, linear and logistic regression models are applied.ResultsNeither interview duration nor gender have effects on item nonresponse. Age accounts for higher INR (β = 0.12, p < 0.001). Cognitive impairment strongly predicts INR (β = − 0.40, p < 0.001). INR significantly differs between NHR with no/mild (3.98%) and moderate cognitive impairment (11.85%). The likelihood of INR > 5% for residents with moderate cognitive impairment is 3.8-times (p < 0.001) of that for those with no/mild impairment.ConclusionsSurveys are adequate for residents with no/mild cognitive impairment but data quality is threatened in residents with moderate impairments. Precision and validity of responses from NHR with progressed cognitive impairment are potentially limited and results may be biased. The results clearly do support the need for a multidisciplinary ‘general theory’ of the question−/answer-process which has to be also inclusive for cognitively impaired elderly persons.
Highlights
Data quality is of special concern when it comes to survey research in nursing homes
Demographics For the pre-test (Fig. 1), a total of 1067 nursing home residents (NHR) was registered as being consultable for participation
Except for varying descriptive distributions of some diagnoses, there are no significant differences in gender, age, duration of stay, and duration of interview—neither between the two groups of cognitive function within each evaluation, nor between the Mini-Mental State Examination (MMSE)-groups of pre- and posttest, nor between pre- and post-tests’ total sample distribution
Summary
Data quality is of special concern when it comes to survey research in nursing homes. This study examines effects of cognitive impairment, age, gender, and interview duration on the data quality in a sample of 659 nursing home residents (NHR). Special attention is given to the inclusion of elderly with cognitive impairments (CI) in surveys and its consequences for data quality, i.e. Kutschar et al BMC Geriatrics (2019) 19:244 altered to fit the subjective perceived social context of the interview situation. Kutschar et al BMC Geriatrics (2019) 19:244 altered to fit the subjective perceived social context of the interview situation While this question-answerprocess has been systematically discussed over the last two decades in general, relatively little is known about the possible obstacles when conducting surveys with cognitively impaired elderly. It can be stated that individuals’ ability to respond accurately to survey questions is highly moderated by their cognitive function. The validity of information obtained by self-report must be questioned: While it is obvious that persons with severe CI are hardly able to self-report even on extremely simplified questions, the chances to obtain reliable and accurate answers from persons with mild to moderate CI have to be discussed
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