Health, well-being and quality of life in aged care: Validation of theoretical domains to inform a person-centred outcomes measurement framework.

Abstract

The constructs of health, well-being and quality of life are not routinely understood or measured for people accessing aged care services. This study aimed to identify and validate theoretical domains of health, well-being and quality of life for recipients of care, their informal carers and staff, and inform the development of a person-centred outcomes measurement framework. First, a rapid review to identify recurrent domains of health, well-being and quality-of-life in aged care, using systematic searches of electronic databases, and review of grey literature, following the PRISMA guidelines. Second, establish content validity of identified domains using (a) Delphi technique with n=134 aged care staff, care recipients and caregivers, and (b) comparability with categories within the International Classification of Functioning, Disability and Health (ICF) and ICF Geriatric Core Set. From 972 records detected in the rapid review, 19 peer-reviewed research articles and 27 grey literature sources were included in the content analysis. Twenty-four domains and 109 concepts were identified, and health, quality of life, security and food and nutrition were ranked as the most important. One domain, cognition, linked to both the Geriatric Core Set and ICF, and 37% of domains and 39% of concepts were evident within the ICF. This study identified and validated 24 important domains of health, well-being and quality of life for the older person receiving care, their informal carers and staff. These domains can be used to guide the selection of outcome measures and facilitate person-centred care and care planning.