Abstract
ObjectivesTo validate the ICECAP-O capability wellbeing measure’s German translation in older people with dementia living in a nursing home, and to investigate the influence of proxy characteristics on responses.MethodCross-sectional study. For 95 residents living in a German nursing home, questionnaires were completed by nursing professionals serving as proxy respondents. We investigated the convergent validity of the ICECAP-O with other Quality of Life (Qol) measures, the EQ-5D extended with a cognitive dimension (EQ-5D+C), the Alzheimer’s Disease Related Quality of Life (ADRQL) measures, and the Barthel-index measure of Activities of Daily Living (ADL). Discriminant validity was investigated using bivariate and multivariate stepwise regression analysis, comparing ICECAP-O scores between subgroups varying in dementia severity, care dependency, ADL status and demographic characteristics.ResultsConvergent validity between the ICECAP-O, EQ-5D+C, ADRQL and Barthel-Index scores was moderate to good (with correlations of 0.72, 0.69 and 0.53 respectively), but differed considerably between dimensions of the instruments. Discriminant validity was confirmed by finding differences in ICECAP-O scores between subgroups based on ADL scores (0.58 below 65 points on the Barthel-index and 0.80 above 65 points) and other characteristics. The ICECAP-O scores based on available tariffs were related to proxy characteristics gender (0.52 males versus 0.65 females) and work experience (0.61 below 2 years of experience versus 0.68 above 2 years).DiscussionThe results of this study suggest that the ICECAP-O is a promising generic measure for general Qol and capability of people with dementia living in a nursing home. Validity tests generally yielded favorable results. Work experience and gender appeared to influence proxy response, which raises questions regarding appropriate proxies, especially since the ICECAP-O may be completed by proxies relatively often. Further research is necessary to validate the German version of the ICECAP-O, with specific attention to proxy completion for people with dementia.
Highlights
Growing life expectancy leads to higher numbers of people with dementia due to increasing risk of incidence of dementia with age [1]
Discriminant validity was confirmed by finding differences in ICECAP-O scores between subgroups based on Activities of Daily Living (ADL) scores (0.58 below 65 points on the Barthel-index and 0.80 above 65 points) and other characteristics
The results of this study suggest that the ICECAP-O is a promising generic measure for general Quality of Life (Qol) and capability of people with dementia living in a nursing home
Summary
Growing life expectancy leads to higher numbers of people with dementia due to increasing risk of incidence of dementia with age [1]. In QALY calculations, values (often referred to as utility scores) are assigned to different health states, which allows the quantification of health gains comprising both length and quality of life gains from interventions [4]. These health states are commonly measured using Health-Related Quality of Life (HrQoL) instruments, which are used for computing the quality adjusted component of QALYs. These health states are commonly measured using Health-Related Quality of Life (HrQoL) instruments, which are used for computing the quality adjusted component of QALYs This makes HrQol instruments an essential outcome measure for economic evaluation. Economic evaluation is increasingly used in the curative sector as a decision support tool for resource allocation, but may aid the allocation of resources in long-term care as well [6] [7] [8]
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