Strategies to measure nursing home residents' satisfaction and preferences related to incontinence and mobility care: implications for evaluating intervention effects.

This study compared four different interview strategies to measure 111 incontinent nursing home residents' "met need" related to incontinence and mobility care. Strategies were compared on criteria related to ceiling effects and stability. Four methods were used: questions that used the term "satisfaction" and direct questions about preferences that did not use the term "satisfaction" and which could be translated into three indirect measures of met need. To facilitate a comparison among the four methods, a statement of satisfaction was interpreted as met need. All of these measures were then compared to direct observations of care processes. Residents were more stable in their reports indicating that their care needs were met than they were in their reports that their needs were not met. The direct satisfaction questions produced information most characterized by ceiling effects compared to information elicited by the preference questions. Despite high reported rates of met need as assessed by two of the four methods, direct observations revealed low frequencies of care provision.