Sheryl Zimmerman1, Josh Allen2, Lauren W Cohen3, Jackie Pinkowitz2, David Reed3, Walter O Coffey4, Peter Reed5, Michael Lepore6, Philip D Sloane7. 1. Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC; School of Social Work, University of North Carolina at Chapel Hill, Chapel Hill, NC. Electronic address: Sheryl_Zimmerman@unc.edu. 2. Center for Excellence in Assisted Living, Oakton, VA. 3. Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC. 4. LeadingAge, Atlanta, Georgia. 5. Sanford Center for Aging, University of Nevada, Reno, Nevada. 6. RTI International, Washington, DC. 7. Program on Aging, Disability, and Long-Term Care, Cecil G. Sheps Center for Health Services Research, University of North Carolina at Chapel Hill, Chapel Hill, NC; Department of Family Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.
Abstract
OBJECTIVES: Develop self-administered questionnaires of person-centeredness for completion by residents and staff in assisted living (AL), in response to concerns that AL is not person-centered; also, demonstrated person-centeredness is necessary for Medicaid support as a home- and community-based services provider. DESIGN: Community-based participatory research partnership among a research team, a consortium of 11 stakeholder organizations, and others. Methods included literature review, item generation and reduction, cognitive testing, field testing, exploratory factor analysis, and convergent and discriminant validity testing. SETTING: Cognitive testing conducted in 2 AL residences and field testing conducted in 19 diverse, stratified AL residences in 6 states. PARTICIPANTS: Eight residents and staff participated in cognitive testing, and 228 residents and 123 staff participated in field testing. MEASUREMENTS: Feasibility and psychometric testing of draft questionnaires that included 75 items (resident version) and 102 items (staff version), with parallel items on both versions as appropriate. RESULTS: The final resident questionnaire included 49 items and 4 factors: well-being and belonging, individualized care and services, social connectedness, and atmosphere. The staff questionnaire included 62 items and 5 factors: workforce practices, social connectedness, individualized care and services, atmosphere, and caregiver-resident relationships. Staff scored person-centeredness higher than did residents, reflecting their different perspectives. CONCLUSION: The Person-Centered Practices in Assisted Living (PC-PAL) questionnaires measure person-centeredness from the perspectives of residents and staff, meaning that they reflect the concepts and items considered to be important to these key stakeholders. Use of these instruments to describe, assess, quantify, ensure, and ultimately improve person-centeredness in AL is feasible and appropriate for all AL settings, and supported by numerous national organizations.
OBJECTIVES: Develop self-administered questionnaires of person-centeredness for completion by residents and staff in assisted living (AL), in response to concerns that AL is not person-centered; also, demonstrated person-centeredness is necessary for Medicaid support as a home- and community-based services provider. DESIGN: Community-based participatory research partnership among a research team, a consortium of 11 stakeholder organizations, and others. Methods included literature review, item generation and reduction, cognitive testing, field testing, exploratory factor analysis, and convergent and discriminant validity testing. SETTING: Cognitive testing conducted in 2 AL residences and field testing conducted in 19 diverse, stratified AL residences in 6 states. PARTICIPANTS: Eight residents and staff participated in cognitive testing, and 228 residents and 123 staff participated in field testing. MEASUREMENTS: Feasibility and psychometric testing of draft questionnaires that included 75 items (resident version) and 102 items (staff version), with parallel items on both versions as appropriate. RESULTS: The final resident questionnaire included 49 items and 4 factors: well-being and belonging, individualized care and services, social connectedness, and atmosphere. The staff questionnaire included 62 items and 5 factors: workforce practices, social connectedness, individualized care and services, atmosphere, and caregiver-resident relationships. Staff scored person-centeredness higher than did residents, reflecting their different perspectives. CONCLUSION: The Person-Centered Practices in Assisted Living (PC-PAL) questionnaires measure person-centeredness from the perspectives of residents and staff, meaning that they reflect the concepts and items considered to be important to these key stakeholders. Use of these instruments to describe, assess, quantify, ensure, and ultimately improve person-centeredness in AL is feasible and appropriate for all AL settings, and supported by numerous national organizations.
Authors: Philip D Sloane; Sheryl Zimmerman; Christianna S Williams; Peter S Reed; Karminder S Gill; John S Preisser Journal: Gerontologist Date: 2005-10
Authors: Sheryl Zimmerman; Philip D Sloane; J Kevin Eckert; Ann L Gruber-Baldini; Leslie A Morgan; J Richard Hebel; Jay Magaziner; Sally C Stearns; Cory K Chen Journal: J Gerontol B Psychol Sci Soc Sci Date: 2005-07 Impact factor: 4.077
Authors: Caroline B Terwee; Sandra D M Bot; Michael R de Boer; Daniëlle A W M van der Windt; Dirk L Knol; Joost Dekker; Lex M Bouter; Henrica C W de Vet Journal: J Clin Epidemiol Date: 2006-08-24 Impact factor: 6.437
Authors: Sheryl Zimmerman; Karen Love; Philip D Sloane; Lauren W Cohen; David Reed; Paula C Carder Journal: J Am Geriatr Soc Date: 2011-06-07 Impact factor: 5.562
Authors: Sheryl Zimmerman; Barbara J Bowers; Lauren W Cohen; David C Grabowski; Susan D Horn; Peter Kemper Journal: Health Serv Res Date: 2015-12-27 Impact factor: 3.402
Authors: A Lynn Snow; M Lindsey Jacobs; Jennifer A Palmer; Patricia A Parmelee; Rebecca S Allen; Nancy J Wewiorski; Michelle M Hilgeman; Latrice D Vinson; Dan R Berlowitz; Anne D Halli-Tierney; Christine W Hartmann Journal: Gerontologist Date: 2018-03-19
Authors: Sheryl Zimmerman; Paula Carder; Lindsay Schwartz; Johanna Silbersack; Helena Temkin-Greener; Kali S Thomas; Kimberly Ward; Robert Jenkens; Liz Jensen; Alfred C Johnson; Jed Johnson; Tim Johnston; Loretta Kaes; Paul Katz; Juliet Holt Klinger; Cathy Lieblich; Beth Mace; Kevin O'Neil; Douglas D Pace; Kezia Scales; Robyn I Stone; Sarah Thomas; Paul J Williams; Keren Brown Williams Journal: J Am Med Dir Assoc Date: 2021-12-31 Impact factor: 4.669
Authors: Le Cai; Gerd Ahlström; Pingfen Tang; Ke Ma; David Edvardsson; Lina Behm; Haiyan Fu; Jie Zhang; Jiqun Yang Journal: BMJ Open Date: 2017-08-28 Impact factor: 2.692