Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study

• Main Authors: Onder Graziano (Author), Carpenter Iain (Author), Finne-Soveri Harriet (Author), Gindin Jacob (Author), Frijters Dinnus (Author), Henrard Jean (Author), Nikolaus Thorsten (Author), Topinkova Eva (Author), Tosato Matteo (Author), Liperoti Rosa (Author), Landi Francesco (Author), Bernabei Roberto (Author)
• Format: Book
• Published: BMC, 2012-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 10.1186/1472-6963-12-5; 1472-6963
• Keywords: Public aspects of medicine; RA1-1270
• Source: BMC Health Services Research, Vol 12, Iss 1, p 5 (2012)

<p>Abstract</p> <p>Background</p> <p>Aims of the present study are the following: 1. to describe the rationale and methodology of the Services and Health for Elderly in Long TERm care (SHELTER) study, a project funded by the European Union, aimed at implementing the interRAI instrument for Long Term Care Facilities (interRAI LTCF) as a tool to assess and gather uniform information about nursing home (NH) residents across different health systems in European countries; 2. to present the results about the test-retest and inter-rater reliability of the interRAI LTCF instrument translated into the languages of participating countries; 3 to illustrate the characteristics of NH residents at study entry.</p> <p>Methods</p> <p>A 12 months prospective cohort study was conducted in 57 NH in 7 EU countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands) and 1 non EU country (Israel). Weighted kappa coefficients were used to evaluate the reliability of interRAI LTCF items.</p> <p>Results</p> <p>Mean age of 4156 residents entering the study was 83.4 ± 9.4 years, 73% were female. ADL disability and cognitive impairment was observed in 81.3% and 68.0% of residents, respectively. Clinical complexity of residents was confirmed by a high prevalence of behavioral symptoms (27.5% of residents), falls (18.6%), pressure ulcers (10.4%), pain (36.0%) and urinary incontinence (73.5%). Overall, 197 of the 198 the items tested met or exceeded standard cut-offs for acceptable test-retest and inter-rater reliability after translation into the target languages.</p> <p>Conclusion</p> <p>The interRAI LTCF appears to be a reliable instrument. It enables the creation of databases that can be used to govern the provision of long-term care across different health systems in Europe, to answer relevant research and policy questions and to compare characteristics of NH residents across countries, languages and cultures.</p>