Quality-of-life Assessment
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HOW DO I ANALYZE RESPONSES?
For many, perhaps most, interview questions it is sufficient to simply calculate the frequency of the various responses to each question: What percentage of the residents interviewed responded "yes" to the question? What percentage responded "no"?
If the question asks for a number in response (e.g., How many times during the day does someone who works here help you to use the bathroom?), then in addition to response frequencies, you may want to calculate an overall average for the question. This single number helps outline the big picture.
Consider creating an excel database that can quickly calculate frequencies and averages for you.
Responses to some questions require special handling:
- Discrepancy questions: As noted earlier, these come in sets of two and compare residents' preferences for care to their perceptions of the care they actually receive. If, for example, the first question asks, "How many times during the day would you like the staff to help you to the bathroom?" then its companion question will ask, "How many times during the day do the staff help you to the bathroom?" To make full use of these questions, you should calculate a "discrepancy score" for each individual by subtracting the second answer from the first. For example, if a resident says he receives toileting assistance once a day but he prefers toileting assistance three times a day, then the discrepancy score is -2 (i.e., 1-3 = -2). The negative difference signals unmet needs. You can use the discrepancy scores for all residents interviewed to calculate an overall average discrepancy score.
- Open-ended questions: Responses to these questions, as well as spontaneous comments to other types of questions, provide valuable information for tailoring care and services to individuals that forced-choice questions by their very nature cannot capture. For starters, then, you should make it a point to simply listen carefully and take into consideration what your residents have to say. If you go one step further and codify their comments, you can analyze this data quantitatively, adding it to the statistical "Big Picture" of care quality in your facility. In a recent study, we evaluated a simple method for coding residents' comments that proved reliable (9).
The method follows three steps:
- Ask whether each comment indicates a desire for change, that is, for something other than the status quo (e.g., "I would like to walk more often"). Code as yes or no.
- If a change is desired, then ask whether interaction with staff is needed to bring about the change (e.g., "I would like more encouragement to walk"). Code as yes or no.
- If interaction with staff is required, then ask whether the comment refers to the manner of care delivery (e.g., "When they dress you they are rough, not kind."). Also ask whether it refers to technical aspects of care, such as frequency or timeliness (e.g., "I would like a shower every day"). Code as either one or the other (manner of care vs. technical care) or both.
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