title: Resident and family satisfaction with incontinence and mobility care: sensitivity to intervention effects?
abstract: OBJECTIVE
  This study evaluated whether the satisfaction levels of long-term-care residents and their family members concerning incontinence and mobility care were sensitive to an improvement intervention.
  
  
  METHODS
  A randomized, controlled intervention trial with incontinent long-term-care residents was conducted wherein research staff provided toileting and walking assistance. The frequency of assistance was of sufficient intensity to significantly improve continence and mobility outcomes in the treatment group as a whole. Interviews were conducted with residents and family members at baseline and after 8 weeks of intervention to assess their satisfaction with and preferences for incontinence and mobility care, using two question types: (a) direct satisfaction and (b) a discrepancy index of "met needs" reflecting the difference between perceived and preferred care frequencies.
  
  
  RESULTS
  Both residents and family members reported high rates of satisfaction to direct satisfaction questions. Residents' reports were sensitive to care improvements based only on the discrepancy index measure. Few family members were able to answer specific questions about incontinence and mobility care frequencies, and their reports were insensitive to care improvements.
  
  
  CONCLUSIONS
  The majority of incontinent long-term-care residents were able to reliably answer questions about their perceived and preferred care frequencies related to incontinence and mobility care. A discrepancy index based on these questions was sensitive to care frequency improvements. Family members' reports were not sensitive to improvements, and direct satisfaction questions were misleading for both residents and family members.
authors.affiliation: Jewish Home for the Aging/UCLA Borun Center for Gerontological Research, 7150 Tampa Avenue, Reseda, CA 91335, USA. ssimmons@ucla.edu
authors.forename: Sandra F
authors.initials: SF
authors.lastname: Simmons
authors.forename: Joseph G
authors.initials: JG
authors.lastname: Ouslander
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005190:Family / Q000523:psychology*; D005242:Fecal Incontinence / Q000451:nursing*; D006707:Homes for the Aged; D006801:Humans; D007407:Interviews as Topic; D009732:Nursing Care / Q000592:standards*; D009735:Nursing Homes; D017060:Patient Satisfaction; D014549:Urinary Incontinence / Q000451:nursing*; D016138:Walking