Proxy sources for information on nursing home residents' quality of life.
OBJECTIVE
This study explores how well staff and family proxies' reports on selected quality-of-life (QOL) domains (comfort, dignity, functional competence, privacy, meaningful activity, food enjoyment, relationships, security, and autonomy) correspond to residents' own reports.


METHODS
We compared QOL domain scores for nursing home residents and 1,326 staff proxies and 989 family proxies at the individual and facility level using means, Pearson correlation statistics, and intraclass correlations. Regression models adjusted for residents' age, gender, length of stay, ability to perform activities of daily living, and cognition.


RESULTS
For each domain in more than half the cases, proxy means were within 1 SD of the resident means. Resident and family proxy individual reports for selected domains were correlated at 0.14 to 0.46 (all p <.000). Resident and staff proxy individual reports were correlated at 0.13 to 0.37 (all p <.000). Correlation of mean levels by facility for staff proxies was 0.26 to 0.64 (generally p <.05) and for family proxies 0.13 to 0.61 (p <.01 except for one domain).


CONCLUSIONS
Although staff and family proxy domain scores are significantly correlated with resident scores, the level of correlation suggests they cannot simply be substituted for resident reports of QOL. Determining how proxy reports can be used for residents who cannot be interviewed at all remains an unresolved challenge.
Kane
Robert L
RL
University of Minnesota School of Public Health, 420 Delaware St. SE, D351 Mayo (MMC 197), Minneapolis, MN 55455, USA. kanex001@umn.edu
Kane
Rosalie A
RA
Bershadsky
Boris
B
Degenholtz
Howard
H
Kling
Kristin
K
Totten
Annette
A
Jung
Kyoungrae
K
D000203:Activities of Daily Living / Q000145:classification / Q000523:psychology; D000339:Affect; D000368:Aged; D000369:Aged, 80 and over; D000544:Alzheimer Disease / Q000523:psychology; D003072:Cognition Disorders / Q000523:psychology; D003258:Consumer Behavior / Q000706:statistics & numerical data; D005260:Female; D016330:Frail Elderly / Q000523:psychology* / Q000706:statistics & numerical data; D006707:Homes for the Aged / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009735:Nursing Homes / Q000706:statistics & numerical data; D015588:Observer Variation; D010549:Personal Satisfaction; D019727:Proxy / Q000706:statistics & numerical data; D011788:Quality of Life / Q000523:psychology*; D012494:Sampling Studies; D013223:Statistics as Topic; D014481:United States