title: The development of a CAHPS instrument for Nursing Home Residents (NHCAHPS).
abstract: We report on a federal initiative to develop a CAHPS (The Consumer Assessment of Healthcare Providers and Systems) survey to measure residents' experiences with quality-of-care and quality-of-life in nursing homes (known as NHCAHPS). We focus on how we created and tested questions for inclusion in the instrument and tested a possible cognitive screener to determine which residents could participate in a NHCAHPS interview. The major lessons learned were: (1) In contrast to other CAHPS surveys, ratings were more useful than reports because of the difficulty that residents had with summarizing over time and people; (2) consistent with other CAHPS surveys, the 0 to 10 response scale appeared to work well with nursing home residents for many of the quality-of-care questions; however, a different response scale was needed for many of the quality-of-life items; and (3) in contrast with typical survey methodology and other CAHPS surveys where explicit time reference periods are used, a non-specific present reference period in questions seemed to work best.
authors.affiliation: Agency for Healthcare Research and Quality, Rockville, MD 20850, USA. jsangl@ahrq.gov
authors.forename: Judith
authors.initials: J
authors.lastname: Sangl
authors.forename: Joan
authors.initials: J
authors.lastname: Buchanan
authors.forename: Carol
authors.initials: C
authors.lastname: Cosenza
authors.forename: Shula
authors.initials: S
authors.lastname: Bernard
authors.forename: Susan
authors.initials: S
authors.lastname: Keller
authors.forename: Nancy
authors.initials: N
authors.lastname: Mitchell
authors.forename: Julie
authors.initials: J
authors.lastname: Brown
authors.forename: Nicholas
authors.initials: N
authors.lastname: Castle
authors.forename: Edward
authors.initials: E
authors.lastname: Sekscenski
authors.forename: Deborah
authors.initials: D
authors.lastname: Larwood
mesh_terms: D003258:Consumer Behavior; D006801:Humans; D009735:Nursing Homes; D011787:Quality of Health Care; D011788:Quality of Life; D012107:Research Design; D011795:Surveys and Questionnaires; D014481:United States