An assessment of the construct validity of the ASCOT measure of social care-related quality of life with older people.
BACKGROUND
The adult social care outcomes toolkit (ASCOT) includes a preference-weighted measure of social care-related quality of life for use in economic evaluations. ASCOT has eight attributes: personal cleanliness and comfort, food and drink, control over daily life, personal safety, accommodation cleanliness and comfort, social participation and involvement, occupation and dignity. This paper aims to demonstrate the construct validity of the ASCOT attributes.


METHODS
A survey of older people receiving publicly-funded home care services was conducted by face-to-face interview in several sites across England. Additional data on variables hypothesised to be related and unrelated to each of the attributes were also collected. Relationships between these variables and the attributes were analysed through chi-squared tests and analysis of variance, as appropriate, to test the construct validity of each attribute.


RESULTS
301 people were interviewed and approximately 10% of responses were given by a proxy respondent. Results suggest that each attribute captured the extent to which respondents exercised choice in how their outcomes were met. There was also evidence for the validity of the control over daily life, occupation, personal cleanliness and comfort, personal safety, accommodation cleanliness and comfort, and social participation and involvement attributes. There was less evidence regarding the validity of the food and drink and dignity attributes, but this may be a consequence of problems finding good data against which to validate these attributes, as well as problems with the distribution of the food and drink item.


CONCLUSIONS
This study provides some evidence for the construct validity of the ASCOT attributes and therefore support for ASCOT's use in economic evaluation. It also demonstrated the feasibility of its use among older people, although the need for proxy respondents in some situations suggests that developing a version that is suitable for proxies would be a useful future direction for this work. Validation of the instrument on a sample of younger social care users would also be useful.
Personal Social Services Research Unit and Quality and Outcomes of Person-Centred Care Research Unit, University of Kent, Canterbury, Kent CT27NF, UK; Personal Social Services Research Unit and Quality and Outcomesof Person-Centred Care Research Unit, London School of Economics and Political Science, Houghton Street, London WC2A 2AE, UK.
Juliette N
JN
Malley
Ann-Marie
AM
Towers
Ann P
AP
Netten
John E
JE
Brazier
Julien E
JE
Forder
Terry
T
Flynn
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003153:Community Health Services / Q000379:methods / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006699:Home Care Services / Q000706:statistics & numerical data*; D006801:Humans; D008019:Life Style; D008297:Male; D061214:Patient Safety; D026684:Personal Autonomy; D010548:Personal Health Services / Q000706:statistics & numerical data*; D011788:Quality of Life; D018570:Risk Assessment; D012944:Social Support; D012959:Socioeconomic Factors; D011795:Surveys and Questionnaires; D006113:United Kingdom