The University of Southampton
University of Southampton Institutional Repository

Finding the right outcome measures for care home research

Finding the right outcome measures for care home research
Finding the right outcome measures for care home research
SIR—Hoppitt, Sackley and Wright (Age and Ageing January 2010) report the results of their trial of therapy for UK care home residents, concluding that there is a lack of appropriate outcomes available for the care home population, and a need for validation of existing measures and development of alternatives in this population.
These conclusions were based on the response rates at three time intervals for measurements of hand grip strength, the Timed Up and Go test, the Falls Efficacy Scale and calcaneal ultrasound densitometry. These measures all had lower response rates than those for the Barthel Index and Rivermead Mobility Index, both of which were completed by proxy where required. Response rates for handgrip varied from 60% (intervention group) and 66% (control group) initially, reducing to 46% and 51% for each group at the third time interval. The authors state that cognitive impairments made it impossible to follow the instructions, while physical impairments meant that some participants were unable to attempt the hand grip.

We recently evaluated the feasibility and acceptability of hand grip strength measurement using a Jamar handheld dynamometer among residents of care homes in Hampshire (BUPA and privately owned). A total of 64/133 (48%) residents from three nursing homes and one dementia registered residential care home participated [mean age 86 years (range 70–98); 18 men, 46 women]. Sixty-two (47%) potential participants were excluded because severe dementia precluded informed consent for the trial, but those with mild to moderate dementia were able to participate (mean Mini-Mental State Examination score 19/30 points, range 6–30). Three (2%) participants were excluded for physical reasons: total deafness (two) and advanced motor neurone disease (one).

Sixty-three of 64 (99%) participants were able to have grip strength measured and hold the dynamometer with both hands; the remaining participant had a fractured arm. Sixty participants answered questions on the acceptability of hand grip assessment, of which 56 (92%) were definitely prepared to repeat, although four (7%) found it painful and 10 (17%) tiring. Additional in-depth interviews with four residents revealed that they found the test straightforward to carry out and had squeezed the dynamometer as hard as they could.

We agree with the authors'’ conclusions that researchers should select outcome measures that are appropriate for use in the intended population, but our research suggests that assessment of hand grip strength is acceptable and feasible in care home populations. Further research is required to fully evaluate the utility of this measurement.

0002-0729
517
Roberts, Helen C.
5ea688b1-ef7a-4173-9da0-26290e18f253
Sayer, Avan Aihie
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Anderson, Frank
a0b4d3f7-f9e6-4f1f-8cbb-a3a60f152f72
Bowman, C.
1f1fe25a-7b32-4166-ab4e-78e2749b40dd
Roberts, Helen C.
5ea688b1-ef7a-4173-9da0-26290e18f253
Sayer, Avan Aihie
fb4c2053-6d51-4fc1-9489-c3cb431b0ffb
Anderson, Frank
a0b4d3f7-f9e6-4f1f-8cbb-a3a60f152f72
Bowman, C.
1f1fe25a-7b32-4166-ab4e-78e2749b40dd

Roberts, Helen C., Sayer, Avan Aihie, Anderson, Frank and Bowman, C. (2010) Finding the right outcome measures for care home research. Age and Ageing, 39 (4), 517. (doi:10.1093/ageing/afq062).

Record type: Article

Abstract

SIR—Hoppitt, Sackley and Wright (Age and Ageing January 2010) report the results of their trial of therapy for UK care home residents, concluding that there is a lack of appropriate outcomes available for the care home population, and a need for validation of existing measures and development of alternatives in this population.
These conclusions were based on the response rates at three time intervals for measurements of hand grip strength, the Timed Up and Go test, the Falls Efficacy Scale and calcaneal ultrasound densitometry. These measures all had lower response rates than those for the Barthel Index and Rivermead Mobility Index, both of which were completed by proxy where required. Response rates for handgrip varied from 60% (intervention group) and 66% (control group) initially, reducing to 46% and 51% for each group at the third time interval. The authors state that cognitive impairments made it impossible to follow the instructions, while physical impairments meant that some participants were unable to attempt the hand grip.

We recently evaluated the feasibility and acceptability of hand grip strength measurement using a Jamar handheld dynamometer among residents of care homes in Hampshire (BUPA and privately owned). A total of 64/133 (48%) residents from three nursing homes and one dementia registered residential care home participated [mean age 86 years (range 70–98); 18 men, 46 women]. Sixty-two (47%) potential participants were excluded because severe dementia precluded informed consent for the trial, but those with mild to moderate dementia were able to participate (mean Mini-Mental State Examination score 19/30 points, range 6–30). Three (2%) participants were excluded for physical reasons: total deafness (two) and advanced motor neurone disease (one).

Sixty-three of 64 (99%) participants were able to have grip strength measured and hold the dynamometer with both hands; the remaining participant had a fractured arm. Sixty participants answered questions on the acceptability of hand grip assessment, of which 56 (92%) were definitely prepared to repeat, although four (7%) found it painful and 10 (17%) tiring. Additional in-depth interviews with four residents revealed that they found the test straightforward to carry out and had squeezed the dynamometer as hard as they could.

We agree with the authors'’ conclusions that researchers should select outcome measures that are appropriate for use in the intended population, but our research suggests that assessment of hand grip strength is acceptable and feasible in care home populations. Further research is required to fully evaluate the utility of this measurement.

This record has no associated files available for download.

More information

Published date: July 2010

Identifiers

Local EPrints ID: 158973
URI: http://eprints.soton.ac.uk/id/eprint/158973
ISSN: 0002-0729
PURE UUID: af89bd4f-e21b-4383-93aa-5c0eff1fc489
ORCID for Helen C. Roberts: ORCID iD orcid.org/0000-0002-5291-1880

Catalogue record

Date deposited: 25 Jun 2010 08:46
Last modified: 14 Mar 2024 02:47

Export record

Altmetrics

Contributors

Author: Avan Aihie Sayer
Author: Frank Anderson
Author: C. Bowman

Download statistics

Downloads from ePrints over the past year. Other digital versions may also be available to download e.g. from the publisher's website.

View more statistics

Atom RSS 1.0 RSS 2.0

Contact ePrints Soton: eprints@soton.ac.uk

ePrints Soton supports OAI 2.0 with a base URL of http://eprints.soton.ac.uk/cgi/oai2

This repository has been built using EPrints software, developed at the University of Southampton, but available to everyone to use.

We use cookies to ensure that we give you the best experience on our website. If you continue without changing your settings, we will assume that you are happy to receive cookies on the University of Southampton website.

×