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Originalarbeit

Interne Konsistenz und Konstruktvalidität des demenzspezifischen Lebensqualitätsinstruments QUALIDEM

Eine Sekundärdatenanalyse einer Querschnittserhebung

Published Online:August 20, 2019https://doi.org/10.1024/1012-5302/a000689

Abstract

Zusammenfassung. Hintergrund: Die Aufrechterhaltung sowie Steigerung der Lebensqualität (LQ) von Menschen mit Demenz gilt als zentrales Ziel der pflegerischen und medizinischen Versorgung. Mit dem QUALIDEM existiert ein theoriebasiertes demenzspezifisches LQ-Instrument in deutscher Sprache. Zur Konstruktvalidität liegen bisher jedoch kaum Ergebnisse vor. Ziel: Evaluation der Itemschwierigkeit, internen Konsistenz und diskriminanten sowie konvergenten Validität des deutschsprachigen QUALIDEM. Methode: Die Überprüfung der Konstruktvalidität erfolgt anhand eines Multi-Trait-One-Method Ansatzes basierend auf einer Stichprobe von 167 Menschen mit einer leichten bis schweren und 71 mit einer sehr schweren Demenz. Ergebnisse: Der Zusammenhang zwischen den QUALIDEM-Subskalen und den Vergleichskonstrukten Agitation, Depression, Angst, Abweichendes motorisches Verhalten, Apathie, Schmerzempfinden und Lebensqualität, erfasst anhand des Alzheimer’s Disease Related Quality of Life Instruments, bestätigte sich in 82 % der vorformulierten Hypothesen in erwarteter Richtung. Der Korrelationskoeffizient zur diskriminanten Validität liegt zwischen 0,04 und −0,60 und für die konvergente Validität zwischen −0,21 und 0,71. Für die Mehrheit der QUALIDEM-Subskalen konnte eine gute interne Konsistenz ermittelt werden. Schlussfolgerungen: Die Ergebnisse der Studie liefern erste Hinweise für die Konstruktvalidität der QUALIDEM-Subskalen sowie zur Weiterentwicklung des Instruments. In zukünftigen Studien sollte die Validität des deutschsprachigen QUALIDEM weiter untersucht werden.


Internal consistency and construct validity of the Quality of Life measurement in dementia QUALIDEM – a secondary data analysis of cross-sectional data

Abstract. Background: Maintaining and improving the Quality of Life (QoL) of people with dementia is the principal aim of nursing and medical care. The QUALIDEM is a theory-based, dementia-specific QoL instrument in the German language. Until now, however, there are hardly any findings on the construct validity. Objective: Evaluation of the item difficulty, internal consistency, discriminant and convergent validity of the German QUALIDEM. Method: The evaluation of the construct validity is based on a Multi-Trait-One-Method approach, using a sample of 167 people with mild to severe dementia and 71 people with very severe dementia. Results: The correlation between the QUALIDEM subscales and the comparative constructs agitation, depression, anxiety, aberrant motoric behavior, apathy, pain and QoL, measured with the Alzheimer’s Disease Related Quality of Life instrument, was confirmed in the expected direction in 82 % of the predefined hypotheses. The correlation coefficients range between 0.04 and −0.60 (discriminant validity) and −0.21 and 0.71 (convergent validity). For the majority of QUALIDEM subscales a good internal consistency could be demonstrated. Conclusion: The results indicate first indications for the construct validity of the QUALIDEM subscales and for the further development of the instrument. In future studies, the validity of the German QUALIDEM should be further investigated.

Literatur

  • Arons, A. M. M., Wetzels, R. B., Zwijsen, S., Verbeek, H., van de Ven, G. & Ettema, T. P. et al. (2017). Structural validity and internal consistency of the Qualidem in people with severe dementia. International Psychogeriatrics, 1 – 11, doi: 10.1017/S1041610217001405. First citation in articleMedline, Google Scholar

  • Banerjee, S., Samsi, K., Petrie, C. D., Alvir, J., Treglia, M. & Schwam, E. M. et al. (2009). What do we know about quality of life in dementia? A review of the emerging evidence on the predictive and explanatory value of disease specific measures of health related quality of life in people with dementia. International Journal of Geriatric Psychiatry, 24(1), 15 – 24. First citation in articleCrossref Medline, Google Scholar

  • Beerens, H. C., Zwakhalen, S. M., Verbeek, H., Ruwaard, D. & Hamers, J. P. (2013). Factors associated with quality of life of people with dementia in long-term care facilities: A systematic review. International Journal of Nursing Studies, 50(9), 1259 – 1270. First citation in articleCrossref Medline, Google Scholar

  • Black, B., Rabins, P. V. & Kasper, J. D. (1999). Alzheimer Disease Related Quality of Life (ADRQL): User’s Manual (2nd ed.). Baltimore: MD: DEMeasure. First citation in articleGoogle Scholar

  • Bortz, J. & Döring, N. (2006). Forschungsmethoden und Evaluation für Human- und Sozialwissenschaftler (4. überarbeitete Aufl.). Heidelberg: Springer. First citation in articleCrossref, Google Scholar

  • Bouman, A. I., Ettema, T. P., Wetzels, R. B., van Beek, A. P., de Lange, J. & Dröes, R. M. (2011). Evaluation of QUALIDEM: a dementia-specific quality of life instrument for persons with dementia in residential settings; scalability and reliability of subscales in four Dutch field surveys. International Journal of Geriatric Psychiatry, 26(7), 711 – 722. First citation in articleCrossref Medline, Google Scholar

  • Bowling, A., Rowe, G., Adams, S., Sands, P., Samsi, K. & Crane et al. (2015). Quality of life in dementia: a systematically conducted narrative review of dementia-specific measurement scales. Aging & Mental Health, 19(1), 13 – 31. First citation in articleCrossref Medline, Google Scholar

  • Bühl, A. & Zöfel, P. (2004). SPSS 12. Einführung in die moderne Datenanalyse unter Windows (9., überarb. und erw. Aufl.). München: Pearson Studium. First citation in articleGoogle Scholar

  • Campbell, D. T. & Fiske, D. W. (1959). Convergent and discriminant validation by the multitrait-multimethod matrix. Psychological Bulletin, 56(2), 81 – 105. First citation in articleCrossref Medline, Google Scholar

  • Cooper, C., Mukadam, N., Katona, C., Lyketsos, C. G., Ames, D. & Rabins, P. et al. (2012). Systematic review of the effectiveness of non-pharmacological interventions to improve quality of life of people with dementia. International Psychogeriatrics, 24(6), 856 – 870. First citation in articleCrossref Medline, Google Scholar

  • Deuschl, G. & Maier, W. (2016). S3-Leitlinie Demenzen. http://www.dgn.org/images/red_leitlinien/LL_2016/PDFs_Download/038013_LL_Demenzen_2016.pdf [05.07.2019]. First citation in articleGoogle Scholar

  • Dichter, M., Bartholomeyczik, S., Nordheim, J., Achterberg, W. & Halek, M. (2011). Validity, reliability, and feasibility of a quality of life questionnaire for people with dementia. Zeitschrift für Gerontologie und Geriatrie, 44(6), 405 – 410. First citation in articleCrossref Medline, Google Scholar

  • Dichter, M. N., Dortmann, O., Halek, M., Meyer, G., Holle, D., Nordheim, J. & Bartholomeyczik, S. (2013). Scalability and internal consistency of the German version of the dementia-specific quality of life instrument QUALIDEM in nursing homes – a secondary data analysis. Health and Quality of Life Outcomes, 11, 91. First citation in articleCrossref Medline, Google Scholar

  • Dichter, M. N., Schwab, C., Meyer, G., Bartholomeyczik, S., Dortmann, O. & Halek, M. (2014). Measuring the quality of life in mild to very severe dementia: Testing the inter-rater and intra-rater reliability of the German version of the QUALIDEM. International Psychogeriatrics, 26(5), 825 – 836. First citation in articleCrossref Medline, Google Scholar

  • Dichter, M. N., Ettema, T. P., Schwab, C. G. G., Meyer, G., Bartholomeyczik, S. & Halek, M. (2016a). Benutzerhandbuch für die deutschsprachige QUALIDEM Version 2.0. https://www.researchgate.net/publication/332441627_QUALIDEM_Benutzer handbuch_fur_die_deutschsprachige_QUALIDEM_Version_20 [05.07.2019]. First citation in articleGoogle Scholar

  • Dichter, M. N., Schwab, C. G., Meyer, G., Bartholomeyczik, S. & Halek, M. (2016b). Item distribution, internal consistency and inter-rater reliability of the German version of the QUALIDEM for people with mild to severe and very severe dementia. BMC Geriatrics, 16(126), doi: 10.1186/s12877-12016-10296-12870. First citation in articleCrossref, Google Scholar

  • Dichter, M. N., Schwab, C. G., Meyer, G., Bartholomeyczik, S. & Halek, M. (2016c). Linguistic validation and reliability properties are weak investigated of most dementia-specific quality of life measurements-a systematic review. Journal of Clinical Epidemiology, 70, 233 – 245. First citation in articleCrossref Medline, Google Scholar

  • Dröes, R. M. (1991). In movement; on psychosocial care for elderly people with dementia [In beweging: over psychosociale hulpverlening an demente ouderen]. Amsterdam: Vrije Universiteit. First citation in articleGoogle Scholar

  • Ettema, T. P., Dröes, R. M., de Lange, J., Ooms, M. E., Mellenbergh, G. J. & Ribbe, M. W. (2005). The concept of quality of life in dementia in the different stages of the disease. International Psychogeriatrics, 17(3), 353 – 370. First citation in articleCrossref Medline, Google Scholar

  • Ettema, T. P., Dröes, R. M., de Lange, J., Mellenbergh, G. J. & Ribbe, M. W. (2007a). QUALIDEM: development and evaluation of a dementia specific quality of life instrument – validation. International Journal of Geriatric Psychiatry, 22(5), 424 – 430. First citation in articleCrossref Medline, Google Scholar

  • Ettema, T. P., Dröes, R. M., de Lange, J., Mellenbergh, G. J. & Ribbe, M. W. (2007b). QUALIDEM: development and evaluation of a dementia specific quality of life instrument. Scalability, reliability and internal structure. International Journal of Geriatric Psychiatry, 22(6), 549 – 556. First citation in articleCrossref Medline, Google Scholar

  • Förstl, H. & Lang, C. (2011). What is dementia? [Was ist Demenz?]. In Förstl, H. (Ed.), Dementia in Theory and Practice [Demenzen in Theorie und Praxis] (S. 4 – 9). Berlin-Heidelberg: Springer. First citation in articleGoogle Scholar

  • Graubner, B. (2016). [ICD-10-GM 2016 Systematic directory: international statistical classification of diseases and related health issues] ICD-10-GM 2016 Systematisches Verzeichnis: Internationale statistische Klassifikationen der Krankheiten und verwandter Gesundheitsprobleme (10. Revision – German Modification, Version 2016 - Stand: 25. September 2015 ed.). Köln: Deutscher Ärzte-Verlag. First citation in articleGoogle Scholar

  • Karimi, M. & Brazier, J. (2016). Health, Health-Related Quality of Life, and Quality of Life: What is the Difference? Pharmacoeconomics, 34, 645 – 649. First citation in articleCrossref Medline, Google Scholar

  • Klapwijk, M. S., Caljouw, M. A., Pieper, M. J., van der Steen, J. T. & Achterberg, W. P. (2016). Characteristics Associated with Quality of Life in Long-Term Care Residents with Dementia: A Cross-Sectional Study. Dementia and Geriatric Cognitive Disorders, 42, 186 – 197. First citation in articleCrossref Medline, Google Scholar

  • Knigge-Demal, B. & Hundenborn, G. (2013). Anforderungs- und Qualifikationsrahmen für den Beschäftigungsbereich der Pflege und persönlichen Assistenz älterer Menschen. Fachhochschule Bielefeld, Deutsches Institut für angewandte Pflegeforschung. https://www.dip.de/fileadmin/data/pdf/projekte/01 Anforderungs_und_Qualifikationsrahmen_09_2013.pdf [05.07.2019]. First citation in articleGoogle Scholar

  • Lawton, M. P. & Brody, E. M. (1969). Assessment of older people: self-maintaining and instrumental activities of daily living. The Gerontologist, 9(3), 179 – 186. First citation in articleCrossref Medline, Google Scholar

  • Menzi-Kuhn, C. (2006). [Q໿uality of life of people with dementia in institutional care] Lebensqualität von Menschen mit Demenz in stationären Langzeitpflegeeinrichtungen (Unpublished Masterthesis). Maastricht University. First citation in articleGoogle Scholar

  • Moyle, W., Mcallister, M., Venturato, L. & Adams, T. (2007). Quality of life and dementia. Dementia, 6(2), 175 – 191. First citation in articleCrossref, Google Scholar

  • Rabins, P. V., Kasper, J. D., Kleinman, L., Black, B. S. & Patrick, D. L. (1999). Concepts and methods in the development of the ADRQL: An instrument for assessing health-related quality of life in persons with Alzheimer’s disease. Journal of Mental Health and Aging, 5, 33 – 48. First citation in articleGoogle Scholar

  • Reisberg, B. (1986). Dementia: a systematic approach to identifying reversible causes. Geriatrics, 41(4), 30 – 46. First citation in articleMedline, Google Scholar

  • Reisberg, B. (1988). Functional assessment staging (FAST). Psychopharmacology Bulletin, 24(4), 653 – 659. First citation in articleMedline, Google Scholar

  • Reisberg, B. (2007). Global measures: utility in defining and measuring treatment response in dementia. International Psychogeriatrics, 19(3), 421 – 456. First citation in articleCrossref Medline, Google Scholar

  • Reuther, S., Holle, D., Buscher, I., Dortmann, O., Muller, R., Bartholomeyczik, S. & Halek, M. (2014). Effect evaluation of two types of dementia-specific case conferences in German nursing homes (FallDem) using a stepped-wedge design: study protocol for a randomized controlled trial. Trials, 15, 319. First citation in articleCrossref Medline, Google Scholar

  • Reuther, S., Dichter, M. N., Bartholomeyczik, S., Nordheim, J. & Halek, M. (2016). Construct validity and internal consistency of the neuropsychiatric inventory – nursing home (NPI-NH) in German nursing homes. International Psychogeriatrics, 28, 1017 – 1027. First citation in articleCrossref Medline, Google Scholar

  • Streiner, D. L. & Kottner, J. (2014). Recommendations for reporting the results of studies of instrument and scale development and testing. Journal of Advanced Nursing, 70(9), 1970 – 1979. First citation in articleCrossref Medline, Google Scholar

  • Streiner, D. L., Norman, G. R. & Cariney, J. (2015). Health Measurement Scales. A practical guide to their development and use (Vol. 5). Oxford: Oxford University Press. First citation in articleGoogle Scholar

  • van Kooten, J., van der Wouden, J. C., Sikkes, S. A. M., Smalbrugge, M., Hertogh, C. & Stek, M. L. (2017). Pain, Neuropsychiatric Symptoms, and Quality of Life of Nursing Home Residents With Advanced Dementia in The Netherlands: A Cross-sectional Study. Alzheimer Disease & Associated Disorders, 31(4), 315 – 321. First citation in articleCrossref Medline, Google Scholar

  • WHO. (1995). The World Health Organization Quality of Life assessment (WHOQOL): position paper from the World Health Organization. Social Science & Medicine, 41(10), 1403 – 1409. First citation in articleGoogle Scholar

  • Wood, S., Cummings, J. L., Hsu, M. A., Barclay, T., Wheatley, M. V. & Yarema, K. T. et al. (2000). The use of the neuropsychiatric inventory in nursing home residents. Characterization and measurement. American Journal of Geriatric Psychiatry, 8(1), 75 – 83. First citation in articleCrossref Medline, Google Scholar