Strategies to measure nursing home residents' satisfaction and preferencesrelated to incontinence and mobility care: Implications for evaluating intervention effects

This study compared four different interview strategies to measure 111 inco ntinent nursing home residents' "met need" related to incontinence and mobi lity care. Strategies were compared on criteria related to ceiling effects and stability. Four methods were used: questions that used the term "satisf action" and direct questions about preferences that did not use the term "s atisfaction" and which could be translated into three indirect measures of met need. To facilitate a comparison among the four methods, a statement of satisfaction was interpreted as met need. All of these measures were then compared to direct observations of care processes. Residents were more stab le in their reports indicating that their care needs were met than they wer e in their reports that their needs were not met. The direct satisfaction q uestions produced information most characterized by ceiling effects compare d to information elicited by the preference questions. Despite high reporte d rates of met need as assessed by two of the four methods, direct observat ions revealed low frequencies of care provision.