Assessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study

TitleAssessment of nursing home residents in Europe: the Services and Health for Elderly in Long TERm care (SHELTER) study
Publication TypeJournal Article
Year of Publication2012
AuthorsOnder G., Carpenter I., Finne-Soveri H., Gindin J., Frijters D., Henrard J.C, Nikolaus T., Topinkova E., Tosato M., Liperoti R., Landi F., Bernabei R.
JournalBMC Health Serv Res
Type of ArticleResearch Support, Non-U.S. Gov't<br/>Validation Studies
ISBN Number1472-6963 (Electronic)<br/>1472-6963 (Linking)
Accession Number22230771
KeywordsActivities of Daily Living, Aged, 80 and over, Cognition Disorders/epidemiology, Cross-Cultural Comparison, Disabled Persons/statistics & numerical data, Europe/epidemiology, European Union, Female, Geriatric Assessment/methods/*statistics & numerical data, Homes for the Aged/*statistics & numerical data, Humans, Long-Term Care/*statistics & numerical data, Male, Nursing Homes/*statistics & numerical data, Reproducibility of Results, Translations

BACKGROUND: Aims of the present study are the following: 1. to describe the rationale and methodology of the Services and Health for Elderly in Long TERm care (SHELTER) study, a project funded by the European Union, aimed at implementing the interRAI instrument for Long Term Care Facilities (interRAI LTCF) as a tool to assess and gather uniform information about nursing home (NH) residents across different health systems in European countries; 2. to present the results about the test-retest and inter-rater reliability of the interRAI LTCF instrument translated into the languages of participating countries; 3 to illustrate the characteristics of NH residents at study entry. METHODS: A 12 months prospective cohort study was conducted in 57 NH in 7 EU countries (Czech Republic, England, Finland, France, Germany, Italy, The Netherlands) and 1 non EU country (Israel). Weighted kappa coefficients were used to evaluate the reliability of interRAI LTCF items. RESULTS: Mean age of 4156 residents entering the study was 83.4 +/- 9.4 years, 73% were female. ADL disability and cognitive impairment was observed in 81.3% and 68.0% of residents, respectively. Clinical complexity of residents was confirmed by a high prevalence of behavioral symptoms (27.5% of residents), falls (18.6%), pressure ulcers (10.4%), pain (36.0%) and urinary incontinence (73.5%). Overall, 197 of the 198 the items tested met or exceeded standard cut-offs for acceptable test-retest and inter-rater reliability after translation into the target languages. CONCLUSION: The interRAI LTCF appears to be a reliable instrument. It enables the creation of databases that can be used to govern the provision of long-term care across different health systems in Europe, to answer relevant research and policy questions and to compare characteristics of NH residents across countries, languages and cultures.




Alternate JournalBMC Health Serv Res