Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England

Allan, Stephen, Rand, Stacey, Towers, Ann-Marie, de Corte, Kaat, Tracey, Freya, Crellin, Liz, Lloyd, Therese, Carroll, Rachael E., Palmer, Sinead, Webster, Lucy Anne, Gordon, Adam Lee, Smith, Nick, Akdur, Gizdem, Killett, Anne, Spilsbury, Karen and Goodman, Claire (2025) Construct validity of measures of care home resident quality of life: cross-sectional analysis using data from a pilot minimum data set in England. Health and Quality of Life Outcomes, 23. ISSN 1477-7525

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Abstract

Background: To maintain good standards of care, evaluations of policy interventions or potential improvements to care are required. A number of quality of life (QoL) measures could be used but there is little evidence for England as to which measures would be appropriate. Using data from a pilot Minimum Data Set (MDS) for care home residents from the Developing resources And minimum dataset for Care Homes’ Adoption (DACHA) study, we assessed the discriminant construct validity of QoL measures, using hypothesis testing to assess the factors associated with QoL. Methods: Care home records for 679 residents aged over 65 from 34 care homes were available that had been linked to health records and care home provider data. In addition to data on demographics, level of needs and impairment, proxy report measures of social care-, capability- and health-related QoL of participants were completed (ASCOT-Proxy-Resident, ICECAP-O, EQ-5D-5L Proxy 2). Discriminant construct validity was assessed through testing hypotheses developed from previous research and QoL measure constructs. Multilevel regression models were analysed to understand how QoL was influenced by personal characteristics (e.g. sex, levels of functional and cognitive ability), care home level factors (type of home, level of quality) and resident use of health services (potentially avoidable emergency hospital admissions). Multiple imputation was used to address missing data. Results: All three QoL measures had acceptable construct validity and captured different aspects of QoL, indicated by different factors explaining variation in each measure. All three measures were negatively associated with levels of cognitive impairment, whilst ICECAP-O and EQ-5D-5L Proxy 2 were negatively associated with low levels of functional ability. ASCOT-Proxy-Resident was positively associated with aspects of quality and care effectiveness at both resident- and care home-level. Conclusion: The study found acceptable construct validity for ASCOT-Proxy-Resident, ICECAP-O and EQ-5D-5L Proxy 2 in care homes, with findings suggesting the three are complementary measures based on different constructs. The study has also provided evidence to support the inclusion of these QoL measures in any future MDS.

Item Type:	Article
Additional Information:	Data availability: Anonymised data extracted from digital care records will be available on request from the corresponding author, SA, following a 24 month embargo from the date of publication.
Uncontrolled Keywords:	quality of life,measurement,care homes,older adults,england,validity
Faculty \ School:	Faculty of Medicine and Health Sciences > School of Health Sciences
UEA Research Groups:	Faculty of Medicine and Health Sciences > Research Centres > Mental Health and Social Care (fka Lifespan Health) Faculty of Medicine and Health Sciences > Research Groups > Dementia & Complexity in Later Life
Depositing User:	LivePure Connector
Date Deposited:	31 Mar 2026 14:30
Last Modified:	31 Mar 2026 14:30
URI:	https://ueaeprints.uea.ac.uk/id/eprint/102676
DOI:	10.1186/s12955-025-02356-0

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