Measuring Veterans' Safe Patient Handling and Mobility Experiences

NIH RePORTER · VA · I01 · · view on reporter.nih.gov ↗

Abstract

Background: Safe Patient Handling and Mobility (SPHM) consists of ergonomic techniques and equipment to move patients who cannot move independently. SPHM helps minimize adverse events (pressure ulcers, falls), and staff injuries. Despite benefits, we know little about how patients experience assisted mobility. With valid and reliable scales, we can measure patient experiences, thus facilitating improved care, more tailored evaluation, and more targeted clinical staff education. Patients in rehabilitation are an ideal group to study. Specific aims: We will develop a valid and reliable self-report survey based upon patients' experiences of assisted mobility: the (PEAM). We have three aims. First, the analysis of qualitative interview data will identify and describe important concepts of patients' experiences. Scales and items will be generated from the interviews. The items will be reviewed by patients and subject experts, assuring content validity. Second, the PEAM will be fielded and the data analyzed to provide support for reliability and construct validity. Third, we will examine the statistical relation between PEAM and associated outcomes to establish criterion validity. Significance: Patient experiences of care are one of the pillars of health care quality. Yet, no measures assess patients' perceptions of assisted mobility. The VA national directive for SPHM mandates program evaluation, yet the Voice of the Veteran is not part of the assessment. The sheer number of rehabilitation unit Veterans calls for their input. The PEAM will provide a valid and reliable measure to address this gap. PEAM will allow identification of best practices, areas in need of improvement, and clinical staff educational priorities. Priority domain: Our study addresses the HSR&D priority of patient-centered care and care management. We examine how methods of care delivery can influence Veterans' experiences and relevant outcomes. Innovation: PEAM will be the first reliable and validated patient-report survey of assisted mobility experiences. Methodology: For Aim 1, we will conduct telephone interviews with 60 Veterans discharged from inpatient rehabilitation units including: SCI, acute rehabilitation, short-stay nursing homes, and polytrauma. We will interview 30 staff at two medical centers about their experiences with SPHM. Our conceptual model and interview questions consist of patient, provider, equipment, environment, and task concepts. We will apply thematic analysis to data to develop and refine constructs. An expert panel will evaluate item fit to constructs. We will interview up to 15 Veterans to ensure items are understood as intended. For Aim 2, we will test the instrument with a sample of Veterans (n=800). Item response theory and confirmatory factor analysis will identify the best performing items. We will assess construct validity between the PEAM and other validated measures. For Aim 3, we will assess criterion validity through field-based observationa...

Key facts

NIH application ID
10075804
Project number
5I01HX002431-02
Recipient
VA BOSTON HEALTH CARE SYSTEM
Principal Investigator
David C Mohr
Activity code
I01
Funding institute
VA
Fiscal year
2021
Award amount
Award type
5
Project period
2019-10-01 → 2022-09-30