ABSTRACT
Purpose of Study: To develop a structured observational tool, the Resident-centered Assessment of Interactions with Staff and Engagement tool (RAISE), to measure 2 critical, multi-faceted, organizational-level aspects of person-centered care (PCC) in nursing homes: (a) resident engagement and (b) the quality and frequency of staff-resident interactions. Design and Methods: In this multi-method psychometric development study, we conducted (a) 120 hr of ethnographic observations in one nursing home and (b) a targeted literature review to enable construct development. Two constructs for which no current structured observation measures existed emerged from this phase: nursing home resident-staff engagement and interaction. We developed the preliminary RAISE to measure these constructs and used the tool in 8 nursing homes at an average of 16 times. We conducted 8 iterative psychometric testing and refinement cycles with multi-disciplinary research team members. Each cycle consisted of observations using the draft tool, results review, and tool modification. Results: The final RAISE included a set of coding rules and procedures enabling simultaneously efficient, non-reactive, and representative quantitative measurement of the interaction and engagement components of nursing home life for staff and residents. It comprised 8 observational variables, each represented by extensive numeric codes. Raters achieved adequate to high reliability with all variables. There is preliminary evidence of face and construct validity via expert panel review. Implications: The RAISE represents a valuable step forward in the measurement of PCC, providing objective, reliable data based on systematic observation.
Subject(s)
Aging/psychology , Attitude of Health Personnel , Behavior Observation Techniques/methods , Homes for the Aged , Nursing Homes , Patient Participation , Quality of Life , Aged , Aged, 80 and over , Female , Geriatric Assessment/methods , Humans , Male , Patient Participation/methods , Patient Participation/psychology , Professional-Patient Relations , Psychometrics/methods , Reproducibility of ResultsABSTRACT
Visual object recognition is often assumed to be insensitive to changes in retinal position, leading to theories and formal models incorporating position-independent object representations. However, recent behavioral and physiological evidence has questioned the extent to which object recognition is position independent. Here, we take a computational and physiological perspective to review the current behavioral literature. Although numerous studies report reduced object recognition performance with translation, even for distances as small as 0.5 degrees of visual angle, confounds in many of these studies make the results difficult to interpret. We conclude that there is little evidence to support position-independent object recognition and the precise role of position in object recognition remains unknown.
