RESUMO
BACKGROUND: There is currently no adequate tool in the literature for assessing the quality of care in nursing homes. Therefore, we developed and tested a new instrument the Nursing Home Care Index (NCI). METHODS: Quality of care is defined in the literature by 8 dimensions. An instrument with 42 questions of 12 validated scales was implemented. The new instrument was tested on 320 staff members in 15 nursing homes. The data were examined with the help of factor analysis and Cronbach's α, which reduced the factors to 3 and the questions to 16. Finally the revised scale was tested in a further pilot study with 136 staff members. RESULTS: The revised scale consists of 16 items. Based on the factor analysis, a 3-factor structure, namely social relationships, personal well-being, and self-determination were identified. These 3 factors explained 51.2% of total variance. Overall Cronbach's α was 0.87. The α reliability for the subscales was 0.86 (self-determination), 71 personal well-being, and 0.78 social relationship, respectively. Based on the NCI score, quality of care can be categorized into 3 classes: good, adequate, and urgent need for action. CONCLUSIONS: The NCI has a double function. Nursing staff and management can now use the NCI to conduct internal quality assurance regarding their caring efforts. In the future, the NCI can become a useful tool for families and residents to compare the quality of care in different nursing homes.
