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Study of the quality and use of patient-based outcomes instruments has been and still is an area of growing interest in many health disciplines, including nursing. In the last 30 years, the number of measures has greatly increased. However, there is enormous disparity in their contents, hampering selection of one or other of these instruments for use in clinical medicine or research. The aim of this article was to describe the quality attributes that patient-based health instruments should meet before being used. For that purpose, we provide a detailed description of the attributes on which there is both national and international consensus. These instruments are grouped in 3 main axes: conceptual adequacy, applicability, and psychometric properties.

Objective: To measure health-related quality of life (HRQoL) in homebound elderly individuals in the District of San Blas (Alicante, Spain)., Method: The sample was composed of 107 people aged more than 75 years old included in the home care program. As a measurement instrument, the Spanish version of COOP/WONCA charts in their complete version were used., Results: The mean age was 83.18 years. Distribution by sex was 76 (71%) women and 31 (29%) men. The mean overall score was 29.7 points with a standard deviation of 5.04. The association between age and total score was 0.19, which was statistically significant (p = 0.045). Comparison of these two means with Student's t-test for independent samples showed no statistically significant differences (t = -580; p > 0.05). When differences between men and women in each of the items of the scale were analyzed, only "social activities" showed a statistically significant difference (t = -2.959; p = 0.04). The time taken to administer the questionnaire was 30 +/- 5 min., Conclusions: HRQoL in our population is worse than that in other studied populations. Due to the ceiling-floor effect of some of the variables, further studies in this type of population are required. The time used in this type of population to complete the questionnaire was five times greater than that used in other populations.

Objective: To perform a literature review of the scales and instruments used to assess the risk of developing a pressure ulcer (RPU) in the adult and elderly population and to analyze whether these scales meet the criteria of validity and reliability. To determine whether a specific scale has been developed for use in the domiciliary care setting and adapted to the Spanish environment., Method: We performed a descriptive study with a search of the CUIDEN, IME, CINAHL and MEDLINE databases between January 1990 and December 2005. A specifically-designed form was used to register the variables. Data extraction was performed by a single person. The key words used were pressure ulcer, decubitus ulcer, pressure sore, risk evaluation scales, validity, sensitivity, specificity and reliability and their equivalents in Spanish., Results: Complete descriptions of 22 instruments and studies of the validity and/or reliability of 15 instruments were found., Conclusions: At present, and based on the results of this review, the RPU scale that has shown the greatest validity and reliability is the Braden-Bergstrom scale.