Search

Purpose: Although surveys are usually piloted before fielding, cognitive-based testing of surveys is not standard practice in nursing home (NH) research. Many terms used in the literature do not have standard definitions and may be interpreted differently by researchers, respondents, and policy makers. The purpose of this study was to ensure that survey respondents understood questions as intended, determine whether the Nursing Home Administrator (NHA) or the Director of Nursing (DON) was better able to answer questions on certain topics, and to inform the answer choices provided for questions. Methods: Using existing survey questions and input from experts, we developed surveys to be administered to DONs and NHAs. Cognitive-based interviews were conducted with 45 participants. We took detailed notes during all interviews, and 2 researchers independently coded these notes for key themes. Results: Many terms and concepts routinely used by NH researchers and policy makers, such as “direct-care workers” and “palliative care,” were not uniformly interpreted by those managing NHs. For example, respondents’ definitions of direct-care workers ranged from nursing assistants to broader categories of clinical and other staff members, including nurses, activities staff, and social workers. We also found NHAs and DONs, at times, did not possess or have access to information the researchers expected them to. Implications: Our results may help explain discrepant findings across NH studies. They also underscore the necessity of cognitive-based testing for survey development and have important implications for policy decisions. [ABSTRACT FROM PUBLISHER]

Purpose: The purpose of this study was to describe how the prevalence of nurse aide training and competency evaluation programs (NATCEPs) provided in the nursing home (NH) setting changed between 1997 and 2007, to explore the environmental factors that may be influencing the prevalence of these programs, and to examine how the changing prevalence of NH-based NATCEPs may be affecting those considering certified nursing assistant (CNA) work. Methods: We used the Online Survey Certification and Reporting (OSCAR) data to generate descriptive statistics for 3 groups of NHs from 1997 to 2007: NHs that never provided an NATCEP, those that provided the program throughout the study period, and those that provided the program intermittently. We gathered information on states’ policies regarding CNA training by telephone and Internet. Data from the National Nursing Assistant Survey were also utilized to describe where CNAs are receiving their training and what proportion of costs they are paying. Results: Prevalence of NH-based programs dropped throughout the study period. It is likely that most CNAs are now receiving their preemployment training outside the NH setting and paying a greater share of their training costs. Implications: The shifting of CNA training to venues other than NHs raises important questions about the quality of training and states’ ability to monitor training programs. In addition, CNAs receiving training outside NHs pay a greater share of their training costs, possibly creating a disincentive to enter the field. [ABSTRACT FROM PUBLISHER]