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A Refined Protocol for Coding Nursing Home Residents' Comments During Satisfaction Interviews

¹ University of California, Los Angeles, School of Medicine.
² Department of Community Health Sciences, University of California, Los Angeles, School of Public Health.
³ Sepulveda, VA, Northridge, California.
⁴ Department of Social Welfare, University of California, Los Angeles, School of Public Affairs.
⁵ Los Angeles Jewish Home for the Aging/Borun Center for Gerontological Research, Reseda, California.

Address correspondence to Lené Levy-Storms, PhD, MPH, Departments of Social Welfare and Medicine, University of California, Los Angeles, School of Public Affairs, Box 651656, 5226 Public Policy Building, Los Angeles, CA 90095-1656. E-mail: llstorms{at}ucla.edu

Objectives. This study's objective was to refine a method for coding nursing home (NH) residents' comments about their perceptions of care into unmet needs specific to the manner and frequency of care delivery.

Methods. NH residents (N = 69) were interviewed with both closed-ended (i.e., forced-choice) and open-ended (i.e., residents' own words) questions about their perceptions of care across eight care domains. Unmet needs included comments indicating that residents desired a change in staff- and non-staff-related care. Staff-related unmet needs were further coded into unmet emotional support (i.e., emotional support or manner of care delivery) and instrumental (i.e., instrumental support or frequency of care) needs.

Results. Of 66 residents who commented, 66% expressed at least one unmet need across eight care domains. Among these 44 residents, 52% and 84% had unmet emotional support and instrumental support needs, respectively ( =.68 and.92). An additional 18% expressed both unmet emotional support and instrumental support needs.

Discussion. The refined method offers a systematic way to code residents' comments about their care into unmet needs related to the manner and frequency of care delivery. The findings have direct implications for the identification of care areas in need of improvement from the resident's perspective and the evaluation of improvement efforts.