Research Priority Setting in Care Homes

Problem

An ageing population is accompanied by a corresponding rise in the number of people requiring long term care, with those entering care having increasingly severe and complex health care needs. Currently, there is little evidence base for much of the care provided in care homes for residents. Research involving care homes is more complex and resource intensive than in other healthcare settings. Given the wide range of topics that require further investigation, and limited research resources, one solution is to identify the priorities for future research. Research priority setting processes assist health care researchers and policymakers to effectively target research that has the greatest potential public health benefit.

Approach

A research priority setting exercise was conducted with individuals involved in the care of older people living in care homes. Care home staff from nursing and residential care homes throughout the UK were invited to take part, either by direct invitation, accessing a URL link posted on websites or through local research networks. The Delphi technique was used to identify research topics and develop consensus among care home staff participants. The survey was conducted across three rounds by email or postal questionnaires. Firstly to elicit topics or areas of uncertainty that were considered by participants to require further research, secondly to prioritise the long list of research questions, followed by a third round to reach a consensus on the short list of questions. The primary aim of the project was to obtain converging consensus on a set of priorities for research in health care in care homes.

Findings

83 participants responded to the initial survey, providing 144 uncertainties or questions. Following analysis and review against existing evidence, 76 research questions remained for prioritisation in the next round. 40/83 participants responded to the interim prioritisation round, and 43/83 participants responded to the final round which ranked the top 15 research questions by importance. After ranking, the top 10 research priorities included questions on person-centred care, dignity, appropriate staffing levels, and training and support requirements for care home staff. Two other groups (60 other care home staff, and 33 professionals including occupational therapists, doctors and social workers) also participated in the final ranking. The results from these groups had a high degree of consistency with the original cohort of participants.

Consequences

This is the first study to establish the research priorities for older people in UK care homes. Research priorities identified by a key stakeholder group have been endorsed by other professionals involved in their care. Sharing these results with clinicians, researchers and funding bodies will help to inform the care of older people by ensuring the future research agenda can be focused on the areas of greatest need.