A Systematic Review of Measures of Social Connection for People Living in Long-term Care Homes

Objective(s): Social connection is important for quality of life and care in long-term care (LTC) homes. However, measuring social connection in LTC residents is challenging due to the high prevalence of dementia and the distinct care environment and activities, so research is limited by a lack of consensus on best approaches to measurement. The objective of our study is to systematically review measures of social connection developed for LTC residents, including those with dementia, by evaluating their measurement properties including structural validity, internal consistency, reliability and construct validity.

Data Sources: Eight databases were used to search for primary research papers, no language limit, published from inception to Nov. 2021. We conducted a second targeted search in April 2022 using our list of identified measures, supplemented with a list of measures used in previous research in this population.

Study Selection: We included studies conducted in LTC residents, which quantified any aspect(s) of social connection, and reported at least one psychometric property for the measure(s) of social connection

Data Extraction: We used COSMIN guidelines to evaluate the measurement properties reported for each identified measure.

Data Synthesis: We identified 62 studies reporting on 38 measures; 21 measured quality of life, wellbeing or life satisfaction and included a social connection subscale or standalone items and 17 measures specifically targeted social connection. We found there was little high quality evidence on psychometric properties such as sufficient content validity (n=0), structural validity (n=3), internal consistency (n=3), reliability (n=1), measurement error (n=0), construct validity (n=4), criterion validity (n=0) and responsiveness (n=0). No measures demonstrated satisfactory psychometric properties on all these aspects, so none could not be recommended for use. However, 34 measures have potential to be recommended but require further research to assess their quality. The remaining four are not recommended for use.

Conclusions: No existing measures have sufficient evidence to be recommended for assessment of social connection in residents of LTC homes. Further validation and reliability studies of existing instruments or the development of new measures are needed to enable accurate measurement of social connection in LTC residents for future observational and interventional studies.

Author(s) Disclosures: None