Developing a framework of concerns from people living with frailty, for the Measure Yourself Concerns and Wellbeing (MYCaW) person-centred outcome measure

• Published in: BMJ open quality Vol. 13; no. 1; p. e002689
• Main Authors: Polley, Marie J, Barker, Ruth E, Collaco, Niçole B, Cam, Christine, Appleton, Joanne, Seers, Helen E
• Format: Journal Article
• Language: English
• Published: England British Medical Journal Publishing Group 31.01.2024; BMJ Publishing Group LTD; BMJ Publishing Group
• Subjects: Content analysis; Data collection; Frailty; geriatrics; Integrated delivery systems; Original Research; patient reported outcome measures; Patient-centered care; patient-centred care; Patients; primary care; Professionals; geriatrics; patient reported outcome measures; primary care; patient-centred care
• ISSN: 2399-6641; 2399-6641
• DOI: 10.1136/bmjoq-2023-002689

IntroductionMeasure Yourself Concerns and Wellbeing is a validated person-centred outcome measure, piloted as a core monitoring tool to understand what matters to people living with frailty in Gloucestershire. This paper describes the acceptability of MYCaW used in this setting, and the development of a framework for analysing personalised concerns from people living with frailty.MethodsMYCaW was implemented in the Complex Care at Home service and South Cotswold Frailty Service from November 2020 onwards. MYCaW was completed at the person’s first meeting with a community matron and then 3 months later. Nineteen staff completed an anonymous survey to provide feedback on the acceptability of the tool. A framework of concerns bespoke to people living with frailty was created via iterative rounds of independent coding of 989 concerns from 526 people. The inter-rater reliability of the framework was determined by using the Cronbach alpha test.ResultsMYCaW was simple to use and helped health professionals’ discussions to be patient focused. A pictorial scale accompanying the Numerical Rating Scale was developed and tested to help people engage with scoring their concerns and well-being more easily. A framework of concerns from people living with frailty was produced with five main supercategories: Mental and Emotional Concerns; Physical Concerns; Healthcare and Service Provision Concerns, Concerns with General Health and Well-being and Practical Concerns. Inter-rater reliability was kappa=0.905.ConclusionsMYCaW was acceptable as a core monitoring tool for people living with frailty and enabled a systematic approach to opening ‘What Matters to Me’ conversations. The personalised data generated valuable insights into how the frailty services positively impacted the outcomes for people living with frailty. The coding framework demonstrated a wide range of concerns—many linked to inequalities and not identified on existing outcome measures recommended for people living with frailty.