Validated 20-item scale measures nursing home residents’ care preferences

A 20-item resident-reported questionnaire developed and validated among nursing home residents without cognitive impairment showed acceptable reliability and validity for measuring preferences about residential care. The Preferences for Residential Care Scale–Resident Version, known as the PRCS-R, assesses four domains: personal autonomy, social contact, therapeutic interaction and communication, and supportive healthcare environment. Person-centered care in nursing homes requires attention to residents’ preferences, and identifying what residents consider important can help inform preference-based care planning.

To create a measure that records these priorities from the residents’ perspective, researchers used a multi-phase development process. Preliminary items drew on person-centered care and self-determination theory, existing preference measures, and relevant literature. The researchers then refined the items through expert review and cognitive interviews with nursing home residents.

The development process also examined content and face validity. Experts reviewed the instrument, while feedback from residents informed further assessment of whether the questions were appropriate and understandable. This sequence combined theoretical and literature-based item generation with consultation and cognitive interviews before the scale entered full psychometric testing.

Psychometric evaluation involved 268 nursing home residents without cognitive impairment. The researchers performed item analysis, confirmatory factor analysis, convergent and discriminant validity testing, assessment of internal consistency, and test–retest reliability. Confirmatory factor analysis supported the proposed four-factor structure, and the study found evidence of both convergent and discriminant validity.

The final PRCS-R achieved a Cronbach’s alpha of 0.93 for the total scale, indicating high internal consistency among the 20 items. The intraclass correlation coefficient for test–retest reliability was 0.88, indicating a high degree of score stability between the two assessments. Together, these findings support the PRCS-R as an acceptable self-report measure of residential-care preferences among residents without cognitive impairment.

The results support using the scale to clarify residents’ care priorities and inform preference-based care planning, although the study did not establish whether the same psychometric performance applies to residents with cognitive impairment. That group was outside the population included in the present validation, and the authors identified further examination of the scale’s properties among residents with cognitive impairment as a direction for future research.

Subject of Research: Development and validation of a resident-reported measure of preferences in nursing home care

Article Title: Measuring resident preferences in nursing homes: development and validation of the preferences for residential care scale-resident version among residents without cognitive impairment

Article References: Hsiao, C.-Y., Chen, H.-W., Li, C.-R., & Tsai, Y.-F. (2026). Measuring resident preferences in nursing homes: development and validation of the preferences for residential care scale-resident version among residents without cognitive impairment. BMC Geriatrics. https://doi.org/10.1186/s12877-026-08472-w

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DOI: 10.1186/s12877-026-08472-w

Keywords: nursing homes, resident preferences, person-centered care, questionnaire validation, psychometrics, care planning, self-determination, reliability, validity, Measuring, resident, preferences