scholarly journals Validation and psychometric evaluation of the Dutch Person-centred care of Older People with cognitive impairment in Acute Care (POPAC)

2020 ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie Roodbol

Abstract Background People with dementia are regularly hospitalized. Person-centered care is the preferred model for caring for people with dementia. To improve the quality of care for people with dementia in an acute care setting, knowledge of the level of person-centeredness of the care is relevant. The POPAC is a tool to determine the level of Person-centred care. Translation enables international comparisons of data and outcomes of Person-centred care. This study aimed to translate and cross-nationally validate the Dutch Person-centred care of Older People with cognitive impairment in Acute Care scale and to evaluate its psychometric properties. Methods After translation, a total of 159 nurses recruited from six hospitals and via social media completed the POPAC. A confirmatory factor analysis was performed to test the factor-structure, and a Cronbach’s alpha scale was utilized to establish the reliability of the scale. Results A confirmatory factor analysis showed that the fit by the Confirmatory Fit Index was a nearly acceptable model fit. The Root Mean Square Error of Approximation and the Standardized Root Mean Square Residual suggested an acceptable model fit. The findings of the authors confirm a three-dimensional structure suggested by previous research. The loadings of the items indicate that these are strong associations with each of the factors. Besides, the factor correlations also indicate that these are strongly associated. These findings indicate that the factors are strongly associated with a general POPAC factor. This study confirms that, statistically, Item 5 could be deleted to improve the reliability of the instrument. Instead of deleting this item, the authors suggest considering rephrasing it into a positive item. Conclusions The Dutch version of the POPAC is sufficiently valid and reliable and can be utilized for assessing person-centered care in acute care hospitals. The study enables nurses to interpret and compare levels of Person-centred care in wards and hospital levels between regions and countries. The results form an important basis for improving the quality of care and nurse-sensitive outcomes such as prevention of complications and length of hospital stay.

2020 ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie Roodbol

Abstract Background: Person-centered care is the preferred model for caring for people with dementia. Knowledge of the level of person-centered care is essential for improving the quality of care for patients with dementia. The Person-centred care of Older People with cognitive impairment in Acute Care scale (POPAC) is a tool to determine the level of person-centered care. This study aimed to translate and validate the Dutch POPAC and evaluate its psychometric properties to enable international comparison of data and outcomes.Methods: After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (114) and via social media (45) completed the POPAC. By performing confirmatory factor analysis, the construct validity was tested. Cronbach’s alpha scale was utilized to establish the internal consistency.Results: The confirmatory factor analysis showed that the Confirmatory Fit Index (0.89) was slightly smaller than the cut-off value of 0.9. The Root Mean Square Error of Approximation (0.075, p=0.012, CI 0.057-0.092) and the Standardized Root Mean Square Residual (0.063) were acceptable with values less than 0.08. Findings confirm a three-dimensional structure. The loadings of the items (0.69-0.77) indicate that these are strong associated with each of the factors. This study confirms that deleting Item 5 improves the Cronbach’s alpha of the instrument as well as of the subscale. Instead of deleting this item, we suggest considering rephrasing it into a positive item.Conclusions: Our findings suggest that the Dutch POPAC is sufficiently valid and reliable and can be utilized for assessing person-centered care in acute care hospitals. The study enables nurses to interpret and compare person-centered care levels in wards and hospital levels between regions and countries. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn J. Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie F. Roodbol

Abstract Background Person-centred care is the preferred model for caring for people with dementia. Knowledge of the level of person-centred care is essential for improving the quality of care for patients with dementia. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale is a tool to determine the level of person-centred care. This study aimed to translate and validate the Dutch POPAC scale and evaluate its psychometric properties to enable international comparison of data and outcomes. Methods After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (n=114) and via social media (n=45) completed the POPAC scale. By performing confirmatory factor analysis, construct validity was tested. Cronbach’s alpha scale was utilized to establish internal consistency. Results The confirmatory factor analysis showed that the comparative fit index (0.89) was slightly lower than 0.9. The root mean square error of approximation (0.075, p=0.012, CI 0.057–0.092) and the standardized root mean square residual (0.063) were acceptable, with values less than 0.08. The findings revealed a three-dimensional structure. The factor loadings (0.69–0.77) indicated the items to be strongly associated with their respective factors. The results also indicated that deleting Item 5 improved the Cronbach’s alpha of the instrument as well as of the subscale ‘using cognitive assessments and care interventions’. Instead of deleting this item, we suggest rephrasing it into a positively worded item. Conclusions Our findings suggest that the Dutch POPAC scale is sufficiently valid and reliable and can be utilized for assessing person-centred care in acute care hospitals. The study enables nurses to interpret and compare person-centred care levels in wards and hospital levels nationally and internationally. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.


2021 ◽  
Author(s):  
Annette Keuning-Plantinga ◽  
Evelyn J Finnema ◽  
Wim Krijnen ◽  
David Edvardsson ◽  
Petrie F Roodbol

Abstract Background: Person-centred care is the preferred model for caring for people with dementia. Knowledge of the level of person-centred care is essential for improving the quality of care for patients with dementia. The person-centred care of older people with cognitive impairment in acute care (POPAC) scale is a tool to determine the level of person-centred care. This study aimed to translate and validate the Dutch POPAC scale and evaluate its psychometric properties to enable international comparison of data and outcomes.Methods: After double-blinded forward and backward translations, a total of 159 nurses recruited from six hospitals (n=114) and via social media (n=45) completed the POPAC scale. By performing confirmatory factor analysis, construct validity was tested. Cronbach’s alpha scale was utilized to establish internal consistency.Results: The confirmatory factor analysis showed that the comparative fit index (0.89) was slightly lower than 0.9. The root mean square error of approximation (0.075, p=0.012, CI 0.057-0.092) and the standardized root mean square residual (0.063) were acceptable, with values less than 0.08. The findings revealed a three-dimensional structure. The factor loadings (0.69-0.77) indicated that the items to be strongly associated with their respective factors. The results also indicated that deleting Item 5 improved the Cronbach’s alpha of the instrument as well as of the subscale ‘using cognitive assessments and care interventions’. Instead of deleting this item, we suggest rephrasing it into a positively worded item.Conclusions: Our findings suggest that the Dutch POPAC scale is sufficiently valid and reliable and can be utilized for assessing person-centred care in acute care hospitals. The study enables nurses to interpret and compare person-centred care levels in wards and hospital levels nationally and internationally. The results form an important basis for improving the quality of care and nurse-sensitive outcomes, such as preventing complications and hospital stay length.


Dementia ◽  
2021 ◽  
pp. 147130122110126
Author(s):  
Alexandra E Harper ◽  
Lauren Terhorst ◽  
Marybeth Moscirella ◽  
Rose L Turner ◽  
Catherine V Piersol ◽  
...  

Background Person-centered care has been shown to increase desired outcomes for people with dementia, yet informal caregivers’ dissatisfaction with care is often reported. For those living in a nursing home, informal caregivers are uniquely situated to provide key insights into the individual’s care. However, little is known of the informal caregivers’ perspective, which hinders efforts to improve their satisfaction with person-centered nursing home care. Thus, we examined the comprehensive experiences, priorities, and perceptions of informal caregivers of nursing home residents with dementia. Methods In collaboration with stakeholders, a scoping review of Medline (Ovid), EMBASE.com , CINAHL (EBSCO), the Cochrane Library (Wiley), and PsycINFO (Ovid) databases from January 2000 to July 2020 was conducted. Data were extracted reflecting the experiences, priorities, and preferences of caregivers of people with dementia residing in nursing homes. Results We identified 114 articles that revealed nine themes: (1) communication, (2) transition to nursing home, (3) quality of care, (4) quality of life, (5) informal caregiver role, (6) knowledge of dementia, (7) end-of-life preferences, (8) medication use to manage neuropsychiatric behaviors, and (9) finances. Conclusion Informal caregivers described aspects of care that led to both positive and negative experiences with and perceptions of nursing home care. The shortcomings in communication were discussed most frequently, indicating a high priority area. While researchers define the identified themes individually, informal caregivers perceive them to be interwoven as they relate to person-centered care delivery. Although we did not assess the quality of included articles, by identifying themes relevant to caregivers’ perspectives of nursing home care, our findings may help to inform efforts to optimize caregivers’ satisfaction with nursing home care for residents with dementia.


2018 ◽  
Vol 6 ◽  
pp. 205031211879281
Author(s):  
Jill-Marit Moholt ◽  
Oddgeir Friborg ◽  
Mari Wolff Skaalvik ◽  
Nils Henriksen

Objectives: The Carers of Older People in Europe Index is a first-stage assessment tool to detect family caregivers in need of support. This instrument assesses caregivers’ subjective perceptions of their caregiving circumstances. The present study examines the psychometric properties of the Norwegian version of the Carers of Older People in Europe Index among family caregivers for older persons with dementia living at home. Methods: Cross-sectional survey data were collected from 430 dementia caregivers. The sample was randomly split as follows: the first half of the sample was used to identify the measurement model using an exploratory factor analysis, and the second half of the sample was used to cross-validate the model using a confirmatory factor analysis. The criterion validity and reliability (internal consistency and test–retest reliability) of the Carers of Older People in Europe Index were also examined. Results: Using an exploratory factor analysis, we extracted three factors that were consistent with previous findings: negative impact of caregiving, positive values of caregiving and quality of support. This model fit the data well using a confirmatory factor analysis. Moreover, a second-order model could replace the three-factor correlated model without sacrificing the model fit, supporting the use of a global impact of caregiving score. The three factors and the global factor correlated with the criteria measures in the expected directions. The internal consistency was assessed using Cronbach’s alpha and was good for the negative impact ( α = 0.86) and the quality of support ( α = 0.76) factors. The positive values factor was less consistent ( α = 0.64). The test–retest reliability was examined using Spearman’s rank order correlation and was good for all three factors. Conclusion: The psychometric properties of the Norwegian version of the Carers of Older People in Europe Index are good. The instrument assesses dementia caregivers’ situations across three primary factors or alternatively validly summarizes the factors in a global impact of caregiving score.


2021 ◽  
Vol 33 (S1) ◽  
pp. 37-38
Author(s):  
Henriëtte van der Roest ◽  
Milan van der Kuil ◽  
Anouk Overbeek ◽  
Egbert Hartstra

BackgroundPositive evidence has been found for person-centered care provisioning (PCC), the level of person- centeredness of care is positively associated with residents’ quality of life, quality of care an wellbeing.When providing PCC, care and support are provided in line with the needs, preferences and capacities of people with dementia. PCC is seen as the golden standard for dementia care. However, in nursing homes, needs and preferences of people with dementia are not always obvious, due to the relatively high levels of cognitive impairment. This, and amongst others time constraints might hinder high PCC by care professionals. Limited evidence show that certain organizational and environmental conditions, such as satisfactory leadership, interdisciplinary collaboration, and continuing education, lead to higher PCC. In order to facilitate care professionals as much as possible in providing PCC, more insight is desirable.ObjectiveThis study aims to provide more insight into the modifiable factors that contribute to PCC for people with dementia in Dutch nursing homes.MethodsA cross-sectional design was applied. Data were collected during the fifth assessment of the Living Arrangements for people with Dementia (LAD)-study from April 2019 until February 2020. Care professionals working in psychogeriatric units in nursing homes filled in an online survey. Organizational characteristics of participating nursing homes were inventoried.The level of PCC was assessed with the Dutch version of the ‘Person-centred care questionnaire’ (PCCq). Modifiable factors potentially impacting the level of provided PCC with regard to staff characteristics (e.g. autonomy, education), organizational features (e.g. size, involvement of family in care), and culture (e.g. learning climate) were included in multiple linear modelling.Preliminary resultsIn total 58 nursing home facilities were included in the study, and 814 care professionals completed the survey. Average PCCq score was 3.2 (SD = 0.4; range 0 to 4, higher scores indicating higher PCC).ConclusionFactors related to staff, and organizational features and culture, that contribute to PPC will be presented. The outcomes of the study will provide input for the optimal organization of dementia care, in order to support care professionals working in nursing homes to provide PCC.


2011 ◽  
Vol 24 (3) ◽  
pp. 406-415 ◽  
Author(s):  
Karin Sjögren ◽  
Marie Lindkvist ◽  
Per-Olof Sandman ◽  
Karin Zingmark ◽  
David Edvardsson

ABSTRACTBackground: Person-centered care is a multidimensional concept describing good care, especially within aged care and care for people with dementia. Research studies evaluating person-centered care interventions seldom use direct measurement of levels of person-centeredness. Existing scales that measure person-centeredness need further testing. This study evaluated the psychometric properties of the Swedish version of the Person-Centered Care Assessment Tool (P-CAT).Methods: A cross-sectional sample of 1465 staff from 195 residential care units for older people in Sweden participated in the study. Validity, reliability, and discrimination ability of the scale were evaluated.Results: Confirmatory factor analysis, parallel analysis and exploratory factor analysis supported the construct validity of a two-factor solution. Reliability and homogeneity were satisfactory for the whole P-CAT as demonstrated by a Cronbach's α of 0.75. Test-retest reliability showed temporal stability of the scale, and the discrimination ability of the scale was satisfactory.Conclusion: The Swedish version of the P-CAT was found to be valid, reliable, and applicable for further use. Two subscales are recommended for the Swedish version.


2019 ◽  
Vol 19 (3-4) ◽  
pp. 343-365 ◽  
Author(s):  
Gentry R. McCreary ◽  
Joshua W. Schutts

AbstractHazing behaviors as a part of group initiations have been theorized to contribute to a sense of group solidarity, to ensure loyalty and commitment of group members, to teach group-relevant skills and attitudes to group members, and to reinforce the social hierarchy within groups. In a survey of members of an international college fraternity (n=2833), researchers propose and test a four-dimensional model of hazing motivation. Using exploratory factor analysis, the proposed four-factor model explains 74 percent of the overall variance and confirmatory factor analysis demonstrated acceptable model fit. Correlation and regression analysis suggested that social dominance- motivated hazing is strongly associated with hazing tolerance, moral disengagement, and a variety of measures related to organizational commitment and attachment.


Author(s):  
Andreas Karlsson Rosenblad ◽  
Pernilla Sundqvist ◽  
Bodil Westman ◽  
Börje Ljungberg

Abstract Purpose To psychometrically evaluate the hypothesized four-factor structure of the 19-item Functional Assessment of Cancer Therapy—Kidney Symptom Index (FKSI-19) health-related quality of life (HRQoL) instrument in a sample of surgically treated renal cell carcinoma (RCC) patients and examine if an alternative factor structure with good psychometric properties may be derived from the available items. Methods The model fit of the hypothesized four-factor structure was examined using confirmatory factor analysis on cohort data from 1731 individuals included in the National Swedish Kidney Cancer Register who had undergone surgery for RCC during the three years 2016–2018 and answered the FKSI-19 instrument within 6–12 months after surgery. Exploratory factor analysis was applied to the same dataset to derive a possible alternative factor solution. Results The four-factor structure did not reach the thresholds for good model fit using the normed χ2-value or the Comparative Fit Index, although the Standardized Root Mean Square Residual and Root Mean Square Error of Approximation measures indicated good and acceptable model fits, respectively. An alternative 14-item trimmed FKSI version (FKSI-14) with a two-factor structure derived from the available FKSI-19 items was found to measure the same aspects of HRQoL as the full FKSI-19 instrument. Conclusion The present study is the first to use psychometric methods for examining the factor structure of the FKSI-19 instrument. The hypothesized four-factor structure of FKSI-19 provided a barely acceptable model fit. The two-factor FKSI-14 structure may be used as an alternative or complement to the four-factor structure when interpreting the FKSI-19 instrument.


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