Search results

The perceived behavior and barriers of community care professionals in encouraging functional activities of older adults

Background: Community care professionals need to encourage older adults in performing functional activities to maintain independence. However, professionals often perform functional activities on behalf of older adults. To change this, insights into the behavior and barriers of professionals in encouraging activities are required. In the current study, the MAINtAIN questionnaire, which was developed for nursing homes, was adopted. The objective was to create a modified version that is suitable for measuring behavior and barriers of community care professionals in encouraging functional activities of clients in the community care setting. The overall aims were to assess the content validity, construct validity, and internal consistency of the modified version. Methods: Data was collected by qualitative and quantitative methods in two phases. During phase one, the MAINtAIN was assessed on appropriateness and feasibility by community nurses (N = 7), and the adapted questionnaire was assessed on content validity by research experts (N = 9) and community care professionals (N = 18). During phase two, the psychometric properties of the adapted MAINtAIN-C were assessed in community care professionals (N = 80). Construct validity was evaluated by an Exploratory Factor Analysis (EFA), and internal consistency was determined by calculating Cronbach’s alpha coefficients. Results: The formulation, verbs, and wording of the MAINtAIN were adapted; some items were excluded and relevant items were added, resulting in the MAINtAIN-C with two scales, showing good content validity. The Behaviors scale (20 items) measures perceived behavior in encouraging functional activities, expressing good internal consistency (Cronbach’s alpha: .92). The Barriers scale measures barriers in encouraging functional activities related to two dimensions: 1) the clients’ context (7 items), with good internal consistency (.78); and 2) the professional, social, and organizational contexts (21 items), showing good internal consistency (.83). Conclusions: The MAINtAIN-C seems promising to assess the behavior and barriers of community care professionals in encouraging functional activities. It can be used to display a possible difference between perceived and actual behavior, to develop strategies for removing barriers in encouraging activities to foster behavioral change. The results also provide guidance for further research in a larger sample to obtain more insight into the psychometric properties.

Psychometric evaluation of the Signs of Depression Scale with a revised scoring mechanism in stroke patients with communicative impairment

Cross-sectional multicentre study to investigate (1) the diagnostic value of the Signs of Depression Scale (SODS) in a Likert scale format and (2) whether the Likert scale improves the diagnostic value compared with the original dichotomous scale. A total of 116 consecutive hospitalized stroke patients, of whom 53 were patients with communicative impairment.

The effect of Youth Assertive Community Treatment

During the past decades deinstitutionalisation policies have led to a transition from inpatient towards community mental health care. Many European countries implement Assertive Community Treatment (ACT) as an alternative for inpatient care for “difficult to reach” children and adolescents with severe mental illness. ACT is a well-organized low-threshold treatment modality; patients are actively approached in their own environment, and efforts are undertaken to strengthen the patient’s motivation for treatment. The assumption is that ACT may help to avoid psychiatric hospital admissions, enhance cost-effectiveness, stimulate social participation and support, and reduce stigma. ACT has been extensively investigated in adults with severe mental illness and various reviews support its effectiveness in this patient group. However, to date there is no review available regarding the effectiveness of youth-ACT. It is unknown whether youth-ACT is as effective as it is in adults. This review aims to assess the effects of youth-ACT on severity of psychiatric symptoms, general functioning, and psychiatric hospital admissions.

Motivational interviewing

Structural validity and reliability of the Dutch Older Patient in Acute Care Survey (OPACS), measuring nurses’ attitude towards older patients

Background: In clinical practice, nurses’ attitudes regarding older patients are important in relation to quality of care. The Older People in Acute Care Survey (OPACS) is an instrument measuring hospital nurses attitudes regarding older patients and is validated in Australia and the USA. The OPACS is translated in Dutch language and content validity of this translation is previously assessed, presenting questionable results. Measurement instruments, however, cannot be “validated” based on content validity evidence alone. Judgmental evidence and statistical analysis should be combined to fully evaluate content domain definition and representation and guide further development. Objective: Assess structural validity and reliability to fully evaluate the OPACS for use in the Netherlands, complementing previous conducted content validity results. Design: Cross-sectional. Setting: Three general hospitals in the Netherlands. Participants: 201 registered nurses. Methods: Confirmatory factor analysis was used to assess the structural validity. Reliability was assessed with Cronbach’s alpha. Results: OPACS Section A (measuring practice experiences) demonstrated to have acceptable structural validity- and good reliability outcomes after exclusion of two items (model fit: x² [df=537]=8475.40, p <0.001, CFI=0.96, TLI=0.96, RMSEA=0.21; Cronbach’s alpha=0.82). Section B (measuring general opinion) demonstrated to have inadequate structural validity outcomes (model fit: x² [df=1127]=9200.29, p<0.001, CFI=0.68, TLI=0.67, RMSEA=0.15). None of the items contributed significant to the factor and therefore no further analysis could be performed (range p(>|z|)= 0.551 -0 .788). Conclusion: Even though structural validity for section A was acceptable, content validity scores of a majority of items in this subscale were low, resulting in questionable use of this subscale for the Dutch context. The findings of this study, in relation to the earlier findings regarding content validity, justify the conclusion that use of the Dutch OPACS in clinical practice and research is not recommended. Given these findings, future research should pursue the development or (cross-cultural) validation of other instruments measuring hospital nurses attitudes towards older patients for the Dutch cultural context. Furthermore, this study demonstrated the influence of cultural differences on measurement instruments and the need for rigorous research before using a measurement instrument in a new culture or context.

Validation of the Rainbow Model of Integrated Care Measurement Tool in Parkinson's Disease

BACKGROUND: Integrated care is essential for improving the management and health outcomes for people with Parkinson's disease (PD); reliable and objective measures of care integration are few.OBJECTIVE: The aim of this study was to test the psychometric properties of the Rainbow Model of Integrated Care Measurement Tool (RMIC-MT, provider version) for healthcare professionals involved in PD care.METHODS: A cross-sectional survey was administered online to an international network representing 95 neurology centers across 41 countries and 588 healthcare providers. Exploratory factor analysis with principal axis extraction method was used to assess construct validity. Confirmatory factor analysis was used to evaluate model fit of the RMIC-MT provider version. Cronbach's alpha was used to assess the internal consistency reliability.RESULTS: Overall, 371 care providers (62% response rate) participated in this study. No item had psychometric sensitivity problems. Nine factors (professional coordination, cultural competence, triple aims outcome, system coordination, clinical coordination, technical competence, community-centeredness, person-centeredness, and organizational coordination) with 42 items were determined by exploratory factor analysis. Cronbach's alpha ranged from 0.76 (clinical coordination) to 0.94 (system coordination) and showed significant correlation among all items in the scale (>0.4), indicating good internal consistency reliability. The confirmatory factor analysis model passed most goodness-of-fit tests, thereby confirming the factor structure of nine categories with a total of 40 items.CONCLUSIONS: The results provide evidence for the construct validity and other psychometric properties of the provider version of the RMIC-MT to measure integrated care in PD. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.