Instrument development and validation of the comprehensive ability of older people assessment scale

Abstract

Aim: The study is aimed to develop and psychometrically test the Comprehensive Ability of Older People Assessment scale and classify the ability grades.

Design: A cross-sectional design was used for instrument development.

Method: The Comprehensive Ability of Older People Assessment scale was developed by a sample of 971 older people from 4 long-term care institutions in China. The data were collected between April 2018 and March 2020. One-way analysis of variance and multiple regression analysis was used to screen scale items, while focus group interviews were used to integrate the subjective and objective items. Confirmative factor analysis and expert judgment were applied to explore construct validity. Reliability was explored through internal consistency estimation using Cronbach's alpha and homogeneity evaluation using corrected item-total correlations. Cluster analysis and discriminant analysis were used to segment the comprehensive ability assessment scores and discriminant function was established to determine the boundary value of each segment, using correlation analysis to perform reverse verification.

Results: Factor analysis yielded 40 items with six dimensions, including "mentation and cognitive," "perception and communication," "emotional problems," "mental and behavioural problems," "daily life and social participation," and "skin and oral status." The Cronbach's α was 0.951, while the dimensions showed Cronbach's α values ranging from 0.760-0.946. The rationality and scientificity of this scale were proved by the correlation analysis of reverse validation.

Conclusion: The 4-grade Comprehensive Ability of Older People Assessment scale is proved to be with good validity and reliability and should be considered for institutional assessors.

Impact: Assessors can accurately evaluate older people's health status and nursing needs through this scale in long-term care institutions, communities and hospitals, so as to provide accurate and high-quality nursing services. It will become a scientific basis for the government to offer accurate pension subsidies, purchase pension services scientifically for older people and establish third-party objective evaluation and supervision.

Keywords: comprehensive ability; instrument development; nursing; older people; reliability; validity.