| Objective1. To introduce the Active Ageing Scale, and build a Chinese evaluation measurement form with good reliability and validity through the cultural adaptation,and provide a authoritative assessment tool to analyze the change of active aging level of the community elderly people before and after the intervention.2. Exploring linkage effect that nursing students’ participation in home care of elderly patients with chronic diseases in community to improve the level of active aging of the elderly, but also enhance the care ability of nursing students for the elderly.MethodsThis research was performed in two consecutive parts, integrated use of the following methods.The first part was tools’ development:The introduction and the revise of the Active Ageing Scale. After getting the authorization of testing standards for licensing, we strictly followed the process of translation, back translation, localization, adjustment and revision of the standards.Through the semantic analysis, we built a Chinese evaluation measurement, suitable for assessment of the level of active aging in the elderly with chronic diseases in community. To verify the applicability and psychometric characteristics of this evaluation form: choosing a total of 350 the elderly by convenience sampling, using the homogeneity reliability to evaluate the internal consistency degree of this form;using exploratory factor analysis to test the structural validity of the questionnaire,using the content validity index to compute the expert content validity.The second part was intervention part:(1)A Quasi-experimental design. Firstly, 56 freshman nursing volunteers were recruited based on the principle of voluntary registration, then they were randomly divided into the intervention group(28)and the control group(28). The intervention group of 28 nursing students were randomly divided into 7 groups, each four nursing students(a leader, three members). The nursing students were trained, including home care knowledge and skills in the early, middle and late stage of service activities.After each family visit experience, we shared meet guiding the conference, the each were responsible for five elderly patients with chronic diseases every week to provide home care. Also collecting in Zhengzhou municipal community, according to the number of chronic diseases in community health records, the extraction conforms to the conditions in home elderly patients with chronic diseases included a total of 66 cases, to randomly divided into intervention group and control group, each group of33 cases. The intervention group was implemented 6 times a week, 1 times a week, 1time after two weeks, 12 weeks and 9 times of home care intervention, and the control group received routine community care service. Data were collected by another researcher in the follow time points: pre-intervention, post-intervention, 1and 3months post intervention. The evaluation tools were questionnaires of demographic data of nursing students and elderly patients with chronic diseases in community. The scale of Kogan’s Attitudes toward Old People Scale(KAOP)and Palmore’s Facts on Aging Quiz 1(FAQ1)of nursing students, and the scale of Active Ageing Scale(AAS)and SF-12 of elderly patients with chronic diseases in community were used to evaluate the intervention effect. Data were analyzed with SPSS20.0, using the descriptive statistics, chi-square Text, T test and the repetitive measurement deviation analysis.(2)Phenomenological research. 15 nursing students and 13 elderly patients with chronic diseases were selected by using purposive sampling according to the phenomenological method, the data was separately collected by semi-structured interview and analyzed with seven step analysis of Colaizzi.ResultsThe results of the first part:The experts of nursing education, education and other related fields discussed the cultural relevance. They had modified the statement of the three items. The evaluation of reliability and validity of the results: The Cronbach’s α of the Active Ageing Scale was 0.932, and all the dimensions of the Cronbach’s α coefficient respectively in0.777~0.913. Guttman Split-Half split half coefficient is 0.823, and the split half coefficient of each dimension respectively in 0.684~0.854. Using Pearson correlation analysis, each dimension, the dimension and quantity table between the total correlation coefficient in 0.387~0.785(P(27) 0.01). The 28 people being investigated were tested when being selected and retested interval of 2 weeks. The test-retest reliability was 0.725, and each dimension measurement reliability were >0.7(P(27) 0.05). The I-CVI of positive aging scale of Chinese version was 0.78, and the content validity index of each content was more than 0.8. The results of principal component analysis and factor analysis and varimax rotation of the Active Aging Scale select 7 factors: Being self-reliant, Being actively engaged with society,Growing spiritual wisdom, Building up financial security, Maintaining healthy lifestyle, Engaging in active learning, Strengthening family ties for being cared for in the late life. The cumulative variance contribution rate is 67.009%. And the confirmatory factor analysis on the previous scale of exploratory factor analysis of seven factor structure was further validated, Chinese version of active ageing volume table of the seven factor model fit better, all the fit indices was up to standard, all items load were greater than 0.4, fitting index χ2=2305.4, χ2/df=3.016, CFI=0.967,RMSEA=0.043, NNFI=0.914.The results of the second part:Intervention research:(1)The results of repeated-measures analysis of variance indicated that the score of KAOP and FAQ1 dropped faster than the control group, the difference was statistically significant(P<0.01), and there was interaction effect with the two factors of time and group(P<0.01). There was statistical significance of the KAOP and FAQ1 score between the two groups after intervention, after 1 month and3 months later(P<0.01).(2)The results of repeated-measures analysis of variance indicated that the score of AAS and SF-12 increased quickly than the control group,the difference was statistically significant(P<0.01), and there was interaction effect with the two factors of time and group(P<0.01). There was statistical significance of the AAS and SF-12 score between the two groups after intervention, after 1 month and 3 months later(P<0.01), but the three dimensions of the score difference is not statistically significant(P>0.05), including the Building up financial security, Being actively engaged with society, and Strengthening family ties for being cared for in the late life.Qualitative research:(1)There were three themes and nine subthemes according to the nursing students experience affected. The first was “attitude changing”,including “subversion bias”, “into the heart” and “heartfelt admiration”. The second theme was “ability promotion”, including “courage to communicate”, “master skill”,and “active learning”. The third theme was “professional identity”, which consisted of“ability affirmation”, “career achievement”, and “strengthen one’s belief”.(2)There were two themes and four subthemes according to the elderly patients with chronic diseases in community experience affected. The first was “active coping with aging”,including “adjust mentality” and “mental health”. The second theme was “scientific coping with chronic diseases”, including “awareness of chronic diseases”, and“effective guidance”. The monitoring of active aging level of the aged under the background of aging in china.Conclusion1. The Chinese version of AAS scale had good reliability and validity, which was suitable for monitoring the level of active aging of the aged under the background of aging in China.2. The linkage effect is a feasible, effective intervention measures, which can effectively make the nursing students have a more positive attitudes change to the elderly, and enhance the aging knowledge level of nursing students and improve the communication ability of nursing students and the ability of autonomous learning, and enhance the nursing students’ professional identity. At the same time, the linkage model of the elderly active aging level has been improved, the level of quality of life of the elderly has been improved, which can be in the training of nursing students for the elderly caring ability and meet the community-dwelling elderly with chronic diseases at home care to promote the implementation. |
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