| BackgroundAs a positive social determinant of health,the association between older adults’social capital and health has been widely discussed in recent years.Relocation to nursing homes tend to be a stressful event for elderly,which face both physical and mental burden.Therefore,it is necessary to explore the social capital for the elderly in nursing homes to provide new ideas for the promotion of physical and mental health.ObjectiveBased on the social capital theory and following the principles of scale development,to develop a social capital scale and test its reliability and validity,so as to provide a valid tool for accurately measuring the social capital among older people in nursing homes.Methods1.Literature Review:To develop the social capital item pool for older adults in nursing homes.Social capital can be further distinguished into structural and cognitive dimensions.Nine electronic databases were searched to summarize measures of social capital.2.Qualitative Research:To supplement the social capital item pool for older adults in nursing homes.In December 2020,semi-structured interview was conducted using a purposive sampling method with caregivers and older people in nursing homes.Interview material was analysed by directed content analysis method.3.Delphi Technique:To select the most valid indicators.A total of 18 experts participated in three rounds of Delphi expert consultation from January to April 2021,and the indicators were revised after group discussions based on expert opinions.4.Field survey:To screen the items and test the reliability and validity of the scale.During May to July 2021,the convenience sampling method was adopted to select 449 older people from two branches of one nursing home in Guangzhou for a questionnaire survey.The data were randomly splitted to two equal sized subsets,where the first data subset was used for item analysis and exploratory factor analysis to screen items,the other subset was used for reliability(internal consistency reliability,split-half reliability and retest reliability)and validity test(construction validity).Results1.Literature Review and Qualitative Research:The social capital item pool for older adults in nursing homes included 2 first-level indicators,7 second-level indicators,46 third-level indicators.2.Delphi Technique:During the three rounds of expert advice,18 experts participated in the consultation.The questionnaire recovery rates were greater than 80.00%and the expert’s authority coefficients were greater than 0.700.After the third round of expert consultation,the Kendall’s harmony coefficient were 0.139～0.222(P<0.01),the experts’ opinions tended to be consistent and consultation was stopped,which initially formed the social capital scale for older people in nursing homes containing 35 items.3.Item Screening:After item analysis and exploratory factor analysis,this study extracted 5 common factors with eigenvalues greater than 1,named trust,sense of belonging,social connection,social participation,limitation of nursing homes,containing 19 items,with factor loadings of 0.529～0.853 and cumulative variance contribution accounted to 62.084%,constructed the social capital scale for older people in nursing homes.4.Reliability and Validity Test:The item content validity index(I-CVI)ranged from 0.833 to 1.000 and the scale content validity index(S-CVI/Ave)was 0.938.The evaluation values of confirmatory factor analysis all met the standard(χ2/df=1.776,CFI=0.921,TLI=0.905,RMSEA=0.056,SRMR=0.068),and the model fitted well.The Cronbach’s alpha coefficient of the scale was 0.802.Half reliability and 2-week test-retest reliability were 0.879 and 0.887 respectively.ConclusionThe scale was developed in rigorous and scientific process and has been proved to be reliable and valid,which can be used to evaluate the level of social capital for older people in nursing homes. |
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