Chinese Version Of TESS-NH Scale And Research On Its Preliminary Application

Purposes:1. To introduce Therapeutic Environment Screening Survey For Nursing Homes (TESS-NH Scale) and translate it into Chinese, and amend it taking the cultural background, nursing and building structure in China into consideration.2. To evaluate the reliability and validity of the amended Chinese version of TESS-NH Scale and discuss its applicability in assession for the therapeutic environment of nursing homes for senile dementia patients in China.3. To assess the situation of the therapeutic environment of nursing homes for senile dementia patients in Fujian, discuss the affecting factors and propose some suggestions.Method:1. To get the approval of the original author of TESS-NH Scale, Doctor Sloane, to have it translated into Chinese,back-translated and cross-cultural tested，and measuring the content validity. The amended Chinese version of TESS-NH Scale has been tested by care units in nursing homes for senile dementia patients for their retest reliability,interrater reliability, in-ternal consistency reliability,split-half reliability and structure vali-dity.2. To evaluate the situations of therapeutic environment of65care units in nursing homes for senile dementia patients in9cities in Fujian from10th,2013to2nd,2014, with the application of amended Chinese version of TESS-NH Scale by the convenient sampling.To describe and analyze the situations and affecting factors of therapeutic environment of care units in nursing homes for senile dementia patients in Fujian with the ways of descriptive statistics,analysis of Kruskal-Wallis H test and Spearman correlated analysis.Results:1. Translate TESS-NH Scale into the amended Chinese version.①Reliability: the Pearson product-moment correlation coefficient of the retest reliability on the scale is0.849(P<0.05);the interrater reliability correlati-on coefficient is0.89（P<0.05); the internal consistency reliability of the scale-Cronbach’s alpha is0.829;that of all dimensions is0.716～0.770; the split-half reliability coefficient is0.751（P<0.01）.②Content validity: The content validity index(CVI) of the scale is computered by Delphi expert consultation,it is0.88～1.00,the average of CVI is0.98.③Structure validity: the factor component analysis method is used for exploratory factor analysis. Exploratory factor analysis extracted six common factor eigenvalues greater than1that can reflect the69.706%information amount6factors for all items load values above0.5;the correlation coefficient between the dimension scores and the total scores of questionnaires is0.507～0.821; the correlation coefficient between the various dimensions is0.252～0.523;the correlation coefficient between each entry and its corresponding dimension is0.266～0.994; most of them show a significant correlation (P <0.05). The correlation coefficient between each entry and its total scores of the Chinese version of SCUEQS scale is the mostly same to the original scale in developmental version and validational version,the most correlation coefficient between each entry and its total scores is0.285～0.735，which show a significant correlation(P<0.05).2. The research result of therapeutic environment of65care units in nurs-ing homes for senile dementia patients in Fujian is scored by the SCUEQS scale.The maximum score is36,the minimum score is16,the average is23.83,the median is23.00, interquartile range is19.00～28.00.The compared with the best effect of38points of SCUEQS,the score of therapeutic environment of65care units in nursing homes for senile dementia patients in Fujian is in the middle and upper level.Among that, the dimension of maintenance gets the highest score(6.49±1.51),and the dimension of visual stimulation/cue gets the lowest score(0.43±0.73).3. The analysis result of affecting factors: There are no distinct differ-rences between the evaluation scores of therapeutic environments for seni-le dementia patients in nursing homes with different institutional attributes, types of units and occupancy rates(P>0.05);there exist differences between those built or rebuilt in different years and those with different payments for each month(P<0.05); multiple linear regressions show that different payments for each month influence the evaluation scores of SCUEQS scale positively(F＝15.759，P=0.000).Conclusion:1. The amended and cross-cultural tested Chinese version of TESS-NH Scale enjoys sound reliability and validity and it’s easy and convenient to handle.It serves as a sensible and applicable evaluation instrument for the standard of therapeutic environment for senile dementia patients in Chinese nursing homes, and act as a theoretical foundation for the design of therapeutic environment for senile dementia patients in China in the future.2. The present standards of therapeutic environments of most care units in nursing home for senile dementia patients in Fujian are above the average. However, it’s not enough just to satisfy the demands on environment for senile dementia patients. The management can make some improvements for the defects and it could provide reference to standardize and improve the overall quality of therapeutic environment of care units in nursing home for senile dementia patients in Fujian.3. There are no significant differences between the standard of therapeutic environment of care units in nursing home for senile dementia patients with different institutional attributes, types of units, occupancy rates;there exist significant differences between those built or rebuilt in different years and those with different payments for each month,while the former is positively related with the payment each month. The administrative authorities should involve properly for this affecting factor, so as to provide the solid guarantee for the improvement of the standard of therapeutic environment of care units in nursing home for senile dementia patients.