Chinesization,Evaluation And Validation Of The Self-care Ability Scale For The Elderly

ObjectiveThe study aimed to translate the Self-Care Ability Scale for the Elderly(SASE)into Chinese,and to test the reliability,validity of the scale in the Chinese context,providing a new reference for assessment,intervention and promotion of the self-care ability of the Chinese elderly.MethodsA cross-sectional design was used to conduct this study.The sample consisted of 620 older people who were from urban communities(410)or hospitals(210),collected by a demographic questionnaire,the Chinese version of the Self-Care Ability Scale for the Elderly(SASE-CHI),the Appraisal of Self-Care Agency Scale-Revised(ASAS-R)and the Exercise of Self-Care Agency scale(ESCA).the validity,reliability and the influence factors of the self-care ability were analyzed by SPSS 21.0 and AMOS21.0.Results1.Samples: 620 cases were consulted,the effective cases were 610,and the effective recovery rate was 98.39%.Among them,327 cases were male,and female were 283.The ages were range from 60 to 95,and the average age was(72.27±8.13).2.Items distinction:Considering Critical Ratio value as distinction index,and the mean score of each item was test by the independent sample t test,and all the results reached significant level(P<0.05).The item-to-total correlation varied between 0.16 to 0.73(P<0.05).3.Validity: content validity,construct validity,Criterion-related validity,discriminant validity,and predictive validity.Content validity: The item content validity indexes were from 0.83 to 1.00,S-CVI/UA was 0.82 and S-CVI/Ave was 0.97.Construct validity: Construct validity was demonstrated in an exploratory factor analysis with a three-factor solution,explaining 73.62% of the variance.The communalities of each item was from 0.52 to 0.98.The three-factor solution of SASE-CHI had a good fit(GFI=0.925,AGFI=0.885,RMR=0.017,RMSEA=0.064,NFI=0.944,IFI=0.968,TLI=0.956,CFI=0.968,PGFI=0.604,PNFI=0.694,and 2x/ df =2.233).Criterion-related validity: The strong correlation of 0.39-0.71(P < 0.05)between ASAS-R and SASE suggested sufficient concurrent validity.Discriminant validity: Considering the score of ESCA as the grouping variable,?116 group and <116 group,and the score of SASE-CHI as the tested variables,and the two groups were test by the independent sample t test,and the results reached significant level(P<0.05).Predictive validity: Regarding ESCA as the gold standard,the sensitivity of 88.2% and the specificity of 84.1%,and the area under the receiver operator characteristic(ROC)curve for the cut-point of SASE was 0.915(95%CI: 0.891-0.939,P<0.05).4.Reliability: the Cronbach's ? of SASE-CHI was 0.89 and the split-half Cronbach's ? was 0.87.The test-retest reliability intra-class correlation coefficients(ICC)of the total scores of SASE-CHI was 0.99(95%CI: 0.99-1.00;P<0.05),and the ICC of each items of SASE-CHI ranged from 0.80 to 0.99.All these explained that the scale had good internal consistency and stability.5.The result of the measurement of SASE-CHI were that: the higher was 30.7%,and the lower was 69.3%.Living alone,with a long period of education and the female were the protection factors of the self-care agency,however,the sense of helplessness,chronic diseases and the older age were the risk factors of the self-care agency.ConclusionsSASE-CHI,with good reliability and validity,could be regarded as a reliable self-care agency assessment tools,and it had the similar test effect to the ESCA,and had strong alignment with ESCA,could be considered to apply to the elderly in the community,the hospital and the nursing homes in China.The self-care agency was on or below the medium level about the elderly in Jinzhou city by SASE-CHI,therefore,the medical staff could be make personalized intervention measures to improving their self-care ability according to the individual self-care agency and the influence factors.However,SASE-CHI need further study before widely used.