| Objectives:1 To devlep a long-term care demand assessment scale for disabled elderly in nursing homes and to test the psychometric assessment of the scale,with the purpose of providing a reference for further standarzing long-term care service and improving the quality of long-term care in nursing homes.2 To preliminarily determine the classification criteria of the long-term care demand assessment scale for the disabled elderly in nursing homes,to further evaluate the status of long-term care demand for disabled elderly in nursing homes and analyze the influencing factors.Methods:1 Based on the theory of Maslow's hierarchy of needs and Zuluaga-Raysmith model,using literature review,semi-structured interviews and expert meeting,the item pool of long-term care demand assessment scale for disabled elderly in nursing homes was initially formed.2 Through 2 rounds of expert consultation involving 23 experts,items was screened and optimized and the scale of long-term care demand assessment for disabled elderly in nursing homes was initially formed.3 With convenirece sampling method,223 disabled elderly from 3nursing homes in Shanghai,Suzhou and Chongqing were investigated using the pre trial version scale.Seven methods were used to further screen the items and form the finial version scale,such as item-total score Peason correlation coefficient,critical ratio,construct validity,content validity,criteria validity,internal consistency reliability and test-retest reliability.4 With convenirece sampling method,411 disabled elderly from 3nursing homes in Shanghai,Suzhou and Chongqing were investigated using the finial veision scale.The factor structure of the scale was further confirmed by the confirmatory factor analysis.5 Based on the results of second field surveys,the grading evaluation standard of the long-term care demand assessment scale for disabled elderly in nursing homes was initially established according to the the daily living ability scale.6 Based on the results of second field surveys,single factor analyses and multiple stepwise regression analyses were conducted to understand the current situation and influencing factors of long-term care demand for disabled elderly in nursing homes.Results:1 Combining the results of literature review,semi-structured interviews and expert meeting,the initial scale included 49 items under 5domains: daily life care demand,medical care demand,health guidance demand,spiritual comfort demand and social participation demand.2 The response rates of two rounds consultation were 74.19% and95.65% and the authority coefficient of experts were 0.850 and 0.905.The coordination coefficients of demainds and items in the second round were0.600 and 0.269,respectively(P < 0.001).The pre trial vision scale included 40 items under 5 domains: daily life care demand,medical care demand,health guidance demand,spiritual comfort demand and social participation demand.3 After screening items by 7 methods,2 items were deleted.The exploratory factor analysis identified six principal factors and explained for80.495% variance.The content validity index of the items ranged from0.889 to 1,and content validity index of the scale was 0.953.The Cronbach's ? coefficient of the scale was 0.948 and test-retest reliability was 0.846.The finial vision scale included 38 items under 6 domains: daily life care demand,basic medical care demand,specialist medical care demand,health guidance demand,spiritual comfort demand and social participation demand.4 Confirmatory factor analysis showed that the model fitted well andthat the long-term care demand assessment scale for disabled elderly in nursing homes had a stable factor strcture.5 The grading evaluation criteria for the long-term care demand assessment scale for disabled elderly in nursing homes was defined as:scores ? 121=lower level demand,scores 121~139 = moderate demand,scale scores > 139 = higher degree of demand.6 The total score and mean score of long-term care demand were(122.06±31.65)and(3.21±0.83),respectively.Univariate analysis showed that long-term care demand for disabled elderly in nursing homes among age,payment,nursing home residence time,risk factors and activities of daily living were statistically significant(P<0.05).Multiple stepwise linear regression analysis showed that age and activities of daily living were the main factors.Conclusions:1 The long-term care demand assessment scale for disabled elderly in nursing homes included 38 items and 6 domains: daily life care demand,basic medical care demand,specialist medical care demand,health guidance demand,spiritual comfort demand and social participation demand.2 Psychometric assessment showed showed that the scale had good reliability and validity,stable factor structure and scientific grading evaluation criteria.It could be used as a tool to investigate the long-termcare demand for disabled elderly in nursing homes.3 The long-term care demand for disabled elderly in the nursing homes was relatively high.The main influencing factors of long-term care demand were activities of daily living,types of diseases,payment methods and education level. |
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