Care Staff’s Daily Living Decision-Making Support Scale for Older Adults with Dementia in Japan: Development of Validity and Reliability
Abstract
:1. Introduction
2. Material and Methods
2.1. Development of the Daily-Living Decision-Making Support Scale for Older Adults with Dementia
2.2. Participants
2.3. Evaluation of Concurrent Validity
2.3.1. Nurses’ Attitudes toward Support for Decision-Making by OwDs
2.3.2. Japanese Version of the Approaches to Dementia Questionnaire (ADQ)
2.4. Ethical Considerations
2.5. Statistical Analysis
3. Results
3.1. Participants’ Characteristics
3.2. Validity Verification
3.2.1. Exploratory Factor Analysis
3.2.2. Constructive Concept Validity
3.2.3. Coexistence Validity
3.3. Reliability Verification
3.3.1. Cronbach’s Alpha Coefficient
3.3.2. Item-Total Correlation Analysis
3.3.3. Test–Retest Reliability
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Items | Mean | SD | |
---|---|---|---|
Age | 41.5 | 12.3 | |
Years of experience in geriatric care | 13.5 | 9.4 | |
Items | n | % | |
Gender | Men | 28 | 20.3 |
Women | 110 | 79.7 | |
Type of Job | Caregiver | 91 | 65.9 |
Nurse | 36 | 26.1 | |
OT | 9 | 6.5 | |
PT | 2 | 1.4 | |
Experienced end of life care conference | Yes | 89 | 64.5 |
No | 49 | 35.5 | |
Experienced asking OwDs on advanced care planning | Yes | 61 | 44.2 |
No | 77 | 55.8 | |
Participated in decision making and advanced care planning workshop | Yes | 41 | 29.7 |
No | 97 | 70.3 | |
Participated in workshop on person-centered care | Yes | 123 | 89.1 |
No | 15 | 10.9 |
Evaluation Scale | Mean | SD |
---|---|---|
Nurses’ attitudes toward support for decision-making by OwDs | ||
1. Working as a team | 16.15 | 2.68 |
2. Respecting the individual’s wishes | 14.76 | 2.82 |
3. Trying to understand the family | 9.41 | 1.80 |
4. Trying to do right by each person | 8.69 | 1.87 |
5. Trying to utilize the individual’s own capabilities | 9.38 | 1.62 |
Approaches to Dementia Questionnaire | ||
1. Hope | 28.64 | 3.92 |
2. Personhood | 44.33 | 4.22 |
The Daily Living Decision-Making Support Scale for Older Adults with Dementia | Factor 1 | Factor 2 | Factor 3 | Mean | SD | I-T Correlation |
---|---|---|---|---|---|---|
1. Support for the formation and expression of intentions in daily life based on the life background and values of people with dementia (OwDs) | ||||||
(1) In reference to the past history of life and sense of values of OwDs, we look for a choice based on their own intentions and values reflected in their desire for life and care. | 0.713 | 0.287 | 0.212 | 3.20 | 0.53 | 0.702 ** |
(2) Although OwDs can talk, they cannot express their real intention sufficiently (especially those with a moderate degree of dementia). Therefore, at first we confirm the consistency of their remarks and the conventional sense of values in OwDs. | 0.682 | 0.354 | 0.15 | 3.09 | 0.68 | 0.725 ** |
(3) During daily living, we explain using simple terms, letters, and real things so that OwDs can express their own will. | 0.465 | 0.123 | 0.221 | 3.39 | 0.56 | 0.519 ** |
(4) When it is difficult for OwDs to express their choices and intentions through verbal communication, we consider their will from their facial expressions and behavior. | 0.449 | 0.355 | 0.300 | 3.36 | 0.52 | 0.673 ** |
2. Attitudes and devising ways to communicate regarding the formation and expression of a will in the daily lives of OwDs | ||||||
(5) We wait for the OwD to respond, even if their communication takes time, to draw the terms for their daily living, so that they can freely express their own will through behavior and facial expressions. | 0.127 | 0.775 | 0.165 | 2.96 | 0.66 | 0.636 ** |
(6) We accept the thoughts of the OwD at any time to show support for their concrete choices in daily living, depending on the pace of the person’s intentions. | 0.413 | 0.636 | 0.209 | 3.09 | 0.67 | 0.737 ** |
(7) To form a will, we support them to make their choices independently and show concrete choices in their daily living according to their pace. We also listen to and acknowledge their expressions. | 0.402 | 0.594 | 0.229 | 3.11 | 0.70 | 0.730 ** |
(8) When it is difficult for OwDs to express their choices and intentions through verbal communication, we speak on their behalf and examine their sense of values while taking note of the consistencies. | 0.262 | 0.385 | 0.168 | 2.96 | 0.62 | 0.565 ** |
3. Devising ways to support OwDs in realizing their intentions in daily life. | ||||||
(9) When OwDs experience difficulties in daily living, we provide them with ways and the care they expect. We plan emotional stability for OwDs. | 0.173 | 0.164 | 0.827 | 3.26 | 0.61 | 0.629 ** |
(10) We accept the decisions of OwDs. If a person declines care, we respect it without forcing care on them. | 0.133 | 0.143 | 0.612 | 3.33 | 0.67 | 0.551 ** |
(11) If the will of OwDs are not granted, we prepare substitute care and support to reconcile at least part of their requests and wishes. | 0.422 | 0.209 | 0.475 | 3.16 | 0.62 | 0.673 ** |
(12) When OwDs have mutual understanding and daily living, we collaborate and support them through inter-professional work, so that they can live independently and their ability is maximized. | 0.254 | 0.197 | 0.462 | 3.29 | 0.64 | 0.468 ** |
Eigenvalue | 5.103 | 1.266 | 0.955 | □ | □ | □ |
Factor contribution ratio | 42.527 | 10.553 | 7.959 | □ | □ | □ |
Accumulation contribution ratio | 61.038 | □ | □ | □ | ||
Cronbach’s α | 0.826 | 0.786 | 0.753 | □ | □ | □ |
Cronbach’s α for the 12 items | □ | □ | 0.873 | □ | □ | □ |
Daily Living Decision-Making Support Scale for Older Adults with Dementia | Nurses’ Attitudes toward Support for Decision-Making by OwDs | Approaches to Dementia Questionnaire | |||||||
---|---|---|---|---|---|---|---|---|---|
Correlation Coefficient | Working as a Team | Respecting the Individual’s Wishes | Trying to Understand the Family | Trying to Do Right by Each Person | Trying to Utilize the Individual’s Own Capabilities | Hope | Personhood | ||
Factor 1 | Support for the formation and expression of intentions in daily life based on the life background and values of OwDs | r | 0.246 | 0.162 | 0.210 | 0.111 | 0.318 | 0.212 | 0.237 |
p-value | 0.004 | 0.057 | 0.013 | 0.193 | 0.000 | 0.013 | 0.005 | ||
Factor 2 | Attitudes and devising ways to communicate regarding the formation and expression of intentions in the daily lives of OwDs | r | 0.360 | 0.391 | 0.426 | 0.343 | 0.416 | 0.119 | 0.290 |
p-value | 0.000 | 0.000 | 0.000 | 0.000 | 0.000 | 0.165 | 0.000 | ||
Factor 3 | Devising ways to support OwDs in realizing their intentions in daily life | r | 0.367 | 0.297 | 0.300 | 0.236 | 0.359 | 0.024 | 0.249 |
p-value | 0.000 | 0.000 | 0.000 | 0.005 | 0.000 | 0.780 | 0.005 |
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Suzuki, M.; Kanamori, T.; Koide, Y.; Asai, Y.; Sato, M.; Naito, T.; Inagaki, K.; Kanamori, M. Care Staff’s Daily Living Decision-Making Support Scale for Older Adults with Dementia in Japan: Development of Validity and Reliability. Int. J. Environ. Res. Public Health 2022, 19, 13664. https://doi.org/10.3390/ijerph192013664
Suzuki M, Kanamori T, Koide Y, Asai Y, Sato M, Naito T, Inagaki K, Kanamori M. Care Staff’s Daily Living Decision-Making Support Scale for Older Adults with Dementia in Japan: Development of Validity and Reliability. International Journal of Environmental Research and Public Health. 2022; 19(20):13664. https://doi.org/10.3390/ijerph192013664
Chicago/Turabian StyleSuzuki, Mizue, Takuya Kanamori, Yukio Koide, Yatami Asai, Masako Sato, Tomoyoshi Naito, Keigo Inagaki, and Masao Kanamori. 2022. "Care Staff’s Daily Living Decision-Making Support Scale for Older Adults with Dementia in Japan: Development of Validity and Reliability" International Journal of Environmental Research and Public Health 19, no. 20: 13664. https://doi.org/10.3390/ijerph192013664