Factor structure of "personhood" for elderly healthcare services: a questionnaire survey of long-term care facilities in Japan.

OBJECTIVE

The purpose of this study was to develop the Personhood Questionnaire (PQ) to determine the factor structure of "personhood" for elderly healthcare services and identify personhood components other than PQ items.

METHOD

We enrolled 314 healthcare professionals at long-term care facilities in Japan. Participants completed a questionnaire consisting of 17 PQ items. The PQ was designed to assess the degree of need in elderly healthcare services on a 5-point Likert scale (Question 1), and identify personhood components other than PQ items (Question 2). We performed factor analysis for answers to Question 1, and text mining and cluster analysis for answers to Question 2.

RESULTS

Factor analysis revealed a four-factor structure. Cronbach's α was 0.87 for the 17 original items and 0.86 for the 15 items after removing two items. Text mining identified 27 personhood components, which were classified into three clusters. The second cluster consisted of non-PQ items.

CONCLUSIONS

Factor 1 was "forming daily life," factor 2 was "forming career and context," factor 3 was "affecting psychological behavior," and factor 4 was "forming basic attributes." Components of the second cluster require further examination before incorporation into the concept of personhood.

IMPLICATIONS FOR REHABILITATION

• Improving the quality of individualized care, in which "personhood" and dignity of elderly people are respected, is an urgent goal. • The Model of Human Occupation (MOHO), a conceptual practice model for occupational therapy, should be used jointly with the International Classification of Functioning, Disability and Health (ICF) to establish the concept of personhood. • The construction of personhood in elderly health care services consists of a four-factor structure, including "forming daily life," "forming career and context," "affecting psychological behavior," and "forming basic attributes." • This study suggests that provision of high-quality individualized care can be achieved by promoting services that focus on "forming daily life,” which has the highest factor contribution.