Care and Public Health Research Institute, Department of Health Services Research, Maastricht University, Maastricht, The Netherlands.
Living Lab in Ageing and Long-Term Care, Maastricht, The Netherlands.
BMC Health Serv Res. 2020 Sep 29;20(1):907. doi: 10.1186/s12913-020-05762-w.
Community care professionals need to encourage older adults in performing functional activities to maintain independence. However, professionals often perform functional activities on behalf of older adults. To change this, insights into the behavior and barriers of professionals in encouraging activities are required. In the current study, the MAINtAIN questionnaire, which was developed for nursing homes, was adopted. The objective was to create a modified version that is suitable for measuring behavior and barriers of community care professionals in encouraging functional activities of clients in the community care setting. The overall aims were to assess the content validity, construct validity, and internal consistency of the modified version.
Data was collected by qualitative and quantitative methods in two phases. During phase one, the MAINtAIN was assessed on appropriateness and feasibility by community nurses (N = 7), and the adapted questionnaire was assessed on content validity by research experts (N = 9) and community care professionals (N = 18). During phase two, the psychometric properties of the adapted MAINtAIN-C were assessed in community care professionals (N = 80). Construct validity was evaluated by an Exploratory Factor Analysis (EFA), and internal consistency was determined by calculating Cronbach's alpha coefficients.
The formulation, verbs, and wording of the MAINtAIN were adapted; some items were excluded and relevant items were added, resulting in the MAINtAIN-C with two scales, showing good content validity. The Behaviors scale (20 items) measures perceived behavior in encouraging functional activities, expressing good internal consistency (Cronbach's alpha: .92). The Barriers scale measures barriers in encouraging functional activities related to two dimensions: 1) the clients' context (7 items), with good internal consistency (.78); and 2) the professional, social, and organizational contexts (21 items), showing good internal consistency (.83).
The MAINtAIN-C seems promising to assess the behavior and barriers of community care professionals in encouraging functional activities. It can be used to display a possible difference between perceived and actual behavior, to develop strategies for removing barriers in encouraging activities to foster behavioral change. The results also provide guidance for further research in a larger sample to obtain more insight into the psychometric properties.
社区护理专业人员需要鼓励老年人进行功能活动以保持独立性。然而，专业人员经常代表老年人进行功能活动。为了改变这种状况，需要了解专业人员在鼓励活动方面的行为和障碍。在当前的研究中，采用了专为养老院开发的 MAINtAIN 问卷。目的是创建一个经过修改的版本，以测量社区护理专业人员在社区护理环境中鼓励客户进行功能活动的行为和障碍。总体目标是评估修改后的版本的内容有效性、结构有效性和内部一致性。
数据通过两个阶段的定性和定量方法收集。在第一阶段，社区护士（N=7）评估 MAINtAIN 的适当性和可行性，研究专家（N=9）和社区护理专业人员（N=18）评估改编问卷的内容有效性。在第二阶段，评估社区护理专业人员的改编后的 MAINtAIN-C 的心理测量特性（N=80）。结构有效性通过探索性因素分析（EFA）进行评估，内部一致性通过计算 Cronbach's alpha 系数来确定。
对 MAINtAIN 的表述、动词和措辞进行了调整；删除了一些项目，并添加了相关项目，从而形成了具有两个量表的 MAINtAIN-C，具有良好的内容有效性。行为量表（20 个项目）衡量鼓励功能活动的感知行为，表现出良好的内部一致性（Cronbach's alpha：.92）。障碍量表衡量与两个维度相关的鼓励功能活动的障碍：1）客户的背景（7 个项目），具有良好的内部一致性（.78）；2）专业人员、社会和组织背景（21 个项目），具有良好的内部一致性（.83）。
MAINTAIN-C 似乎有望评估社区护理专业人员在鼓励功能活动方面的行为和障碍。它可用于显示感知行为和实际行为之间的差异，制定消除鼓励活动障碍的策略，以促进行为改变。结果还为在更大样本中进行进一步研究提供了指导，以更深入地了解心理测量特性。
