The University of Iowa, College of Nursing, 432 CNB, 50 Newton Road, Iowa City, IA 52242, USA.
The University of Iowa, College of Nursing, 432 CNB, 50 Newton Road, Iowa City, IA 52242, USA.
Int J Nurs Stud. 2021 Feb;114:103824. doi: 10.1016/j.ijnurstu.2020.103824. Epub 2020 Nov 12.
Using valid instruments to assess caregiving knowledge, attitudes, skills, and behaviors in mealtime care for people living with dementia is critical to evaluate the process and effects of mealtime assistance interventions. Yet, the quantity and psychometric quality of such instruments are unknown.
This systematic review described and evaluated psychometric properties of instruments that were developed and used to assess mealtime caregiving knowledge, attitudes, skills, and behaviors for people with dementia.
We searched Pubmed, CINAHL, AgeLine, PsychINFO, and Cochrane Library for records published between January 1st, 1980 and June 31st, 2019, with follow-up searches by December 20th, 2019. Records were eligible if they included any instrument developed, tested, and/or used to measure the concepts of interest, including mealtime caregiving knowledge, attitudes, skills, and/or behaviors. After eligible records were identified, instruments that were reported in the eligible records were identified and extracted. Instruments were eligible if they were originally developed to measure the concepts of interest or developed in non-mealtime activities and later used or tested to measure the concepts of interest. From eligible records, eight characteristics of eligible instruments were extracted: (1) development process, (2) the concept/construct the instrument operationalizes, (3) sample and setting the instrument was used/tested in, (4) administration method, (5) description of items, (6) scoring format/interpretation, (7) reliability, and (8) validity. The psychometric quality of eligible instruments was evaluated using a newly developed psychometric quality assessment tool.
A total of 9438 records were retrieved and 19 eligible instruments were identified. Ten instruments assessed mealtime caregiving skills or behaviors; 5 assessed attitudes, intention, self-efficacy, empathy; and 4 assessed knowledge. All instruments were scored as having low psychometric quality, except for Mealtime Engagement Scale with moderate psychometric quality in assessing mealtime engagement toward people with dementia. Reasons for low psychometric quality included limited psychometric testing, inadequate estimates of psychometric properties, and use of small sample size.
While all instruments warrant further testing, Mealtime Engagement Scale demonstrated moderate psychometric quality with preliminary evidence of reliability and validity to assess mealtime engagement toward people with dementia. Future testing of Mealtime Engagement Scale is needed in larger diverse samples in different care settings to accumulate psychometric evidence and expand the use.
使用有效的工具来评估在为痴呆症患者提供饮食时的照顾知识、态度、技能和行为，对于评估饮食辅助干预的过程和效果至关重要。然而，目前尚不清楚此类工具的数量和心理测量学质量。
本系统综述描述和评估了为评估痴呆症患者的饮食照顾知识、态度、技能和行为而开发和使用的工具的心理测量学特性。
我们在 Pubmed、CINAHL、AgeLine、PsychINFO 和 Cochrane Library 中检索了 1980 年 1 月 1 日至 2019 年 6 月 31 日期间发表的记录，并于 2019 年 12 月 20 日进行了随访检索。如果记录包括任何用于测量感兴趣概念（包括饮食照顾知识、态度、技能和/或行为）的工具的开发、测试和/或使用，则记录即为合格。在确定了合格记录后，确定并提取了报告在合格记录中的工具。如果工具最初是为测量感兴趣的概念而开发的，或者是在非饮食活动中开发的，后来用于或测试用于测量感兴趣的概念，则该工具即为合格。从合格记录中提取了合格工具的八个特征：（1）开发过程，（2）工具操作的概念/结构，（3）工具在研究中使用/测试的样本和设置，（4）管理方法，（5）项目描述，（6）评分格式/解释，（7）可靠性，和（8）有效性。使用新开发的心理测量质量评估工具评估了合格工具的心理测量质量。
共检索到 9438 条记录，确定了 19 个合格工具。10 个工具评估了饮食照顾技能或行为；5 个工具评估了态度、意图、自我效能、同理心；4 个工具评估了知识。所有工具的心理测量质量评分均较低，只有评估痴呆症患者饮食参与度的“饮食参与量表”具有中度心理测量质量。心理测量质量低的原因包括有限的心理测量测试、心理测量特性的估计不足以及使用小样本量。
虽然所有工具都需要进一步测试，但“饮食参与量表”在评估痴呆症患者的饮食参与度方面表现出中度心理测量质量，初步证明了可靠性和有效性。需要在不同的护理环境中，使用更大的、多样化的样本对“饮食参与量表”进行进一步的测试，以积累心理测量学证据并扩大其使用。
