老年护理评估实践（G-CAP）调查的制定和测试。
Development and testing of the Geriatric Care Assessment Practices (G-CAP) survey.
机构信息
School of Public Health and Health Systems, University of Waterloo, 200 University Avenue West, Waterloo, ON, N2L 3G1, Canada.
SE Research Centre, SE Health, 90 Allstate Parkway, Suite 300, Markham, ON, L3R 6H3, Canada.
出版信息
BMC Geriatr. 2021 Apr 1;21(1):220. doi: 10.1186/s12877-021-02073-5.
BACKGROUND
While the Resident Assessment Instrument-Home Care (RAI-HC) tool was designed to support comprehensive geriatric assessment in home care, it is more often used for service allocation and little is known about how point-of-care providers collect the information they need to plan and provide care. The purpose of this pilot study was to develop and test a survey to explore the geriatric care assessment practices of nurses, occupational therapists (OTs) and physiotherapists (PTs) in home care.
METHODS
Literature review and expert consultation informed the development of the Geriatric Care Assessment Practices (G-CAP) survey-a 33 question, online, self-report tool exploring assessment and information-sharing methods, attitudes, knowledge, experience and demographic information. The survey was pilot tested at a single home care agency in Ontario, Canada (N = 27). Test-retest reliability (N = 20) and construct validity were explored.
RESULTS
The subscales of the G-CAP survey showed fair to good test-retest reliability within a population of interdisciplinary home care providers [ICC2 (A,1) (M ICC = 0.58) for continuous items; weighted kappa (M kappa = 0.63) for categorical items]. Statistically significant differences between OT, PT and nurse responses [M t = 3.0; M p = 0.01] and moderate correlations between predicted related items [M r = |0.39|] provide preliminary support for our hypotheses around survey construct validity in this population. Pilot participants indicated that they use their clinical judgment far more often than standardized assessment tools. Client input was indicated to be the most important source of information for goal-setting. Most pilot participants had heard of the RAI-HC; however, few used it. Pilot participants agreed they could use assessment information from others but also said they must conduct their own assessments and only sometimes share and rarely receive information from other providers.
CONCLUSIONS
The G-CAP survey shows promise as a measure of the geriatric care assessment practices of interdisciplinary home care providers. Findings from the survey have the potential to inform improvements to integrated care planning. Next steps include making adaptations to the G-CAP survey to further improve the reliability and validity of the tool and a broad administration of the survey in Ontario home care.
背景
虽然居民评估工具-家庭护理（RAI-HC）工具旨在支持家庭护理中的综合老年评估，但它更常用于服务分配，而对于护理人员如何收集他们规划和提供护理所需的信息知之甚少。本研究旨在开发和测试一项调查，以探索家庭护理护士、职业治疗师（OT）和物理治疗师（PT）的老年护理评估实践。
方法
文献回顾和专家咨询为老年护理评估实践（G-CAP）调查的制定提供了信息，这是一个 33 个问题的在线自我报告工具，用于探索评估和信息共享方法、态度、知识、经验和人口统计学信息。该调查在加拿大安大略省的一家家庭护理机构进行了试点测试（N=27）。探索了重测信度（N=20）和构念效度。
结果
在跨学科家庭护理提供者人群中，G-CAP 调查的分量表显示出良好的重测信度[连续项目的 ICC2（A，1）（M ICC=0.58）；分类项目的加权kappa（M kappa=0.63）]。OT、PT 和护士的反应之间存在统计学显著差异[M t=3.0；M p=0.01]，预测相关项目之间存在中度相关性[M r=|0.39|]，这初步支持了我们在该人群中调查构念效度的假设。试点参与者表示，他们更经常使用临床判断，而不是标准化评估工具。目标设定的最重要信息来源是客户的投入。大多数试点参与者听说过 RAI-HC；然而，很少有人使用它。试点参与者同意他们可以使用他人的评估信息，但也表示他们必须进行自己的评估，并且只是偶尔共享信息，很少从其他提供者那里接收信息。
结论
G-CAP 调查作为衡量跨学科家庭护理提供者老年护理评估实践的一种手段具有一定的前景。调查结果有可能为改进综合护理计划提供信息。下一步包括对 G-CAP 调查进行调整，以进一步提高工具的可靠性和有效性，并在安大略省家庭护理中广泛进行调查。
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