Feature ArticlePsychometric testing of Korean versions of self-efficacy and outcome expectations for restorative care activities scales
Introduction
In 2003 in Korea, 13,308 elderly people were admitted to 171 aged care facilities; by 2013, this population had increased to 102,747 people across 2497 facilities.1 In the United States, the number of elderly people living in nursing homes was approximately 1,480,000 in 2000, and 1,383,000 in 2012,2 indicating a negligible change in the population of elderly people living in nursing homes over 10 years3; however, it is well known that many elderly people reside in nursing homes in the U.S. These figures reflect an increase in the elderly population living in long-term care facilities due to age-related diseases such as dementia, Parkinson's disease, and stroke, which impede independent daily living in the elderly population.3
Most elderly people who are admitted to long-term care facilities have physical or mental health problems, and are receiving assistance from nurses or direct care (DC) workers for a large part of their daily life.4 Accordingly, following admission to long-term care facilities, these people may experience a functional decline in activities of daily living and increased dependence.5, 6
This deterioration of the admitted elderly's physical function and capacity to perform daily activities affects DC workers. DC workers provide a complete form of care, rather than helping the admitted elderly to move, dress and wash themselves as much as they are able.7 DC workers provide full restricted assistance, or do not encourage the admitted elderly to perform daily activities or participate in physical activities—which can have negative effects, such as loss of ability to perform daily activities or regression.8 In this context, restorative care, which has been termed “Function-Focused Care” (FFC),7 is a philosophy of care that focuses on evaluating older adults' underlying ability and functioning, and helping them spend more time engaging in physical activity and maintaining their functional abilities.9 Examples of providing FFC include walking a resident to the bathroom rather than using a bedpan, and engaging a fully dependent resident in hand-over-hand feeding.10 This may limit the gradual deterioration of physical function, and help the individual to function independently as much as possible in daily life. Also, this type of care ultimately aims to maintain the admitted elderly's dignity and psychological well-being.7
Preceding studies have found that, among DC workers, knowledge of restorative care and self-efficacy are positively correlated with higher outcome expectations, and that self-efficacy is positively correlated with greater job satisfaction.11, 12 Interventions that improve DC workers' self-efficacy and knowledge of restorative care may thus increase DC workers' care outcome expectations and improve results in restorative care.13 It is therefore critical to measure care providers' self-efficacy and outcome expectations before developing and evaluating interventions targeting restorative care.
In this context, the Nursing Assistant Self Efficacy for Restorative Care Scale (NASERC) and the Nursing Assistant Outcome Expectations for Restorative Care Scale (NAOERC) were developed and verified as valid and reliable measures for use among DC workers in the United States.11, 14 For the purpose of applying the NASERC and NAOERC to long-term care facilities in Korea, we evaluated the Korean versions of these scales as valid and reliable tools when used with Korean DC workers. Thus, this study aimed to test the psychometric properties of the Korean version of the NASERC and NAOERC.
Section snippets
Design
This study used a cross-sectional design analyzing questionnaire responses to test the validity, reliability, and item evaluation of the K-NASERC and K-NAOERC, which are Korean versions the NASERC11 and NAOERC.14
Sample
The study was a cross-sectional study on 697 DC workers in 69 facilities. Participants were selected through convenience sampling targeting long-term nursing facilities; participants were located in two cities and eight provinces in Korea. This ensured an adequate variety of originating
Study participants
Study participants' characteristics are presented in Table 1. All participants were women; participants' average age was 54.21 ± 6.48. Participants practicing religions accounted for 79.1% of the sample; Christianity was most common, at 36.4%. Average total working experience was 46.84 ± 34.61 months; average working experience in the current facility was greatest at 32.71 ± 29.06 months. Regarding patient numbers per participant, 45.5% of participants managed ≤10 patients.
Participants' K-NASERC, K-NAOERC, and knowledge scores
Participants'
Discussion
This study determined the validity, reliability, and item evaluation of the K-NASERC and K-NAOERC, which are Korean translations of self-efficacy and outcome expectation scales examining DC workers administering restorative care in elderly nursing facilities. With the increasing number of admitted elderly, self-efficacy in DC workers caring for the admitted elderly is an essential part of nursing.24 This study found that DC workers in elderly nursing facilities scored an average of 82.72 out of
Conclusion
This study's findings show that the K-NASERC and K-NAOERC scales are satisfactorily valid and reliable in measuring restorative care activities among DC workers who have worked in long-term care facilities in South Korea. Additionally, Rasch model analysis of the K-NASERC and K-NAOERC indicates acceptable item data fit. This study therefore provides basic information regarding restorative care in long-term nursing facilities, and indicates that the K-NASERC and K-NAOERC may be used to examine
Acknowledgement
This work was supported by Ewha University Research Grant of 2010 and Basic Science Research Program through the National Research Foundation of Korea (NRF) funded by the Ministry of Science, ICT & Future Planning (No. 2013R1A1A1010718).
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