PSYCHOMETRIC EVALUATION OF THE EASYCARE … · Psychometric evaluation of the EASYcare Standard...

PSYCHOMETRIC EVALUATION OF THE EASYCARE

STANDARD 2010 IN A PORTUGUESE POPULATION

MARIA PIEDADE BRANDÃO, School of Health Sciences, University of

Aveiro, Portugal

LILIANA XAVIER SOUSA, Department of Health Sciences, University of

Aveiro, Portugal; UNIFAI (RU)

International Istanbul Initiative on

Ageing -Istanbul, Turkey, October 4-6, 2013

Psychometric evaluation of the EASYcare Standard 2010 in a Portuguese population Maria Piedade Brandão

Liliana Xavier Sousa

Background Objective Material and Methods Results Discussion References

• The increase in life expectancy observed in Western societies, has resulted in a steep rise of older population.

• In Europe in 1971, older people represented 15% of the total population, 20% in 2000, and it is expected to reach as much as 35% by 2050 (Christensen et al., 2009)

• In Portugal, this prevalence ranged from 8% in 1960 to 17% in 2007 and projections to the year 2050 suggest an increase to 32% (INE, 2003; INE, 2008).

• As the individuals live longer, the quality of longer life becomes a central issue for both personal and social well being.

Background

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• There is growing interest in assessing the needs of the older people, especially in the context of community health care and social work (Powell, J 2007).

• Thus, the literature recommends the use of simple individual evaluations, comprehensive and multidimensional in order to facilitate individualized responses (Fletcher, A. 2004).

• The EASYcare (Elderly Assessement System) is an assessment instrument for older people, which seeks to answer these circumstances (Kane R. et al, 1998 ; Sousa L. & Figueiredo D., 2003).

• The main characteristic of the EASYcare methodology is the approach centered on older people’s own perception and simple language.

Background

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Objective

This study aims at examine the psychometric properties of the three EASYcare Standard 2010 subscales: Independence , Risk of Falls and Risk of Breakdown of Care

Objective

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Instrument

Instrument: EASYcare 2010 (Elderly Assessment System), Portuguese version.

EASYcare is an instrument for assessment, extended worldwide (Philp I. 2000; Philp et al. 1998; Philp et al. 2001), used to identify older people’s perceptions in relation to their health and care needs, capturing competence and not performance.

Material and Methods

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Participants

• Sample: 560 participants ≥ 65 years old; scoring below maximum on the

Mini Mental State Examination (MMSE) • Interviews were administered by master students (Master in Gerontology,

University of Aveiro), coordinated by the second author, between October 2009 and December 2010


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Statistical analysis

• Descriptive statistics were calculated for all the variables in the study.

• Analyses were conducted between the above participant residence division and three subscales included in EASYcare standard 2010 (independency, risk of breakdown in care, and risk of falls) .

• Chi-square tests were performed for categorical data and internal consistency was assessed for all the items through Cronbach’s alpha coefficient α (Statistical Package for the Social Sciences 19.0).

• To evaluate construct validity, the items from the three subscales were analyzed through an exploratory factor analysis

• P-value < 0.05 was considered statistically significant.


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Mean age was 77.8 ± 7.1 years

Sociodemographics and settings

Total (n=560) Community-living

(n = 196)

Under institutional care

(n = 364) p

Age

Mean (SD)

77.8 (7.1)

Mean (SD)

77.0 (6.7)

Mean (SD)

78.3 (7.3)

0.08

n (%) n (%)

n (%)

Gender

Male 237 (42.3) 65 (33.2) 172 (47.3) <0.01

Female 323 (57.7) 131 (66.8) 192 (52.7)

Results

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Total (n=560) Community-living

(n = 196)


(n = 364)

p

Residence area n (%) n (%) n (%)

Urban 307 (54.8) 131 (66.8) 176 (48.4) <0.001

Rural 253 (45.2) 65 (33.2) 188 (51.6)

Education level

No formal education 115 (20.5) 18 (9.2) 97 (26.6) <0.001

Formal education 445 (79.5) 178 (90.8) 267 (73.4)

Results

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Total (n=560)

Community-living

(n = 196)


(n = 364)

p

Marital Status n (%) n (%) n (%)

Single 32 (5.7) 10 (5.1) 22 (6.0) 0.91

Married 258 (46.1) 94 (48.0) 164 (45.1)

Divorced/Separated 21 (3.8) 7 (3.6) 14 (3.8)

Widow/Widower 249 (44.5) 85 (43.4) 164 (45.1)

Results

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Background Objective Material and Methods Results Discussion References Results

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Community-living (n=196)

Mean

Score(SD) Kurtosis Skewness

Internal

consistency

(Cronbach’s

alpha)

Independency

(18 items)

11.2 (16.1)

6.9 2.4

0.90

Risk of breakdown

in care

(12 items)

4.6 (2.2) 0.4 0.2

0.63

Risk of

falls

(8 items)

1.2 (1.3)

1.7

3.80 0.41

Psychometric properties of three subscales includes in the EASYcare Standard 2010

The scale Risk of breakdown in care was compromised by a lack of responses to question 7.2: In

general, would you say your health is excellent, very good, good or poor?




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(n = 364)

Mean

Score(SD) Kurtosis Skewness

Internal

consistency

(Cronbach’s

alpha)

Independency

(18 items)

33.5 (27.0) 6.9 2.4

0.94

Risk of breakdown

in care

(12 items)

5.1 (2.2) 0.4 0.2 0.75

Risk of

falls

(8 items)

2.9 (1.9) -1.0 -0.0 0.54

Psychometric properties of three subscales includes in the EASYcare Standard 2010






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Scores by settings

Homes for

the aged

Home help

service

Day care

center

Pain unit of

hospital

Continuity

of care unit

Internal

medicine

service of

hospitals

Senior

universities

Primary care

services

n (%)

Total (n=560) 41 (7.3) 15 (2.7) 13 (2.3) 33 (5.9) 25 (4.5) 250 (44.6) 70 (12.5) 113 (20.2)

mean (sd)

Independency

(18 items) 31.5 (19.1) 31.3 (29.0) 17.1 (18.4) 24.9 (25.6) 59.8 (28.2) 32.5 (26.8) 3.7 (6.0) 15.1 (18.4)

Risk of breakdown

in care (12 items)

5.4 (2.2)

(N=30)

6.0 (1.9)

(N=9)

4.0

(N=1) 6.2 (2.7) 6.9 (2.1) 4.8 (2.9)

3.8 (1.9)

(N=69)

5.1 (2.2)

(N=110)

Risk of falls

(8 items) 3.2 (1.9) 2.9 (1.9) 1.3 (1.7) 3.6 (2.0) 3.9 (1.4) 2.7 (1.9) 0.7 (0.9) 1.5 (1.3)






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The Cronbach’s alpha according to the setting

In Day care center was not possible evaluated the Cronbach’s alpha (n=1)

0

0.1

0.2

0.3

0.4

0.5

0.6

0.7

0.8

0.9

1

Homes forthe aged

Home helpservice

Day carecenter

Pain unit ofhospital

Hospitalcontinuity of

care unit

Hospitalinternal

medicine

unit

Senioruniversity

Healthprimary

care

Breakdown

Falls

Independence

Desirable

range of

0.7–0.95




Main findings

• The Portuguese version of EASYcare Standard 2010 was found to have very satisfied psychometric properties through the Independency scale for community-living and institutionalized individuals;

• To have satisfied psychometric properties through the Risk of breakdown in care scale could be suitable for assessing self-perceptions about level of dependency and the risk of falls.

• The Risk of falls scale needs to be revised.

Discussion

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References

Christensen K., Doblhammer G., Rau R. and Vaupel J.W., Ageing populations: the challenges ahead, Lancet 374 (2009), pp. 1196–1208

INE (Instituto Nacional de Estatística), Estatísticas Demográficas 2007 [Demographic Statistics 2007] (Portugal), INE, Lisbon, Portugal (2008).

INE (Instituto Nacional de Estatística), Resident Population Projections 2000–2050 (Portugal), INE, Lisbon, Portugal (2003).

Powell, J.; Robison, J.; Roberts, H. & Thomas, G. (2007). The single assessment process in primary care: older people’s accounts of the process. British Journal of Social Work, 37(6): 1043-1058.

Sousa, L. & Figueiredo, D. (2003). (In)dependência na população idosa – um estudo exploratório na população portuguesa. Psychologica, 33, 109-122.

Terwee CB, Bot SD, de Boer MR, van der Windt DA, Knol DL, 2. Dekker J, et al. Quality

criteria were proposed for measurement properties of health status questionnaires. J Clin Epidemiol 2007; 60: 34–42

References

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Many thanks for your attention!

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