社区老年人养老服务需求测量工具的开发及信效度测量介绍

摘要

目的 介绍一种由社区卫生服务中心开发的、用于测量社区内老年人养老服务需求的工具,为我国老年人养老服务需求的合理评估提供参考.方法 在前期老年人养老服务需求的测量维度确认的基础上,通过文献循证及专家咨询对各维度下测量条目及其选项进行构建,并通过专家咨询和横断面调查,评价该测量工具的信度和效度.结果 该测量工具涵盖躯体健康状况、心理健康状况、社会健康状况、养老意愿4个方面,由11个维度构成,用于评估区域内老年人养老服务需求.信度评价结果显示,社区老年人躯体健康状况、心理健康状况内各测量维度具有相关性(P＜0.01),提示信度良好.效度评价结果显示,老年人养老服务需求各测量维度评估事项、评估办法、分级办法的适用性评分均值均在2分以下,且生活自理能力、视力、老年人自我意愿/信息的表达能力、老年人对他人表达的意愿/信息的理解能力、家属照护提供能力等的评估办法得到50％以上专家支持,反映表面效度和内容效度佳.马陆镇辖区老年人当前所在的养老场所与使用本工具测得的养老服务需求总分具有相关性(r=0.214,P＜0.01),且评估健康状况的各测量维度中,除了焦虑情况外,其他各维度与老年人的养老场所均有相关性(P＜0.05),提示效标效度尚可.老年人自我养老意愿、家属养老意愿与当前所在养老场所的一致性均较差(Kappa=0.063,P=0.007;Kappa=0.051,P=0.006).结论 本次所研制的养老服务需求测量工具的总体性能尚可,得到供方及评估方的认可,对需方的测量结果也显示具有良好的的内部一致性,以及与实际养老情况的一致性.%Objective To develop a measuring tool for the elderly care service needs in the community.Methods Based on the literature search and Delphi expert consultation,a measuring tool for elderly care service needs was developed.The reliability (internal consistency coefficient) and validity (surface validity,content validity,criterion-related validity) of the developed measurement tool were evaluated with on-site expert consultation and the cross-sectional survey.Results A 11-dimension measurement tool was developed,which covered physical health,mental health and desires for old-age support assessment.The reliability evaluation showed that there was significant correlation (P＜0.05) among the measurement dimensions of the physical health and the mental health of the elderly in community.The validity evaluation showed that the measurement methods for the measurement dimensions of the elderly care needs,including the evaluation items,evaluation methods,and rating methods,all got below 2 scores in applicability assessment,and the measurement methods of the self-care ability,vision,the self-willingness/information expression of the elderly,the ability of the elderly to understand the willingness/information expressed by others,and the ability to provide family care were all supported by more than 50％ experts,which indicated that the surface validity and content validity were good.There was a significant positive correlation between the living places of the elderly and the needsof elderly care services (r=0.214,P＜0.01),and there were significant correlations between all measurement dimensions with the living place except anxiety (P＜0.05),which indicated that the measurement tool had an acceptable criterion-related validity.The consistency of self-supporting willingness,the family willingness to care for the elderly with the current old-age care place were relatively poor (Kappa=0.063,P=0.007;Kappa=0.051,P=0.006).Conclusion The overall performance of the measurement tool for the elderly care service needs developed in this study is acceptable.It has been approved by both the elderly care service suppliers and the elderly care service needs evaluators.It also shows some internal consistency in measurement results of the demanders,and is consistent with the actual living place.