Ate Dijkstra

A criterion-related validity study of the nursing-care dependency (NCD) scale

The purpose of this study was to examine some aspects of the criterion-related validity of the Nursing-Care Dependency (NCD) scale. This 15-item counting scale has recently been developed for assessing the care dependency of demented or mentally handicapped in-patients. Its criterion-related validity was investigated by studying the relationship between the Nursing-Care Dependency scale, the Rating Scale for Elderly Patients (RSEP), the Behavior Observation Scale for Intramural Psychogeriatrics (BOSIP) and the Scale for Social Functioning (SSF). Data were collected from 322 demented and 105 mentally handicapped patients using the mentioned instruments. High correlations were found between NCD and RSEP, and NCD and SSF. There was a low relationship between the NCD sumscore and BOSIP subscales-scores. The NCD was able to purposefully distinguish diagnostic groups of demented patients when an external criterion was used.

The Care Dependency Scale for measuring basic human needs: an international comparison

AIM To report a study conducted to compare the utility of the care dependency scale across four countries. BACKGROUND The care dependency scale provides a framework for assessing the needs of institutionalized patients for nursing care. Hendersons components of nursing care have been used to specify the variable aspects of the concept of care dependency and to develop the care dependency scale items. DESIGN The study used a cross-cultural survey design. METHOD Patients were recruited from four different countries: Japan, The Netherlands, Poland and Turkey. In each of the participating countries, basic human needs were assessed by nurses using a translated version of the original Dutch care dependency scale. Psychometric properties in terms of reliability and validity of the care dependency scale have been assessed using Cronbachs alpha, Guttmans lambda-2, inter-item correlation and principal components analysis. Data were collected in 2008 and 2009. RESULTS High internal consistency values were demonstrated. Principal component analysis confirmed the one-factor model reported in earlier studies. CONCLUSION Outcomes confirm Hendersons idea that human needs are fundamental appearing in every patient-nurse relationship, independent of the patients age, the type of care setting and/or cultural background. The psychometric characteristics of the care dependency scale make this instrument very useful for comparative research across countries.

Independence of elderly patients with arterial hypertension in fulfilling their needs, in the aspect of functional assessment and quality of life (QoL)

Functional efficiency is the ability to be independent in fulfilling the basic needs of everyday life. Independence in meeting these needs is important to maintain a good quality of life (QoL). Chronic diseases affecting elderly people may, to some extent, limit fulfilling numerous needs, however, the acquired ability to live with a disease enables such patients to cope well with their needs. The aim of the study was to evaluate in the examined patients the independence in meeting their bio-psycho-social needs in relation to functional efficiency and QoL. The study group was recruited among hospitalized patients in the Department and Clinic of Geriatrics, 91 women and 59 men, for a total of 150 people. The mean age of the study group was 73.4 years. The research was carried out using a diagnostic poll method with the application of The Functional Assessment of Chronic Illness Therapy questionnaire (FACIT-F version 4); Activities of Daily Living questionnaire (ADL) of assessment of daily efficiency on the basis of the Katz Scale; Care Dependency Scale questionnaire (CDS) used to measure the level of the care dependency and human needs. The results of CDS for the study group were running at high level and were dependent on the marital status and age. No impact of gender, place of residence, education, material situation and disease duration was revealed. Similarly, FACIT-F scores were higher for married patients than for widowed ones, and they were age-dependent. Most of CDS scores were at a high level, which means that the investigated patients were, to a limited extent, care-dependent in meeting their needs. In the majority of subjects, the level of daily activities was high, which proves an independent functioning. Results of CDS were dependent on FACIT-F scores in the study group.

Predictors of care dependency in Alzheimer's disease after a two-year period.

This paper presents the results from a panel study in the Netherlands of 68 female in-patients with Alzheimers disease. The main focus of this study was to investigate longitudinal changes and differences in care dependency. Descriptive statistics indicated an increase in almost all 15 features of dependency in a two-year period. A stepwise regression procedure revealed that the loss of social relationships, the loss of the ability to communicate, and the degree of care dependency at entry to the study were the strongest predictors of the follow-up ratings. The pattern of findings reveals that the Care Dependency Scale is sensitive to care dependency increase after a two-year period, and that the scale has utility in establishing longitudinal patterns of care dependency.

Care Dependency Scale - psychometric testing of the Polish version

The importance of this study lies in the availability of psychometrically sound assessment instruments, which are of critical importance for the study of patients care dependency and the provision of care to these patients. The aim of this study was to identify the psychometric properties of the Care Dependency Scale (CDS) by analyzing data gathered in Poland. The Polish research instrument was a translation of the original Dutch CDS. Psychometric evaluations were carried out based on a convenience sample of 216 older patients. A high alpha coefficient of 0.98 was obtained. Subsequent inter-rater and test-retest reliability revealed Kappa values between 0.82-0.97 and 0.64-0.86, respectively. Factor analysis (principal component analysis) confirmed the one-factor model reported in earlier studies. The analysis of the scale showed that the instrument is promising to be used in elderly care in Poland. The Polish version of the CDS permits comparison with results from earlier studies using this instrument.

Pflegeabhängigkeit im Pflegeheim--eine psychometrische Studie

Zusammenfassung. Ein niederländisches Instrument zur Erfassung der Pflegeabhängigkeit wurde ins Deutsche übersetzt und hinsichtlich verschiedener Gütekriterien überprüft. Es wurden gute Ergebnisse erzielt für die Reliabilität und Validität. Die Skala kann für die Anwendung im Altenheim empfohlen werden. Zukünftige weitere methodologische Prüfungen werden empfohlen.Summary.The Dutch Care Dependency Scale, an instrument for the assessment of a patient’s care dependency, has been translated into German. The purpose of this study was to examine the reliability and validity of the German version of the scale. The 15-item scale has been developed for the use in nursing homes. Data were collected from 81 people living in nursing homes in Berlin, Germany. The sample was measured three times. Cronbach’s alpha was 0.94. Interrater and intrarater reliability revealed moderate to substantial Kappa statistics. As the results of this study were satisfying, positive recommendations regarding the suitability of the German version of the Care Dependency Scale for use in nursing homes could be made. However, further psychometric testing of the scale is recommended.

Psychometric properties of the extended Care Dependency Scale for older persons in Egypt

AIM The aim of this study was to determine the validity and reliability of the modified Arabic Care Dependency Scale for self-assessment of older persons in Egypt and to compare these self-assessments to proxy assessments by care givers and family members. BACKGROUND The Care Dependency Scale is an internationally used instrument to measure care dependency. The Arabic version may improve data collection on this phenomenon in the Middle East where the population is ageing. DESIGN A cross-sectional study with a sample of 611 older persons living in Greater Cairo. Participants belonged to three groups: nursing home residents, home care recipients and non-care recipients; 459 participants were also rated by proxies and 171 repeated their self-assessment after two weeks. METHODS The correlation between sum scores of the Care Dependency Scale and the Activities of Daily Living scale was calculated to establish criterion validity. Construct validity was determined by comparing care recipients and non-care recipients with regard to their Care Dependency Scale sum scores and by exploratory factor analysis. Intraclass coefficients were used to assess test-retest reliability of self-ratings for each item. Mean differences between self and proxy assessment were calculated. RESULTS The Care Dependency Scale had a strong correlation to the Activities of Daily Living scale and is able to distinguish between care recipients and non-care recipients. Factor analysis revealed one factor for basic needs and one factor for psychosocial needs. ICC values were >0.7 for most items related to the factor for basic needs among care recipients. Proxy assessment yielded higher care dependency than self assessment. CONCLUSION Care Dependency Scale items for basic needs are suitable to assess care dependency among Egyptian care recipients. RELEVANCE TO CLINICAL PRACTICE Assessment of care dependency is useful to obtain data for appropriate resource allocation among care recipients.

Care dependency in nursing home : a psychometric study

Zusammenfassung. Ein niederländisches Instrument zur Erfassung der Pflegeabhängigkeit wurde ins Deutsche übersetzt und hinsichtlich verschiedener Gütekriterien überprüft. Es wurden gute Ergebnisse erzielt für die Reliabilität und Validität. Die Skala kann für die Anwendung im Altenheim empfohlen werden. Zukünftige weitere methodologische Prüfungen werden empfohlen.Summary.The Dutch Care Dependency Scale, an instrument for the assessment of a patient’s care dependency, has been translated into German. The purpose of this study was to examine the reliability and validity of the German version of the scale. The 15-item scale has been developed for the use in nursing homes. Data were collected from 81 people living in nursing homes in Berlin, Germany. The sample was measured three times. Cronbach’s alpha was 0.94. Interrater and intrarater reliability revealed moderate to substantial Kappa statistics. As the results of this study were satisfying, positive recommendations regarding the suitability of the German version of the Care Dependency Scale for use in nursing homes could be made. However, further psychometric testing of the scale is recommended.

Health and nursing problems of elderly patients related to bio-psycho-social need deficiencies and functional assessment

Elderly population is characterized by larger need for social welfare and medical treatment than other age groups. Along with aging, there is a number of emerging health, nursing, caring, psychological and social problems. Complexity of these problems results from overlapping and advancing involutional changes, multi-illness, decreased functional efficiency and other factors. The aim of the study was the assessment of health problems in geriatric patients as well as bio-psycho-social need deficiencies in a view of selected parameters of functional efficiency. The research group consisted of the Chair and Clinic of Geriatrics, 186 women and 114 men, 300 persons in total. The research was carried out using a diagnostic poll method with the application of the Activities of Daily Living (ADL) questionnaire of assessment of daily efficiency on the basis of the Katz Scale; the Care Dependency Scale (CDS) questionnaire used to measure the level of the care dependency and human needs, Nortons bed sores risk assessment scale, the Nursing Care Category (NCC) questionnaire applied to assess the need for nursing care. In most patients the results unveiled manifestations of three or more illnesses. Functional efficiency was at low and average level. Half of the subjects were endangered by risk of bed sores as well as showed high need fulfillment deficiency. The highest level of the deficiency was observed in patients in the eldest age group as well as suffering from multi-illness. Material status, education, place of residence or gender showed no significant influence on the level of need fulfillment.

Cultural Adequecy of the Care Dependency Scale for Older Persons in Egypt: A Delphi Study

Purpose: The aim of this study is to determine the cultural adequateness of the Arabic version of the Care Dependency Scale (CDS), an internationally used instrument to measure care needs by either self-reports or external assessment. Method: A Delphi study in two rounds about the Arabic version was performed with 37 panelists in Cairo. Acceptance of CDS items was rated on a 4-point Likert-type scale. Results: Agreement among panelists in the second round was found for 11 CDS items, but 2 items had decreased acceptance after rephrasing and 2 were rejected. Discussion: Rejected items seem to reflect a heterogeneous perception in the target population. Despite some limitations, the CDS is a promising instrument to detect care needs among older Egyptians.