Function-Focused Care: validation of self-effecacy, outcomes expectations and knowledge scales

Abstract

Background: The nursing assistant (NA) plays an important role in maintaining the health and independency of institutionalized older adults (OA) [1]. These professionals are required to help OA to achieve and maintain their highest level of function. The Function-Focused Care (FFC) is a philosophy of care that promotes the restoration and/or maintenance of physical function. In the institutional context it is relevant empowering NA to adopted this philosophy [2]. Objective: This study intends to analyse the perception of NA in relation to the FFC, through scales of self-efficacy, outcomes expectations and knowledge, as well as, the validity and reliability related properties. Methods: Quantitative approach of a descriptive/correlational cross-sectional type. A self-report questionnaire consisting of sociodemographic and professional variables and the scales of self-efficacy, expectations and knowledge were applied. Further details about the scales used can be found in Costa [3]. The validation/reliability procedures for each scale consisted in the calculation of exploratory factor analysis, Cronbach's alpha, and in the intra-class correlation coefficient (ICC) for test/retest purposes. Correlation between the scales themselves, with feelings related to the care of elderly, and sociodemographic and professional variables were tested using the Spearman Rank test. Results: The sample consisted of 73 NA (100% women) with a mean age of 46.4 (± 9.9) years from 5 different institutions. The scale of the self-efficacy showed a three-factor model with the total variance of 73.4%, Cronbach's alpha = 85.2% and ICC = 0.80. The scale of outcomes expectations presented one factor, Cronbach's alpha=95.2% and ICC = 0.97. The scale of Knowledge obtained a percentage of correct answers only of 44.7%. It was not possible to develop predictive models to relate these scales in a pre-intervention situation. Also, the low correlation between the scales and feelings related to the care of OA (difficulty, gratification, physical overload and emotional overload) or sociodemographic and professional variables (age, years of experience, and self-knowledge), indicated a weak dependence between them. Finally, the institution variable showed not to be a confounding variable (that is, does not influence these results). Conclusions: The Portuguese version of the scales analysed showed satisfactory data validity and reliability. These results suggest that the Portuguese version of these scales can be used to evaluate the FFC performed by the NA. These results point to the importance of implementing a FFC program in the institutions and analyse its impact on AO care and on NA.