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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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
• 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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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
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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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
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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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
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
Material and Methods
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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
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.
Material and Methods
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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
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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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
Total (n=560) Community-living
(n = 196)
Under institutional care
(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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Sociodemographics and settings
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
Total (n=560)
Community-living
(n = 196)
Under institutional care
(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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Sociodemographics and settings
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 Results
11
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?
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 Results
12
Under institutional care
(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
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?
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 Results
13
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)
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?
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 Results
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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
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
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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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
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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