Psychometric Evaluation of the Making it CLEAR Questionnaire: A Resilience Measure for Older Adults

Psychometric properties of an Arabic translation of the resilience scale for older adults

OBJECTIVES

A significant gap currently exists in the availability of reliable and scientifically rigorous measures for evaluating resilience among older Arabic-speaking populations. The primary objective of this study was to assess the psychometric properties of an Arabic adaptation of the 15-item Resilience Scale of Older Adults (RSOA) in a sample of Arabic-speaking Egyptian older adults.

METHOD

Using a cross-sectional design and a convenience sample of 539 Egyptian older adults, with 60.7% aged between 65 and 75 years (50.3% females), participants completed an online Google form-based anonymous questionnaire, including sociodemographic information, the RSOA, and the 10-item CD-RISC. To ensure accurate translation, the forward-backward translation method was employed. Confirmatory factor analysis (CFA) and gender invariance in the RSOA were analyzed. McDonald's ω and Cronbach's α were calculated to assess internal consistency.

RESULTS

The results demonstrate that the Arabic RSOA and its subscales exhibit high internal consistency, with McDonald's ω and Cronbach's α values ranging from 0.83 to 0.93. CFA analysis revealed that the four-factor model fit of RSOA was acceptable. Measurement invariance was supported across genders. Furthermore, both genders exhibited no significant differences in all four RSOA dimensions. Convergent validity was supported by demonstrating that the four RSOA sub-scores and total scores correlated positively and significantly with the 10-item CD-RISC.

CONCLUSION

While further cross-cultural validation involving other Arab countries and communities is necessary, this study suggests that the Arabic RSOA may be used to measure resilience among broader Arabic-speaking older adults in clinical and research contexts.

Self-efficacy, resilience and healthy ageing among older people who have an acute hospital admission: A cross-sectional study

AIM

To examine the associations between self-efficacy, resilience and healthy ageing among older people who have an acute hospital admission.

DESIGN

A cross-sectional study.

METHODS

Survey and medical record data were collected from older people on discharge from hospital. The survey measured self-efficacy with the 6-item General Self-Efficacy scale (GSE-6), resilience with the Brief Resilience Scale (BRS), and healthy ageing with the Selfie Ageing Index (SAI). Medical record data included potential confounders: co-morbidities, frailty items, previous falls and previous admission in the last 28 days. Multi-linear regression and Spearman's rank correlation coefficient were used to examine the independent associations between self-efficacy, resilience and healthy ageing.

RESULTS

Responses were received from 143 older people (mean age 79). After adjusting for potential confounders, co-morbidities (ß = -0.08, p = 0.001) remained negatively associated with healthy ageing, while self-efficacy (ß = 0.03, p = 0.005) and resilience (ß = 0.05, p < 0.001) remained positively associated with healthy ageing (R2  = 0.243). Positive correlations were found between self-efficacy (ρ = 0.33, p < 0.01), resilience (ρ = 0.38, p < 0.001) and healthy ageing. Positive correlations were also found between self-efficacy and resilience (ρ = 0.38, p < 0.01). Those with lower self-efficacy and resilience were more likely to report reduced activities of daily living, mobility, physical activity and mood.

CONCLUSION

Findings indicate that while the number of co-morbidities have negative consequences for healthy ageing among older people who are hospitalised, the promotion of self-efficacy and resilience can potentially contribute to healthy ageing within the physical and psychological domains.

IMPLICATIONS FOR PATIENT CARE

Nurses can promote self-efficacy, which can potentially increase resilience and help to improve self-management of chronic conditions, functional ability in daily activities, mobility and physical activity and reduce both anxiety and depressive symptoms.

PATIENT CONTRIBUTION

Participant feedback throughout the data collection process assisted in the evaluation of study methods and data interpretation. This included processes such as assessing selected tools and clarifying the meanings of healthy ageing factors.

Tools for measuring individual self-care capability: a scoping review

BACKGROUND

Our ability to self-care can play a crucial role in the prevention, management and rehabilitation of diverse conditions, including chronic non-communicable diseases. Various tools have been developed to support the measurement of self-care capabilities of healthy individuals, those experiencing everyday self-limiting conditions, or one or more multiple long-term conditions. We sought to characterise the various non-mono-disease specific self-care measurement tools for adults as such a review was lacking.

OBJECTIVE

The aim of the review was to identify and characterise the various non-mono-disease specific self-care measurement tools for adults. Secondary objectives were to characterise these tools in terms of their content, structure and psychometric properties.

DESIGN

Scoping review with content assessment.

METHODS

The search was conducted in Embase, PubMed, PsycINFO and CINAHL databases using a variety of MeSH terms and keywords covering 1 January 1950 to 30 November 2022. Inclusion criteria included tools assessing health literacy, capability and/or performance of general health self-care practices and targeting adults. We excluded tools targeting self-care in the context of disease management only or indicated to a specific medical setting or theme. We used the Seven Pillars of Self-Care framework to inform the qualitative content assessment of each tool.

RESULTS

We screened 26,304 reports to identify 38 relevant tools which were described in 42 primary reference studies. Descriptive analysis highlighted a temporal shift in the overall emphasis from rehabilitation-focused to prevention-focused tools. The intended method of administration also transitioned from observe-and-interview style methods to the utilisation of self-reporting tools. Only five tools incorporated questions relevant to the seven pillars of self-care.

CONCLUSIONS

Various tools exist to measure individual self-care capability, but few consider assessing capability against all seven pillars of self-care. There is a need to develop a comprehensive, validated tool and easily accessible tool to measure individual self-care capability including the assessment of a wide range of self-care practices. Such a tool could be used to inform targeted health and social care interventions.

Longitudinal Associations Between Disaster Damage and Falls/Fear of Falling in Older Adults: 9-Year Follow-Up of Survivors of the 2011 Great East Japan Earthquake and Tsunami

Background and Objectives

Fear of falling and falls are common in older adults. However, their associations with natural disaster exposures remain poorly understood. This study aims to examine longitudinal associations between disaster damage with fear of falling/falls among older disaster survivors.

Research Design and Methods

In this natural experiment study, the baseline survey (4,957 valid responses) took place 7 months before the 2011 Great East Japan Earthquake and Tsunami, and 3 follow-ups were conducted in 2013, 2016, and 2020. Exposures were different types of disaster damage and community social capital. Outcomes were fear of falling and falls (including incident and recurrent falls). We used lagged outcomes in logistic models adjusting for covariates and further examined instrumental activities of daily living (IADLs) as a mediator.

Results

The baseline sample had a mean (standard deviation) age of 74.8 (7.1) years; 56.4% were female. Financial hardship was associated with fear of falling (odds ratio (OR), 1.75; 95% confidence interval (CI) [1.33, 2.28]) and falls (OR, 1.29; 95% CI [1.05, 1.58]), especially recurrent falls (OR, 3.53; 95% CI [1.90, 6.57]). Relocation was inversely linked with fear of falling (OR, 0.57; 95% CI [0.34, 0.94]). Social cohesion was protectively associated with fear of falling (OR, 0.82; 95% CI [0.71, 0.95]) and falls (OR, 0.88; 95% CI [0.78, 0.98]) whereas social participation increased the risk of these issues. IADL partially mediated observed associations between disaster damage and fear of falling/falls.

Discussion and Implications

Experiences of material damage rather than psychological trauma were associated with falls and fear of falling, and the increased risk of recurrent falls revealed a process of cumulative disadvantage. Findings could inform targeted strategies for protecting older disaster survivors.