Development and psychometric properties of ECPICID-AVC to measure informal caregivers’ skills when caring for older stroke survivors at home

Distance interventions for enhancing preparedness in informal caregivers of older adults: A systematic review protocol

INTRODUCTION

Informal caregivers provide care to older adults but report lack of preparedness to enact the role. Intervention programs delivered by distance offer one alternative to support preparedness. Three review studies conducted to date have highlighted the benefits of distance interventions for enhancing preparedness among informal caregivers of older adults. However, these reviews have been limited in presenting and discussing how intervention components influenced outcomes. Additionally, they have not compared different distance delivery approaches for informal caregivers of older adults or assessed their varying impact on preparedness outcomes. These limitations make the effectiveness of diverse distance approaches unclear.

AIM

To evaluate the effects of distance interventions aimed at enhancing preparedness among informal caregivers of older adults.

METHODS

This protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) guidelines and is guided by the Cochrane Handbook for Systematic Reviews of Interventions. It has been registered in PROSPERO (CRD42023400668). Databases used in the search will include CINAHL, Cochrane Library, EMBASE, MEDLINE, PsycINFO, Scopus, and ProQuest Theses and Dissertations Global. The search will not be restricted by publication year to include all relevant studies. Studies published in English and Portuguese will be included. Study quality will be assessed using Downs and Black's checklist. If metanalysis is possible, it will be performed using the ReviewManager (RevMan) software.

CONCLUSIONS

The study will be the first of its type to systematically review and synthesize components and approaches of distance interventions aimed at supporting preparedness of informal caregivers of older adults.

The meaning of preparedness for informal caregivers of older adults: A concept analysis

AIM

To examine the concept of preparedness over time in research with informal caregivers of older adults.

DESIGN

Concept analysis.

METHODS

Rodgers' evolutionary method of concept analysis was used to guide this theoretical paper due to the dynamic nature of preparedness, which is influenced by both context and time. Using Rodgers' inductive approach, concept elements were derived from a content analysis of included studies. In the final step, to generate hypotheses and implications regarding the concept, the conceptual structure of preparedness of informal caregivers of older adults was connected to a theoretical problem in the nursing discipline using the Caregiving Stress Process Framework.

DATA SOURCES

Four databases (EBSCO CINAHL, Ovid MEDLINE, Ovid PsycINFO and Scopus) were searched in November 2022 and updated in September 2023. No date limits were set for searching, as the intent was to analyse possible variations of the concept over time.

RESULTS

The attributes of preparedness include self-confidence, having knowledge, skills and abilities to perform daily tasks, handling emotions and developed over time. These attributes can be compared with the stressors outlined in the Caregiving Stress Process Framework (i.e., the moment the caregiver identifies some 'stressor'; something that prevents them from feeling confident in their preparedness).

CONCLUSION

The concept of preparedness of informal caregivers of older adults is defined as caregiver's self-confidence about their current competence related to the knowledge, skills and abilities to perform daily tasks, and to handle emotions over time. To link the concept to a theoretical perspective, we propose adaptations to a well-known theory, the Caregiving Stress Process Framework. Future research on caregiving preparedness needs to avoid circular definitions and work with the attributes of preparedness to support caregivers.

IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE

This paper contributes to the development of interventions that focus on the health and preparedness of informal caregivers of older adults. Clarifying the concept of preparedness helps nurses to support caregivers since it is then known which aspects are included in the preparedness of caregivers (e.g., daily tasks and handling emotions). A more fulsome understanding of preparedness supports us to see beyond stressors of caregiving.

IMPACT

This study addresses informal caregivers of older adults' preparedness to provide care. We synthesized existing definitions that have been used in research with this population to propose a robust conceptualization of the concept of preparedness, which contributes to better understanding of how preparedness can be supported.

REPORTING METHOD

We were unable to locate a reporting method related to this kind of work (concept analysis).

PATIENT OR PUBLIC CONTRIBUTION

Not applicable as no new data generated.

Validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department (NSCAIP-ED) instrument

Aim To report the development and validation of the Nurses' Skills to Care for Alcohol-Intoxicated Patients in Emergency Department instrument, shortened NSCAIP-ED. Methods: A mixed-methods design was used to develop the instrument. It was used to conduct a survey where ED nurses self-evaluated their skills to care for acutely ill alcohol-intoxicated patients (N = 1220, n = 252). The data were utilised to perform instrument validation using confirmatory factor analysis (CFA) and Cronbach's alpha. Results: The construct validity was tested statistically. The CFA model fit indicators showed mostly acceptable fit (chi-square test p < 0.001; RMSEA 0.079; CFI 0.923; TLI 0.918; SRMR 0.084) and instruments' scales had well acceptable Cronbach's alpha values (all alphas were in the range of 0.866-0.912). Conclusions: The NSCAIP-ED is a feasible and reliable instrument that can be used when measuring nurses' skills to care for alcohol-intoxicated patients in the ED. This instrument could be useful for nursing managers in EDs for evaluating their nursing staff's skills in the care area in question, but also for designing continuing education based on the results.

Adaptation and Validation of the Capacity Scale for Informal Caregivers of Elderly Stroke Patients to be Used in Brazil

BACKGROUND AND PURPOSE

The Portuguese instrument for informal caregivers' skills providing care of aged people after a stroke (ECPICID-AVC) evaluates the capacities that informal caregivers must have for supporting aged stroke survivors. The purpose was to adapt and validate the ECPICID-AVC to be used in Brazil.

METHODS

A methodological study was conducted.

RESULTS

The terms with the lowest degree of comprehension were adapted. The factor analysis suggested the exclusion of three items and that the remaining be grouped into six domains. The factor loadings varied from 0.525 to 0.924. The internal intra-assessor consistency was satisfactory (ICC = 0.94, CI 95%). Total reliability was considered excellent (Cronbach's alpha = 0.914).

CONCLUSIONS

The ECPICID-AVC is considered appropriate for using in Brazil.

Relationship between elderly stroke patient caregivers scale and nursing diagnoses

ABSTRACT Objective: To describe relationships between the ECPICID-AVC scale factors and the NANDA-I domains, classes, and Nursing Diagnoses (NDs). Method: Cross-mapping study between the NANDA-I taxonomy and ECPICID-AVC scale was constructed based on the eight ECPICID-AVC scale factors and the 13 NANDA-I domains. A descriptive analysis was performed to present the mapped elements. Results: Areas of similarity and intersection were found between the eight ECPICID-AVC factors and nine NANDA-I domains, 19 classes, and 72 NDs. All scale factors were mapped with the Domain 1/Health Promotion, Class 2/Health Management and the ND “Frail elderly syndrome”. Final considerations: The ECPICID-AVC scale factors were mapped with nine domains, their classes and diagnoses. This study demonstrates the importance of identifying nursing diagnoses and their relationship with factors that evaluate caregiving capacity. The ECPICID-AVC can help nurses generate nursing diagnoses regarding the caregiver’s needs and their capacities related to care to focus such needs.

Application of meta-summary to derive a measurement instrument from the literature: a method exemplar

BACKGROUND

Measurement tools are a common method to collect data in observational and survey research. Nurse researchers have developed numerous scales and instruments, many derived from published literature. However, few studies report systematic or replicable approaches to analysing the literature from which measures were derived. This is a significant challenge to construct validity.

AIM

To provide a method exemplar of meta-summary and categorical factor analysis to refine scale items and establish construct definition.

DISCUSSION

A rigorous method for deriving items from the literature is largely absent from nursing literature. This exemplar addresses the often-cited limitation of scales that authors rarely assure content validity before experts assess their newly derived scales.

CONCLUSION

Without sufficient methodological rigour, practitioners and researchers must speculate about the content validity of newly derived instruments. Meta-summary provides a useful approach to developing scales from the literature.

IMPLICATIONS FOR PRACTICE

The method detailed here is of use when deriving measurement instruments from the literature. It provides a systematic and replicable strategy that assures construct validity.

Identification of resources and skills developed by partners of patients with advanced colon cancer: a qualitative study

PURPOSE

Family caregivers play an important role in caring for patients with advanced cancer. To become competent, individuals must draw on and mobilise an adequate combination of resources. Our goal was to identify the skills developed by caregivers of patients with advanced cancer and the associated resources mobilised. We chose to do it with partners of patients with colon cancer.

METHODS

The study used a cross-sectional qualitative design based on 20 individual interviews and a focus group. Partners were recruited from patients treated in three hospitals of France. Semi-structured interviews were conducted until data saturation was achieved. Each interview was transcribed verbatim, and thematic analyses were performed to extract significant themes and subthemes.

RESULTS

Results from the individual and focus group interviews showed that the skills implemented by the partners (in domains of social relationships and health, domestic, organisational, emotional and well-being dimensions) were singular constructs, dependant on if resources (personal, external and schemes) may have been missing and insufficient. In addition, partners may have had these resources but not mobilised them.

CONCLUSION

The identification of the skills and associated resources could allow healthcare professionals better identifying and understanding of the difficulties met by partners in taking care of patients. This could enable them to offer appropriate support to help the caregivers in their accompaniment.

Training informal caregivers to care for older people after stroke: A quasi-experimental study

AIMS

This study aimed at evaluating whether training on practical skills involved in providing care reduces the burden experienced by informal caregivers and improves their general health condition.

BACKGROUND

A substantial number of informal caregivers lack skills to deliver poststroke assistance to older people after hospital discharge, which leads to burden situations as well as mental and physical health deterioration of the former.

DESIGN

A quasi-experimental design.

METHODS

This study involved 174 informal caregivers of older people who overcame a stroke. The control group (N = 89) received the usual type of care delivered in healthcare units. The experimental group (N = 85) adopted the InCARE programme for 1 week (T0), 1 month (T1) and 3 (T2) months and received telephone support by counselling caregivers on the subsequent 3rd, 6th, 8th and 10th weeks to hospital discharge. It aimed at facilitating the caregiver's adjustment to the demands of a poststroke stage and at increasing knowledge and practical skills to support the decision-making. Data collection occurred between February-December 2014 at the Community Home Care Services in northern Portugal.

RESULTS

The experimental group obtained significantly better results regarding practical skills as well as lower burden levels and a better general mental health condition when compared with the control group 1 (T1) and 3 (T2) months after intervention.

CONCLUSION

Findings suggest that our programme improved practical skills, helped reduce burden levels with better scores and improvement regarding general mental health condition of informal caregivers.