Development and evaluation of the content validity, practicability and feasibility of the Innovative dementia-oriented Assessment system for challenging behaviour in residents with dementia

Abstract

BackgroundOne of the most difficult issues for care staff is the manifestation of challenging behaviour among residents with dementia. The first step in managing this type of behaviour is analysing its triggers. A structured assessment instrument can facilitate this process and may improve carers’ management of the situation. This paper describes the development of an instrument designed for this purpose and an evaluation of its content validity and its feasibility and practicability in nursing homes.MethodsThe development process and evaluation of the content validity were based on Lynn’s methodology (1998). A literature review (steps 1 + 2) provided the theoretical framework for the instrument and for item formation. Ten experts (step 3) evaluated the first version of the instrument (the Innovative dementia-oriented Assessment (IdA®)) regarding its relevance, clarity, meaningfulness and completeness; content validity indices at the scale-level (S-CVI) and item-level (I-CVI) were calculated. Health care workers (step 4) evaluated the second version in a workshop. Finally, the instrument was introduced to 17 units in 11 nursing homes in a field study (step 5), and 60 care staff members assessed its practicability and feasibility.ResultsThe IdA® used the need-driven dementia-compromised behaviour (NDB) model as a theoretical framework. The literature review and expert-based panel supported the content validity of the IdA®. At the item level, 77% of the ratings had a CVI greater than or equal to 0.78. The majority of the question-ratings (84%, n = 154) and answer-ratings (69%, n = 122) showed valid results, with none below 0.50. The health care workers confirmed the understandability, completeness and plausibility of the IdA®. Steps 3 and 4 led to further item clarification. The carers in the study considered the instrument helpful for reflecting challenging behaviour and beneficial for the care of residents with dementia. Negative ratings referred to the time required and the lack of effect on residents´ behaviour.ConclusionsThere was strong evidence supporting the content validity of the IdA®. Despite the substantial length and time requirement, the instrument was considered helpful for analysing challenging behaviour. Thus, further research on the psychometric qualities, implementation aspects and effectiveness of the IdA® in understanding challenging behaviour is needed.Electronic supplementary materialThe online version of this article (doi:10.1186/s12913-017-2469-8) contains supplementary material, which is available to authorized users.

Process evaluation of the response of nursing homes to the implementation of the dementia-specific case conference concept WELCOME-IdA: A qualitative study

“…The IdA was developed based on a comprehensive literature review [25] and expert consultation. A detailed description of the development and evaluation of IdA has been published elsewhere [26]. We chose an intra-professional nursing approach to WELCOME-IdA due to the results of a prior feasibility study [10].…”

“…Role conflicts also occurred when the moderator was the primary caregiver of the resident being discussed. One participant reported, "[...] last time, the moderator was the primary nurse of the resident, and he felt the need to step out of the moderator's role and to bring in his own suggestions, his own remarks" (E75, R2_WB1, [26][27]. For this reason, some nursing homes always selected the moderator from a different nursing ward (external moderator) (E29, E75).…”

“…The full process structure of WELCOME-IdA was not completed, and the DSCC ended without any planning of care interventions (E29_R2_WB2, [14][15]. Thus, a second meeting was held to complete the DSCC (E29_ZI_ WB1, [19][20][21][22][23][24][25][26]. Subsequently, this procedure was not continued (E29_R2_WB2, 7-10).…”

An Overview Evaluation of the Content Validity Used in Scale Development Studies

“…Eğer panelde yer alan uzman sayısı 5'ten fazla ise, M-İGİ değeri 0,78'den düşük olmamalıdır. 24 İGO, içerik geçerliliğini ölçmek için kullanılan en eski ve en yaygın yöntemlerden biridir. Lawshe (1975) tarafından önerilen İGO değerinin hesaplanabilmesi için, ölçekte yer alan her bir maddenin "gerekli", "faydalı, ancak gerekli değil" ve "gerekli değil" biçiminde derecelendirilmesi gerekir.…”

Development and psychometric properties of the Thai Graves’ ophthalmopathy quality of life (GO-QOL) questionnaire

“…The scale level CVI (S-CVI) was computed with 2 different indices: 1) universal agreement (S-CVI/UA) was calculated by the formula S-CVI/UA = A / B, where A is the number of items that were judged relevant to grade3 or grade 4 by all experts (I-CVI = 1.0), and B is the number of total items, and 2) average agreement (S-CVI/Ave) was computed by summing all I-CVI and dividing by the number of total items [14]. An acceptable S-CVI should be at least 0.8 [14,15].…”