The Appropriateness of Adapting the Australian Environmental Assessment Tool–High Care (EAT-HC) for Persons With Dementia in Singapore

Abstract

Objectives: This study investigated the level of acceptance in Singapore of the eight principles of design underpinning the Environmental Assessment Tool–High Care (EAT-HC), which is commonly used in Australia to evaluate environments for the care of people living with dementia. A secondary goal was to identify topics particularly relevant to the Singaporean context, which are not included in the Australian EAT-HC. Background: This study was undertaken in preparation for the development of a Singaporean version of the Australian EAT-HC. Methods: Discussions from 23 focus groups involving 150 family caregivers, aged care staff, administrators, and architects were recorded and thematically analyzed to identify the characteristics of the principles underpinning the EAT-HC that are unlikely to be relevant in a Singaporean version and to identify additional topics required to tailor it to reflect the Singaporean culture. The thematic analysis was supplemented with quantitative data obtained through the use of simple Likert-type scales measuring the appropriateness of each principle in the Singaporean context. Results: The principles of design that underpin the EAT-HC were highly accepted by participants and provided a framework for a systematic exploration of Singaporean residential care for people with dementia. Some topics of particular relevance to Singapore were identified. These can be subsumed by the principles without the need for the principles to be changed. Conclusion: The results support the use of the design principles underpinning the EAT-HC as the foundation of a tool for the evaluation of Singaporean dementia facilities.

The Development and Reliability of the Singaporean Environmental Assessment Tool (SEAT) for Facilities Providing High Levels of Care for People Living With Dementia

“…The other two items, Items 5 and 64, dealing with the flooring of external environments and the need for familiar furniture refer to uncommon but desirable features in nursing homes in Singapore. While the psychometrics could be improved by the exclusion of these items, their educational function is considered to be very important (Sun & Fleming, 2018; Sun, 2020). Participants indicated that the SEAT was an important innovation, especially in aged care, and despite coming from a range of occupational backgrounds, they indicated that the tool is aligned with their goals of improving aged care, can be learned quickly, and is potentially useful to them.…”

“…The SEAT is an adaptation of the EAT-HC. The adaptation was based on the views of 150 participants (caregivers of people living with dementia, clinicians, care staff, design and aged care administrators, and policy makers) who took part in 23 focus groups discussion about the relevance of the principles of design and the content of the individual items (Sun, 2020). Results from the thematic analysis revealed a high level of acceptance of the applicability of the design principles and the content of the individual items and resulted in the development of six additional items for the SEAT bringing the total items from 77 items in the original EAT-HC to 83 items used in the first stage of testing.…”

Japanese Translation and Validation of the Environmental Assessment Tool–Higher Care

“…Based on this study results, we plan to modify EAT-HC by adapting to cultural aspects of Japan. Developing an environmental assessment instrument with cultural adaptation would set higher expectations for the residents' QOL (Sun, 2020). Our next step is to translate the EAT-HC handbook to clarify the meaning of each question before applying it to small-scale dementia-care facility design.…”

Feasibility, Interrater Reliability and Internal Consistency of the German Environmental Audit Tool (G-EAT)

“…Background information was added to describe the meaning of the question in more detail. This necessity is also pointed out by Sun (2021) and Brennan and colleagues (2021), who emphasize the different literacy levels of staff of facilities using the instrument to collect data [38]. Even for other instruments that depict the built environment, additional information is provided in manuals to address the difficulties of this difficult-to-capture construct [39][40][41].…”