| Object:To compile a scale to understand the cognitive level and demand for"Internet+care services"among the disabled elderly at home in Shihezi city,and to assess the factors influencing the cognitive level and demand for"Internet+care services".The scale was used to assess the factors influencing the perception and demand of"Internet+care service",and to provide a theoretical basis for the establishment of the next"Internet+care service"model.Methods:1.Literature research:To understand the current status of research on"Internet+care services"for elderly people with disabilities at home,and to construct a preliminary pool of entries on the perception and demand of"Internet+care services";2.Delphi method:Invite experts to evaluate the preliminary"Internet+nursing service"cognitive scale and demand scale,and form a preliminary pretest scale;3.Questionnaire survey:The cross-sectional questionnaire survey method was used.A multi-stage whole-group random sampling method was applied to 502 elderly people with disabilities at home in Shihezi City to conduct a questionnaire survey,and the reliability and validity of the scale were tested to form the"Internet+care service"awareness scale and demand scale.Analysis of the current situation and factors influencing the level of awareness and demand for"Internet+care services"among the elderly with disabilities at home in Shihezi;4.Statistical analysis:SPSS26.0 software was used for statistical analysis of the data.Results:1.Development and reliability testing of the"Internet+care service"cognitive scale for the elderly with disabilities at home.(1)Construction of indicators of"Internet+care services"for the elderly with disabilities at home:(1)Based on the literature review,15 items were constructed after the suggestion of the research group and the experts were consulted;(2)After two rounds of delphi method,the effective recovery rate of the questionnaire was 100%and 86.67%,and the authority coefficients of the experts were 0.891 and 0.892.The coefficients were 0.891,0.892,judgment coefficients 0.933,0.931,familiarity 0.92,0.907,and Kendall coordination coefficients 0.212-0.205.(2)Reliability test:item analysis(1)the CR values of the scale entries were all>3,and the differences were statistically significant(P<0.001);(2)the correlation between each entry and the total score was>0.3.Validity analysis:(1)content validity:the content validity(I-CVI)of the scale entries ranged from 0.90 to 1.00,and the total content validity(S-CVI)of the scale was 0.857;(2)structural validity:the KMO value was 0.899,and theχ~2value of Bartlett’s spherical test was 5946.732,with statistically significant differences(P<0.05),suitable for exploratory factor analysis.Factor analysis extracted a total of 2 factors with eigenvalues>1,and the cumulative variance rate was 81.997%.Reliability analysis(1)internal consistency:the Cronbach’s alpha coefficient of the scale was 0.913;(2)split-half reliability:the Spearman-Brown coefficient of the scale was 0.944;(3)retest reliability:the retest reliability of the scale was 0.913.2.Development and reliability testing of the"Internet+care service"demand scale for elderly people with disabilities at home.(1)Construction of the indicators of the"Internet+care service"demand scale for elderly people with disabilities at home:(1)Based on the literature review,the research team and the experts were advised to construct 3 primary indicators and 41 secondary indicators;(2)After two rounds of delphi method,the effective recovery rate of the questionnaire was 100%,86.67%,and the authority coefficient was 0.891,0.892.86.67%,expert authority coefficients of 0.891,0.892,judgment coefficients of 0.933,0.931,familiarity of 0.92,0.907,and Kendall coordination coefficients of 0.129～0.547.(2)Reliability test:item analysis(1)except for entry 5,entry 8 and entry 23,all other entries had CR values>3and the differences were statistically significant(P<0.001);(2)except for entry 9,entry 10 and entry 37,all other entries had correlation values>0.3 with the total score;validity analysis(1)content validity:the content validity(I-CVI)of each entry of the scale ranged from 0.80 to 1.00,and the total content validity(S-CVI)of the scale was 0.931;(2)structural validity:the KMO value was 0.792,and the χ~2 of Bartlett’s spherical test was 4962.254,the difference was statistically significant(P<0.05),and exploratory factor analysis could be done.Factor analysis extracted a total of nine factors with eigenvalues>1,and the cumulative variance rate was 60.781%.Reliability analysis(1)Internal consistency:the Cronbach’s alpha coefficient for the total scale was 0.817.the Cronbach’s alpha coefficient for the daily care dimension was0.702,the Cronbach’s alpha coefficient for the care dimension was 0.829,The Cronbach’s alpha coefficient for the psychological comfort dimension was 0.797;(2)Split reliability:the Spearman-Brown coefficient for the scale was 0.689.The Spearman-Brown coefficient for the daily care dimension was 0.689,and the Spearman-Brown coefficients for the community and medical institution under the care dimension were 0.680 and 0.739,respectively,and the Spearman-Brown coefficient for the psychological comfort dimension was 0.806.The Spearman-Brown coefficients were 0.680 and 0.739 for the care dimension and 0.806 for the psychological comfort dimension,respectively;(3)Retest reliability:the retest reliability of the scale was 0.872,The retest reliability of each dimension ranged from 0.734 to 0.846.3.The current situation and factors influencing the level of awareness and demand of"Internet+care service"among the disabled elderly at home in Shihezi.(1)There are 368 people(73.3%)who do not know or do not know much about"Internet+care service".(2)Age,education level,marital status,family size,number of children,children’s economic conditions,whether they have primary caregivers,monthly income,and whether they have chronic diseases have significant effects on the awareness of"Internet+care services"among elderly people who are disabled at home(P<0.05);age,education level,marital status,family size,number of children,residence status,and the number of children have significant effects on the awareness of"Internet+care services"among elderly people who are disabled at home(P<0.05);age,education level,marital status,family size,number of children,residence status,whether there is a primary caregiver,monthly income,health status,and whether there is chronic disease have significant effects on the demand for"Internet+care services"among the elderly with disability at home(P<0.05).(3)There was a positive correlation between the cognition and demand of"Internet+care service"and self-perceived aging and social support among the elderly with disability at home.(4)There was a positive effect of literacy on the perception of"Internet+care services"(β=0.166,t=5.271,P<0.001);there was a negative effect of having a primary caregiver on the perception of"Internet+care services"(β=-0.248,t=-3.649,P<0.001);and the presence of chronic diseases had a positive effect on the perception of Internet+care services(β=0.187,t=2.343,P<0.001).Age had a positive effect on the demand for Internet+care services(β=0.017,t=3.647,P<0.05);the number of children had a negative effect on the demand for Internet+care services(β=-0.203,t=-2.788,P<0.05);and the presence of primary caregiver had a negative effect on the demand for Internet+care services(β=-0.200,t=-3.435,P<0.05).Conclusion:1.The"Cognition of Internet+Care Services for Elderly People with Disabilities at Home"and"Demand for Internet+Care Services for Elderly People with Disabilities at Home"developed in this study have good reliability and validity.2.age,education level,monthly income,marital status,number of family members,number of children,economic conditions of children,whether they have a primary caregiver,whether they have chronic diseases,are the main factors affecting the cognition of"Internet+care services"among the elderly people with disabilities at home;age,education level,marital status,number of family members,number of children,living condition,whether they have a primary caregiver The main factors affecting the demand for"Internet+care services"among the elderly with disabilities at home are age,education level,marital status,number of family members,number of children,residence status,whether they have a primary caregiver,monthly income,health status,and whether they have chronic diseases.3.There is a positive relationship between the cognition and demand for"Internet+care services"and self-perceived aging among the elderly with disabilities at home.4.Education and the presence of chronic diseases had a positive effect on the perception of Internet+care services,while the presence of a primary caregiver had a negative effect on the perception of Internet+care services.Age positively influenced the demand for Internet+care services,while the number of children and the presence of a primary caregiver negatively influenced the demand for Internet+care services. |
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