Research On Comprehensive Ability Assessment Of The Elderly And The Classification Of Graded Care In Geriatric Nursing Facilities

[Objective]1.Establish an objective and reasonable pool of items for comprehensive evaluation of the elderly in pension institutions,develop a set of comprehensive evaluation scale for the elderly in pension institutions with Chinese characteristics,and evaluate the ability of the elderly.2.Based on the comprehensive evaluation scale for the elderly in pension institutions,the care grade of the elderly was determined and the grade of the elderly was classified.[Methods]1.On the basis of the previous research of the research group,the InterRAI-LTCF and the questionnaire issued by the Ministry of Civil Affairs were used to evaluate the ability and needs of the elderly.The "Working Time Measurement Form for Elderly Care Services for the Aged Agencies",and the Information chemical time measurement platform were used to measure the time of nursing services for the elderly.2.The sample data of the survey were entered in Excel,and the data were statistically analyzed using SPSS23.0,using descriptive statistical analysis,screening for scale items by one-way ANOVA and multiple regression analysis,and the focus group interview method was used to fuse the subjective and objective screening items to form the initial table of the comprehensive evaluation scale for the elderly.3.Exploratory factor analysis of the scale structure,forming a conceptual framework of the scale,analyzing the structural validity and reliability of the scale,and correcting the items to form a formal scale.4.In the large sample experiment,the cluster sampling method,cluster analysis and discriminant analysis were used to divide the ability evaluation scores of 246 elderly people into segments,and the boundary values of each segment were established.[Results]1.The Comprehensive Evaluation scale for the elderly in Pension institutions includes six dimensions,which are named as mental state and cognitive ability,sensory perception and communication,emotional problems,mental and behavioral problems,daily life and social participation ability,skin and oral status,40 items.2.Scale analysis:2.1 Scale reliability2.1.1 Cronbach’ α coefficient:the intrinsic consistency reliability of the total scale was 0.951,and the Cronbach score of each dimension was 0.663 to 0.946.2.1.2 Split-half reliability:the half-half reliability of the total scale is 0.941,and the coefficient of each dimension is 0.614-0.938.2.2 Scale validity2.2.1 Content validity:the scale is based on theoretical basis and revised through expert consultation and experiments.The percentage of S-CVI/UA of the scale is 87.5%,which is greater than 80%,indicating that the content validity of the scale is good.S-CVI/Ave uses the I-CVI mean of all items of the scale to show that the S-CVI/Ave value of the scale is 0.982>0.9,and the I-CVI of the scale item is 0.857mi 1.00,indicating that the content validity of the items of the scale is good and meets the requirements.2.2.2 Construct validity:confirmatory factor analysis was used to investigate the construct validity of the scale.Confirmatory factor analysis showed that X2/df was 8.874,>0.05,RMSEA was 0.043,<0.08,X2/df was 0.043,CFI and TLI were 0.970 and 0.923,respectively,all>0.90,indicating that the model had good fit and structural validity.3.Classification of Graded CareIn this study,cluster analysis and discriminant analysis were used to evaluate the mental state and cognitive ability,sensory perception and communication,emotional problems,mental and behavioral problems,daily life and social participation ability,skin and oral status of the elderly in pension institutions.The comprehensive assessment of care for the elderly was divided into four grades:Care 0(ability intact),Care 1(mild disability),Care 2(moderate disability)and Care 3(severe disability).4.Reverse verificationIn this study,the newly formed scale and the Civil Administration scale were used to evaluate the same group of elderly people.The spearman correlation analysis was conducted between the(civil affairs and comprehensive assessment scale)grades(1,2,3,4)and the cognitive score,activities of daily life,depression score,pain score,communication score and pressure sore score in InterRAI-LTCF,respectively.The results showed that the correlation coefficient of the comprehensive evaluation scale was higher than that of the civil affairs scale.Then it shows that the comprehensive scale is more related to the ability of the elderly and their own situation,and the evaluated results and grades are more convincing.[Conclusions]1.The Comprehensive Ability Evaluation scale for the elderly in Pension institutions includes 6 dimensions and 40 item pools.2.This scale has good reliability and validity and can be used as a tool for comprehensive evaluation of the elderly in pension institutions.3.The demarcation value of each grade:Care 0(ability intact):0-35 points;Care 1(mild disability):36-51 points;Care 2(moderate disability):52-80 points;Care 3(severe disability):81-1 10 points.