Development and Validation of the Care Risk Perception Scale (CRPS) for Caregivers of Older Adults With Dementia in Long-Term Care Facilities.

IF 4.2 2区医学 Q2 GERIATRICS & GERONTOLOGY

Journal of the American Medical Directors Association Pub Date : 2025-07-10 DOI:10.1016/j.jamda.2025.105759

Liqin Wei, Lihui Pu, Mengying Qiu, Jiayi Zhu, Shuai Yuan, Xiaofeng Xie, Fengying Zhang

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引用次数: 0

Abstract

Objectives: Global aging has increased the demand for long-term care facilities (LTCFs) for older adults with dementia. This challenge is further exacerbated by systemic barriers such as insufficient infrastructure and a shortage of trained caregivers within LTCFs. These limitations heighten care risks for vulnerable populations and underscore the urgent need for tools to evaluate caregivers' risk perceptions-a critical determinant of safety practices. This study developed and validated the Care Risk Perception Scale (CRPS), a specialized instrument designed to assess caregivers' perceived risk associated with dementia care and inform targeted interventions in LTCFs.

Design: A mixed-method design was used, including literature review, 2 rounds of Delphi expert consultation (n = 22), and psychometric validation with 501 caregivers in LTCFs.

Setting and participants: Participants were caregivers of older adults with dementia in LTCFs in Sichuan Province, China. Inclusion criteria required at least 3 months of caregiving experience and cognitive competence, March-September 2024.

Methods: A mixed-method design was used: (1) literature review and 2 Delphi rounds (22 experts) generated a preliminary scale; (2) psychometric validation involved 501 caregivers from 150 Chinese LTCFs, including item analysis, exploratory factor analysis (n = 200), and confirmatory factor analysis (n = 301).

Results: The final CRPS contains 23 items across 4 dimensions: institutional, environmental, psychological support, and competency risks. The scale demonstrated strong reliability (Cronbach's α = 0.882 overall; 0.753-0.905 for subscales) and validity (content validity = 0.928). Exploratory factor analysis extracted 4 factors explaining 69.78% variance (Kaiser-Meyer-Olkin = 0.888, Bartlett's χ² = 3753.073, P < .001). Confirmatory factor analysis confirmed model fit (χ²/df = 2.725, Comparative Fit Index = 0.928, Root Mean Square Error of Approximation = 0.075). Split-half reliability was 0.457 (P < .001), and test-retest reliability was 0.714 (P < .001).

Conclusions and implications: The CRPS is a scientifically robust tool to assess care risk perceptions in LTCFs. By identifying caregivers' risk awareness gaps, it supports targeted interventions and policy reforms for standardized safety audits to enhance dementia care quality and safety.

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长期护理机构老年痴呆护理风险感知量表（CRPS）的编制与验证

全球老龄化增加了对老年痴呆症患者长期护理设施（ltcf）的需求。基础设施不足和长期护理中心内训练有素的护理人员短缺等系统性障碍进一步加剧了这一挑战。这些限制增加了弱势群体的护理风险，并强调迫切需要评估护理人员风险感知的工具——这是安全实践的关键决定因素。本研究开发并验证了护理风险感知量表（CRPS），这是一种专门的工具，旨在评估护理人员与痴呆护理相关的感知风险，并为ltcf的针对性干预提供信息。设计：采用混合方法设计，包括文献回顾，2轮德尔菲专家咨询（n = 22），并对501名ltcf护理人员进行心理测量验证。环境和参与者：参与者是中国四川省ltcf中老年痴呆患者的照顾者。纳入标准要求至少3个月的护理经验和认知能力，时间为2024年3月至9月。方法：采用混合方法设计：(1)通过文献综述和2轮（22名专家）德尔菲法编制初步量表；(2)心理测量验证包括项目分析、探索性因子分析（n = 200）和验证性因子分析（n = 301）。结果：最终的CRPS包含制度、环境、心理支持和能力风险4个维度的23个项目。量表具有较强的信度(总体Cronbach′s α = 0.882；分量表0.753-0.905)和效度（内容效度= 0.928）。探索性因子分析提取4个因子解释69.78%的方差（Kaiser-Meyer-Olkin = 0.888, Bartlett’s χ2 = 3753.073, P < 0.001）。验证性因子分析证实模型拟合（χ2/df = 2.725，比较拟合指数= 0.928，近似均方根误差= 0.075）。二分信度为0.457 (P < .001)，重测信度为0.714 （P < .001）。结论和意义：CRPS是评估ltcf患者护理风险认知的科学可靠工具。通过确定护理人员的风险意识差距，它支持有针对性的干预措施和政策改革，以实现标准化安全审计，从而提高痴呆症护理的质量和安全性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Medical Directors Association 医学-老年医学

CiteScore

11.10

自引率

6.60%

发文量

472

审稿时长

44 days

期刊介绍： JAMDA, the official journal of AMDA - The Society for Post-Acute and Long-Term Care Medicine, is a leading peer-reviewed publication that offers practical information and research geared towards healthcare professionals in the post-acute and long-term care fields. It is also a valuable resource for policy-makers, organizational leaders, educators, and advocates. The journal provides essential information for various healthcare professionals such as medical directors, attending physicians, nurses, consultant pharmacists, geriatric psychiatrists, nurse practitioners, physician assistants, physical and occupational therapists, social workers, and others involved in providing, overseeing, and promoting quality