Hostname: page-component-7c8c6479df-ph5wq Total loading time: 0 Render date: 2024-03-27T15:05:51.507Z Has data issue: false hasContentIssue false

Development and initial testing of the Person-centered Care Assessment Tool (P-CAT)

Published online by Cambridge University Press:  27 July 2009

David Edvardsson*
Affiliation:
Department of Nursing, Umeå University, Umeå, Sweden Australian Centre for Evidence Based Aged Care (ACEBAC), La Trobe University, Melbourne, Australia
Deirdre Fetherstonhaugh
Affiliation:
Australian Centre for Evidence Based Aged Care (ACEBAC), La Trobe University, Melbourne, Australia
Rhonda Nay
Affiliation:
Australian Centre for Evidence Based Aged Care (ACEBAC), La Trobe University, Melbourne, Australia
Stephen Gibson
Affiliation:
National Ageing Research Institute (NARI), Victoria, Australia
*
Correspondence should be addressed to: David Edvardsson, Department of Nursing, Umea University, S-901 87 Umea, Sweden. Phone: +46 90 786 91 43; Fax: +46 90 786 91 69. Email: david.edvardsson@nurs.umu.se.

Abstract

Background: Person-centered care is increasingly regarded as being synonymous with best quality care. However, the concept and its precise meaning is a subject of debate and reliable and valid measurement tools are lacking.

Method: This article describes the development and initial testing of a new self-report assessment scale, the Person-centered Care Assessment Tool (P-CAT), which measures the extent to which long-term aged care staff rate their settings to be person-centered. A preliminary 39-item tool generated from research literature, expert consultations and research interviews with aged care staff (n = 37), people with early onset dementia (n = 11), and family members (n = 19) was distributed to a sample of Australian aged care staff (n = 220) and subjected to item analysis and reduction.

Results: Psychometric evaluation of the final 13-item tool was conducted using statistical estimates of validity and reliability. The results showed that the P-CAT was shown to be valid and homogeneous by factor, item and content analyses. Cronbach's α was satisfactory for the total scale (0.84), and the three subscales had values of 0.81, 0.77, and 0.31 respectively. Test–retest reliability were evaluated (n = 26) and all analyses indicated satisfactory estimates.

Conclusion: This study provides preliminary evidence in support of the psychometric properties of the P-CAT when used in an Australian sample of long-term aged care staff. The tool contributes to the literature by making it possible to study person-centered care in relation to health outcomes, organizational models, characteristics and levels of staffing, degrees of care needs among residents, and impact of interventions.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2009

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Brooker, D. (2004). What is person-centered care in dementia? Reviews in Clinical Gerontology, 13, 215222.CrossRefGoogle Scholar
Brooker, D. (2005). Dementia care mapping: a review of the research literature. Gerontologist, 45, 1118.CrossRefGoogle ScholarPubMed
Brooker, D. (2007). Person Centered Dementia Care: Making Services Better. London: Jessica Kingsley.Google Scholar
Chenoweth, L. and Jeon, Y. (2007). Determining the efficacy of dementia care mapping as an outcome measure and a process for change: a pilot study. Aging and Mental Health, 11, 237245.Google Scholar
Chenoweth, L., King, M. T., Jeon, Y. H. et al. (2009). Caring for Aged Dementia Care Resident Study (CADRES) of person-centred care, dementia-care mapping, and usual care in dementia: a cluster-randomised trial. Lancet Neurology, 8, 317325Google Scholar
Clarke, A. (2000). Using biography to enhance the nursing care of older people. British Journal of Nursing, 9, 429433.Google Scholar
Clarke, A., Hanson, E. J., and Ross, H. (2003). Seeing the person behind the patient: enhancing the care of older people using a biographical approach. Journal of Clinical Nursing, 12, 797–706.Google Scholar
Cohen-Mansfield, J. and Bester, A. (2006). Flexibility as a management principle in dementia care: the Adards example. Gerontologist, 46, 540544.Google Scholar
Davis, S., Byers, S., and Walsh, F. (2008). Measuring person-centered care in a sub-acute health care setting. Australian Health Review, 32, 496504.CrossRefGoogle Scholar
Downs, M., Small, N. and Froggatt, K. (2006). Person-centered care for people with severe dementia. In Burns, A. and Winblad, B. (eds.), Severe Dementia. (pp 193204). Chichester: Wiley.CrossRefGoogle Scholar
Edvardsson, D., Sandman, P. O. and Rasmussen, B. (2005). Sensing an atmosphere of ease – a tentative theory of supportive care settings. Scandinavian Journal of Caring Sciences, 19, 344353.Google Scholar
Edvardsson, D., Winblad, B. and Sandman, P. O. (2008). Person-centered care for people with severe Alzheimer's disease: current status and ways forward. Lancet Neurology, 7, 362367.Google Scholar
Edvardsson, D., Koch, S. and Nay, R. (2009). Psychometric evaluation of the English version Person-Centered Climate Questionnaire – Patient version. Western Journal of Nursing Research, 31, 235244.CrossRefGoogle ScholarPubMed
Ericson, I. et al. (2001). What constitutes good care for people with dementia? British Journal of Nursing, 10, 710714.Google Scholar
Fossey, J. et al. (2006). Effect of enhanced psychosocial care on antipsychotic use in nursing home residents with severe dementia: cluster randomized trial. BMJ, 332, 756761.CrossRefGoogle Scholar
Hoeffer, B. et al. (2006). Assisting cognitively impaired nursing home residents with bathing: effects of two bathing interventions on caregiving. Gerontologist, 46,524532.Google Scholar
Kitwood, T. (1997). Dementia Reconsidered: The Person Comes First. Buckingham: Open University Press.Google Scholar
Kontos, P. C. (2005). Embodied selfhood in Alzheimer's disease: rethinking person-centered care. Dementia, 4, 553570.CrossRefGoogle Scholar
McCormack, B. (2004). Person-centeredness in gerontological nursing: an overview of the literature. International Journal of Older People Nursing, 13, 3138.Google Scholar
Murphy, K. (2007). Nurses’ perceptions of quality and the factors that affect quality care for older people living in long-term care settings in Ireland. Journal of Clinical Nursing, 16, 873884.Google Scholar
Neal, M. and Barton Wright, P. (1999). Validation therapy for dementia. Cochrane Database of Systematic Reviews, 1.Google Scholar
Norberg, A. (1998). Interaction with people suffering severe dementia. In Wimo, A., Jönsson, B., Karlsson, G. and Winblad, B. (eds.), Health Economics of Dementia (pp 113121). Chichester: Wiley.Google Scholar
Rogers, C. (1961). On Becoming A Person: A Therapist's View of Psychotherapy. London: Constable.Google Scholar
Sandman, P. O., Edvardsson, D. and Winblad, B. (2006). Care of patients in the severe stage of dementia. In Gauthier, S. (ed.), Clinical Diagnosis and Management of Alzheimer's Disease (pp 233246). London: Taylor & Francis.Google Scholar
Slater, L. (2006). Person-centeredness: a concept analysis. Contemporary Nurse, 23, 135144.Google Scholar
Sloane, P. D. et al. (2004). Effects of person-centered showering and the towel bath on bathing associated aggression, agitation, and discomfort in nursing home residents with dementia: a randomized, controlled trial. Journal of the American Geriatrics Society, 52, 17951804.Google Scholar
Sloane, P. D. et al. (2007). Dementia care mapping as a research tool. International Journal of Geriatric Psychiatry, 22, 580589.Google Scholar
White, D. L., Newton-Curtis, L. and Lyons, K. S. (2008). Development and initial testing of a measure of person-directed care. Gerontologist, 48, 114123.Google Scholar