Testing Reliability and Validity of the Person-centered Climate Questionnaire-staff version in Korean for Long-term Care Facilities

Hae Sagong; Da Eun Kim; Soyoung Bae; Ga Eon Lee; David Edvardsson; Ju Young Yoon

doi:10.12799/jkachn.2018.29.1.11

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Sagong, Kim, Bae, Lee, Edvardsson, and Yoon: Testing Reliability and Validity of the Person-centered Climate Questionnaire-staff version in Korean for Long-term Care Facilities

Original Article

J Korean Acad Community Health Nurs 2018;29(1):11-20.

Published online: 12 March 2018

DOI: https://doi.org/10.12799/jkachn.2018.29.1.11

Testing Reliability and Validity of the Person-centered Climate Questionnaire-staff version in Korean for Long-term Care Facilities

Hae Sagong¹, Da Eun Kim¹, Soyoung Bae¹, Ga Eon Lee², David Edvardsson³, Ju Young Yoon⁴

¹College of Nursing, Seoul National University, Seoul, Korea

²Department of Nursing, Dong-A University, Busan, Korea

³Northern Health Clinical Schools of Nursing College of Science, La Trobe University, Heidelberg, Australia

⁴Research Institute of Nursing Science, Seoul National University, Korea

Corresponding author: Yoon, Ju Young Research Institute of Nursing Science, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea. Tel: +82-2-740-8817, Fax: +82-2-766-1852, E-mail: yoon26@snu.ac.kr

Received 14 July 2017 Revised 14 November 2017 Accepted 26 January 2018

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To test the reliability and validity of the Korean version of the Person-centered Climate Questionnaire - staff version (KPCQ-S) in long-term care institutions.

Methods

A total of 297 staff in long-term care institutions including nine nursing homes (NHs) and 4 long-term care hospitals (LTCHs) were included. The KPCQ-S was developed following the WHO guidelines of the process of translation and adaptation of instruments. An internal consistency using Cronbach’s ⍺ was tested for reliability. Exploratory factor analysis (EFA) was used to examine the construct validity. Convergent and discriminant validity were examined using Pearson correlation.

Results

EFA demonstrated the construct validity of the 14-item KPCQ-S with three-factor solutions, specifically three factors (safety, everydayness, and community) in NHs and four factors (safety, everydayness, community, and comprehensibility) in LTCHs. Convergent validity was found in the correlation with the work satisfaction (r=.55). The KPCQ-S showed satisfactory internal consistency reliability (Cronbach’s ⍺=.91).

Conclusion

The KPCQ-S is found to be a reliable and valid tool for measuring staff perceptions of the person centeredness of long-term care environments.

Keywords: Personhood, Long-term care, Environment

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Table 1.

General Characteristics of Long-term Care Facilities

Variables	Total (n=13)	NH (n=9)	LTCH (n=4)
Variables	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD
Location	11 (84.6)	7 (77.8)	4 (100.0)
Urban	2 (15.4)	2 (22.2)	0 (0.0)
Rural
Ownership	6 (46.2)	5 (55.6)	1 (25.0)
Incorporated	7 (53.8)	4 (44.4)	3 (75.0)
Private
Operating years	10.85±6.01	12.22±6.74	7.75±2.22
Number of beds	111.69±81.35	72.78±38.26	199.25±88.34
Number of residents per nursing staff (RN+NA)	16.73±4.71	18.16±4.70	13.49±3.11
Number of residents per RN	36.78±34.49	46.45±40.93	19.84±3.73
Number of residents per PCW	11.63±11.84	6.99±4.38	22.08±17.31

NH=nursing home; LTCH=long-term care hospital; RN=registered nurse; NA=nurse aid; PCW=personal care worker.

Table 2.

General Characteristics of Study Participants

Variables	Categories	Total staff (N =297)	NH staff (n=163)	LTCH staff (n=134)	x² or t (p)
Variables	Categories	n (%) or M±SD	n (%) or M±SD	n (%) or M±SD	x² or t (p)
Age (year)		49.91±11.32	51.21±10.26	48.35±12.32	2.17 (.006)
	＜40	62 (20.7)	25 (15.3)	37 (27.6)
	40~＜50	60 (20.2)	34 (20.9)	26 (19.4)
	50~＜60	107 (36.0)	66 (40.5)	41 (30.6)
	≥60	68 (22.9)	38 (23.3)	30 (22.4)
Gender	Female	279 (93.9)	151 (92.6)	128 (95.5)	1.61 (.204)
Education attainment	Middle school or less	41 (13.8)	24 (14.7)	17 (12.7)	5.35 (.253)
	High school	93 (31.3)	54 (33.1)	39 (29.1)
	College diploma	79 (26.6)	36 (22.1)	43 (32.1)
	Bachelor degree	70 (23.6)	39 (23.9)	31 (23.1)
	Graduate school	12 (4.0)	9 (5.5)	3 (2.2)
Type of occupation	Registered nurse	57 (19.2)	17 (10.4)	40 (29.9)	43.37 (＜.001)
	Nurse assistant	37 (12.5)	17 (10.4)	20 (14.9)
	Social worker	25 (8.4)	21 (12.9)	4 (3.0)
	Personal care worker	141 (47.5)	95 (58.3)	46 (34.3)
	Physical therapist	30 (10.1)	8 (4.9)	22 (16.4)
	Others	4 (1.3)	3 (1.8)	1 (0.7)
Total wok experiences (year)		6.89±5.95	6.7±5.69	7.01±6.24	-0.30 (.583)
Current work experiences (year)		3.93±3.51	4.56±4.04	3.16±2.54	3.45 (＜.001)
PCC education (times)	Internal program	1.55±1.28	1.79±1.21	1.26±1.30	3.61 (.115)
PCC education (times)	External program	1.09±1.19	1.36±1.23	0.75±1.07	4.49 (.001)
Work shift	Rotating shift	151 (51.9)	79 (48.5)	72 (53.9)	7.57 (.023)
Work shift	Fixed shift	143 (48.1)	81 (49.7)	62 (46.3)
Monthly income (10,000 won)	＜150	166.63±35.20	164.92±33.70	168.64±36.93	-0.90 (.005)
	150~＜199	103 (34.7)	56 (34.4)	47 (35.1)
	200~＜249	118 (39.7)	74 (45.4)	44 (32.8)
	≥250	59 (19.9)	21 (12.9)	38 (28.4)
		17 (5.7)	12 (7.4)	5 (3.7)

NH=nursing home; LTCH=long-term care hospital; PCC=person-centered care; Missing cases [Age: NH=3, LTCH=1; Gender: NH=2, LTCH=2; Education level: NH=1, LTCH=1; Length of employment with the current facility: NH=4, LTCH=3, Total career: NH=46, LTCH=23, PCC internal education: NH=3, LTCH=1, PCC external education: NH=6, LTCH=1, Working type: NH=3].

Table 3.

Item Performance, Reliability and Result of Factor Analysis

Item	Item contents	M±SD	Corrected Item–total correlation	Cronbach's ⍺ if item deleted	Total staff (n=297)			NH staff (n=163)			LTCH staff (n=134)
Item	Item contents	M±SD	Corrected Item–total correlation	Cronbach's ⍺ if item deleted	Factor 1	Factor 2	Factor 3	Factor 1	Factor 2	Factor 3	Factor 1	Factor 2	Factor 3	Factor 4
1	A place where I feel welcome	4.47±0.86	.56	.90	0.67	0.03	0.06	0.53	0.15	0.12	0.76	0.13	0.08	-0.19
2	A place where I feel acknowledged as a person	4.50±0.83	.64	.90	1.02	-0.12	0.04	0.99	-0.08	0.05	0.96	-0.16	-0.04	0.15
3	A place where I feel I can be myself	4.31±1.11	.52	.90	0.67	0.17	-0.15	0.77	0.12	-0.13	0.62	0.12	-0.05	0.04
4	A place where the patients are in safe hands	4.76±0.80	.68	.90	0.08	0.55	0.17	0.11	0.73	-0.01	-0.08	0.01	0.11	0.74
5	A place where the staff use a language that the patients can understand	4.84±0.65	.68	.90	0.14	0.43	0.25	0.13	0.42	0.28	0.03	0.05	-0.15	0.92
6	A place which feels homely even though it is in an institution	4.75±0.88	.72	.89	0.07	0.67	0.08	0.11	0.68	0.03	0.06	0.30	0.10	0.41
7	A place where there is something nice to look at	4.50±1.14	.54	.90	-0.04	0.72	-0.08	0.04	0.63	0.06	-0.01	0.76	-0.15	0.02
8	A place where it is quiet and peaceful	4.70±0.86	.71	.89	-0.06	0.96	-0.12	-0.04	0.94	-0.12	-0.01	0.77	0.03	0.12
9	A place where it is possible to get unpleasant thoughts out of your head	4.33±1.00	.55	.90	0.16	0.48	-0.00	0.22	0.47	-0.08	0.13	0.46	0.25	-0.11
10	A place which is neat and clean	4.76±0.85	.65	.90	-0.00	0.48	0.28	-0.10	0.66	0.18	0.06	0.07	0.22	0.44
11	A place where it is easy for the patients to keep in contact with their loved ones	4.86±0.82	.61	.90	-0.02	0.13	0.66	-0.12	0.36	0.55	0.02	-0.23	0.51	0.40
12	A place where it is easy for the patients to receive visitors	5.03±0.71	.52	.90	0.01	-0.17	0.86	-0.04	-0.07	0.88	0.06	-0.06	0.76	-0.10
13	A place where it is easy for the patients to talk to the staff	5.07±0.66	.63	.90	-0.02	-0.03	0.86	0.08	-0.13	0.93	-0.10	0.13	0.82	-0.01
14	A place where the patients have someone to talk to if they so wish	40.91±0.73	.62	.90	-0.05	0.11	0.73	-0.01	0.08	0.70	0.00	-0.02	0.78	0.06
	M±SD of sub-domai				4.43±0.83	4.67±0.66	4.97±0.61	4.43±0.82	4.84±0.62	5.10±0.57	4.42±0.82	4.22±0.83	4.81±0.62	4.63±0.68
	M±SD of whole scale						4.71±0.58			4.82±0.55				4.55±0.58
	Cronbach's ⍺ of sub-domain				.83	.66	.85	.83	.87	.87	.83	.70	.81	.84
	Cronbach's ⍺ of whole scale					.91			.91		.89
	Explained variance (%)					65.8%			67.8%	70.8%

NH=nursing home; LTCH=long-term care hospital; Factor 1: A climate of safety, Factor 2: A climate of everydayness, Factor 3: A climate of community, Factor 4: A climate of comprehensibility.

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