Abstract
BackgroundBetween 75 and 89% of residents living in long-term care facilities have limited mobility. Nurses as well as other licensed and unlicensed personnel directly involved in resident care are in a key position to promote and maintain the mobility of care-dependent persons. This requires a certain level of competence. Kinaesthetics is a training concept used to increase nursing staff’s interaction and movement support skills for assisting care-dependent persons in their daily activities. This study aims to develop and test an observation instrument for assessing nursing staff’s competences in kinaesthetics.MethodsThe Kinaesthetics Competence (KC) observation instrument was developed between January and June 2015 based on a literature review, a concept analysis and expert meetings (18). The pilot instrument was evaluated with two expert panels (n = 5, n = 4) regarding content validity, usability and inter-rater agreement. Content validity was assessed by determining the content validity index (CVI). The final instrument was tested in a cross-sectional study in three nursing homes in the German-speaking part of Switzerland between July 2015 and February 2016. In this study nursing staff (n = 48) was filmed during mobilization situations. Based on this video data two observers independently assessed nursing staff’s competences in kinaesthetics with the KC observation instrument. Inter-rater reliability and inter-rater agreement was evaluated using the intra-class correlation coefficient (ICC) and percentage of agreement. Construct validity was assessed by a discriminating power analysis. Internal consistency was evaluated using Cronbach’s alpha coefficient and item analysis.ResultsThe final version of the KC observation instrument comprised of four domains (interaction, movement support of the person, nurses’ movement, environment) and 12 items. The final instrument showed an excellent content validity index of 1.0. Video sequences from 40 persons were analysed. Inter-rater reliability for the whole scale was good (ICC 0.73) and the percentage of inter-rater agreement was 53.6% on average. Cronbach’s alpha coefficient for the whole instrument was 0.97 and item-total correlations ranged from 0.76 to 0.90. The construct validity of the instrument was supported by a significant discrimination of the instrument between nursing staff with no or basic and with advanced kinaesthetics training for the total score and 3 of 4 subscales.ConclusionsThe KC observation instrument showed good preliminary psychometric properties and can be used to assess nursing staff’s competences in mobility care based on the principles of kinaesthetics.
Highlights
Between 75 and 89% of residents living in long-term care facilities have limited mobility
Immobility is a major factor contributing to a reduced quality of life and preventable adverse events among older adults living in residential long-term care: increased incidences of urinary infections, pressure ulcers, contractures and falls, as well as a persistent decline in function and physical activity [5, 22]
The aim of this study was to develop and psychometrically [1] test the Kinaesthetics Competence (KC) observation instrument, an instrument to be used by kinaesthetics trainers or other health professionals who are familiar with kinaesthetics to assess the level of nursing staff’s competences in kinaesthetics
Summary
Between 75 and 89% of residents living in long-term care facilities have limited mobility. Nurses as well as other licensed and unlicensed personnel directly involved in resident care are in a key position to promote and maintain the mobility of care-dependent persons. This requires a certain level of competence. Kinaesthetics is a training concept used to increase nursing staff’s interaction and movement support skills for assisting caredependent persons in their daily activities. Immobility is a major factor contributing to a reduced quality of life and preventable adverse events among older adults living in residential long-term care: increased incidences of urinary infections, pressure ulcers, contractures and falls, as well as a persistent decline in function and physical activity [5, 22]. The competences which nursing staff should have in order to perform interventions that promote mobility in activities of daily living (ADL), are emphasised in curricular guidelines and nursing standards [3, 4, 23]
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