Evaluating physical environments for older people-Validation of the Swedish version of the Sheffield Care Environment Assessment Matrix for use in Finnish long-term care.

Niina Wahlroos,Riitta Suhonen,Minna Stolt,Susanna Nordin

doi:10.1111/opn.12383

Abstract

To validate a Finnish version of the Sheffield Care Environment Assessment Matrix (S-SCEAM) instrument for assessing the physical environment of long-term care settings and to describe the current status of the environmental quality of long-term care settings for older people in Finland. The importance of providing a well-designed physical environment for older people is supported by the research literature. There is limited research of the physical environments of long-term care settings from the perspective of nursing science and nor is there much research into the instruments for assessing them. A descriptive, correlational and observational study. Forward and back translation process was used followed by structured observations with S-SCEAM-Fin in 20 long-term care units in intensive residential care facilities for older people with 24-h nursing assistance and with extensive support for daily activities. Spearman's rho correlation, Cohen's kappa, percentage of agreement and Kuder-Richardson formula coefficients were calculated to assess psychometric properties of the translated S-SCEAM-Fin. S-SCEAM-Fin standardised scores were calculated to describe the current status of the environmental quality. Inter-scale (domain) correlations showed low to moderate correlations between the domains. Consistency was acceptable in four of the domains. Cohen's kappa values indicated good (0.796 and 0.648) intra-rater and inter-rater (0.910 and 0.553) reliability. The overall mean of the standardised scores was 57.00, but there was variation between domains. Small units received the highest scores in the six domains. S-SCEAM-Fin was useful in assessing environmental quality. Assessment of the environmental quality disclosed deficiencies in ensuring settings adequate for older people. The increasing numbers of older people with health conditions are residing in long-term care settings. It is essential to create supportive physical environments. The instrument can be useful when planning new facilities or proposing new recommendations for institutional living environments.

Highlights

The physical environment is an essential aspect of an individual's health and well-being (Huisman et al, 2012; Ulrich et al, 2008) and can be expected to be especially important in long-term care (LTC) where many residents spend most of their time inside and around the setting (Bernard & Rowles, 2013)
The present article describes the process of translation and adaptation of S-SCEAM-Fin, the Finnish version of the observational Sheffield Care Environment Assessment Matrix (SCEAM)
The data were used to assess the reliability of the Finnish version of S-SCEAM (S-SCEAM-Fin) and for a preliminary description of the state of environmental quality in LTC settings

Summary

Introduction

The physical environment is an essential aspect of an individual's health and well-being (Huisman et al, 2012; Ulrich et al, 2008) and can be expected to be especially important in long-term care (LTC) where many residents spend most of their time inside and around the setting (Bernard & Rowles, 2013). With increasing levels of physical and cognitive frailties such as impaired mobility and deteriorated spatial perception, the physical environment should be adjusted to meet the needs of the older persons (Lawton & Nahemov, 1973). To ensure that long-term care settings will support people with frail health, more knowledge is required on the quality of the physical environment. Together they construct a complex interaction which contributes to a person's well-being (Kim, 1987). Physical environment affects the experience of well-being for example by delivering the physical and cognitive support for older person. Decreasing agitation in a person with cognitive impairments and increasing physical activity (Douma et al, 2017; Wilkes et al, 2005) are other examples of outcomes which a high-quality physical environment has been shown to produce. Made adjustments are using colours and reference points to highlight walking paths, or to re-arrange the furniture to encourage feeling of home (van Hoof et al, 2016; Marquardt et al, 2014) or social interaction (Geboy, 2009)

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Discussion

Conclusion