Abstract
BackgroundPerson-centeredness is increasingly advocated in the literature as a gold-standard, best practice concept in health services for older people. This concept describes care that incorporates individual and multidimensional needs, personal biography, subjectivity and interpersonal relationships. However, acute in-patient hospital services have a long-standing biomedical tradition that may contrast with person-centred care. Since few tools exist that enable measurements of the extent to which acute in-patient hospital services are perceived as being person-centred, this study aimed to translate the English version of the Person-centred care of older people with cognitive impairment in acute care scale (POPAC) to Swedish, and evaluate its psychometric properties in a sample of acute hospital staff.MethodsThe 15-item POPAC was translated, back-translated and culturally adjusted, and distributed to a cross-sectional sample of Swedish acute care staff (n = 293). Item performance was evaluated through assessment of item means, internal consistency by Cronbach’s alpha on total and on subscale levels; temporal stability was assessed through Pearson’s product correlation and intra-class correlation between test and retest scores. Confirmatory factor analysis was used to explore model fit.ResultsThe results indicate that the Swedish version POPAC provides a tentatively construct-valid and reliable contribution to measuring the extent to which acute in-patient hospital services have processes and procedures that can facilitate person-centred care of older patients with cognitive impairment. However, some questions remain regarding the dimensionality of POPAC.ConclusionsPOPAC provides a valuable contribution to the quest of improving acute care for older patients with cognitive impairment by enabling measures and subsequent accumulation of internationally comparable data for research and practice development purposes. POPAC can be used to highlight strengths and areas for improvements in care practice for older patients, and to illuminate aspects that risk being overlooked in busy acute hospital settings.
Highlights
Person-centeredness is increasingly advocated in the literature as a gold-standard, best practice concept in health services for older people
The overall result of this study indicates that the Swedish version POPAC is tentatively construct-valid and reliable as a measure of the extent to which acute in-patient hospital wards are perceived to have processes and procedures that facilitate person-centred care (PCC) of older patients with cognitive impairment
Some questions remain regarding the dimensionality of POPAC, as one of the model fit estimates did not reach the cut-off, and as two subscales did not quite reach the reliability targets
Summary
Person-centeredness is increasingly advocated in the literature as a gold-standard, best practice concept in health services for older people. This concept describes care that incorporates individual and multidimensional needs, personal biography, subjectivity and interpersonal relationships. It has been argued that a more person-centred pathway in acute hospital services, where bio-psychosocial needs are in focus for care of older patients with cognitive impairment, improve outcomes for patients, family members and staff [1,2]. Acute hospital services that contain such barriers risk failing to meet the biopsychosocial needs of older patients [1], and risk missing out on economic and personal benefits such as lower costs and higher staff and patient satisfaction that have been linked to increasing hospital personcenteredness [14,15,16,17]
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