Abstract
Objectives We translated and modified an ambiance scale for use by (in)formal caregivers in Dutch nursing homes. We tested validity and reliability of the modified Ambiance Scale. Method Convenience sampling was used to enrol (in)formal caregivers in three nursing homes in the Netherlands. 104 questionnaires were filled in; 45 by informal caregivers, 46 by formal caregivers. Ten caregivers filled in the questionnaire twice for test-retest purposes. Three original items were used, and seven newly were added to form the modified Ambiance Scale. Each item consisted of an adjective pair assessing an aspect of ambiance on a scale of 1 (homelike) to 5 (institutional). Caregivers filled in the questionnaire on two different days to assess intra rater reliability. Differences in scoring between formal and informal caregivers and between original and new items were analyzed. Results The questionnaire was easy to comprehend and fill in. Internal consistency was good (a = 0.93). Validity was found to be good. Factor analysis demonstrated that eight items identified as one factor. No differences in scoring between the first and second assessment were found (p<.001). Formal caregivers scored ambiance more chaotic than informal caregivers did (p<.01). No differences in scoring between original and new items were found (p =.06). Conclusion This study demonstrated that the modified Ambiance Scale had good internal consistency, moderate replicability and both informal and formal caregivers’ overall ratings were comparable. The modified Ambiance Scale is a valid, reliable and easy to use tool to assess ambiance in nursing home settings.
Highlights
The overall effect of physical and social features of a perceived environment on feelings, moods, behaviour, actions, and reactions of individuals, is commonly described with the term ambiance (Brawley, 1992)
In total 104 sampled ratings were received, of which 91 different caregivers filled in the modified Ambiance Scale (m-AS). 10 caregivers filled in the m-AS twice, and 3 questionnaires could not be included in analysis because of missing data
This study demonstrated that the m-AS had good internal consistency and a moderate replicability
Summary
The overall effect of physical and social features of a perceived environment on feelings, moods, behaviour, actions, and reactions of individuals, is commonly described with the term ambiance (Brawley, 1992). The environment and ambiance in nursing homes are mainly controlled and shaped by staff members. Staff is likely to tolerate (unconsciously) more and different sounds (Southwell & Wistow, 1995) These imperfect ambiances can adversely influence feelings, behaviour, actions, moods, and quality of life of the residents (Southwell & Wistow, 1995; Van Vracem, Spruytte, Declercq, & Van Audenhove, 2016). Nursing home residents depend on the caregivers to adjust the environment according to their needs to make them feel safe and at home (Brawley, 1992)
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