Psychometric Properties of a Measure of Person-Directed Care: Data From Two Samples of Nursing Home Administrators in South Korea

Purpose: This study examines the validity and reliability of a measure of person-directed care (PDC) among nursing home administrators. The tool originally developed by White and colleagues (2008) was modified for nursing homes in South Korea. This instrument appropriately operationalizes PDC theoretically and statistically.

 Method: The data consists of two independantly collected parts. The first data was collected from 223 nursing home directors (or managers) in 2010. The second one was from 239 at the same managerial position in 2012. Both of the data were achieved by using the proportionate random-stratified sampling method from four regions nationwide. The first one was used to design a Korean version of the PDC scale by revising the original measure, and the second one was used to confirm the reliability and validity of the amended measure. Chi-square tests and one-sample t tests confirmed that there were no significant differences between facility characteristics of two samples.

 Results: Item analysis and exploratory factor analysis of data from the first sample generated a 33-item PDC measure with eight factors. Subsequently, item analysis of data from the second sample reduced the number of items to 32. Confirmatory factor analysis was run to confirm the construct validity of the revised instrument: however, the model fit was not good and five alternative models formulated through statistical analysis and theoretical considerations were tested. A model with seven factors and a total of 30 items was finally selected. This model had acceptable fit (χ² = 650.96, p < .001), RMSEA = .059, NNFI = .88, CFI = .90, and IFI = .90). In addition, the overall scale had good internal consistency reliability, with Cronbach’s alpha coefficients as follows: .925 for the full scale, .656 for autonomy, .782 for personhood, .838 for knowing the person, .785 for support relationship, .804 for comport care, .812 for work with residents, and .848 for management structure.

 Conclusions: The findings statistically validate the use of the revised PDC scale, which has seven factors and 30 items, to measure person-directed care among nursing home administrators in South Korea. This study provides theoretical and empirical evidence supporting the use of the PDC scale to assess person-directed care in long-term care settings. In addition, geriatric professionals in South Korea, such as administrators in nursing homes, evaluators of care quality and research in public and private settings, and researchers on long-term care issues, can use the revised scale to assess the level of person-directed care in nursing homes and to develop evidence-based strategies for enhancing service quality in the facilities.

References

White, D. L., Newton-Curtis, L., & Lyons, K. S. (2008). Development and initial testing of a measure of person-directed care. The Gerontologist, 48(supple 1), 114-123.