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Background and Purpose:The purpose of this study was to expand on the limited psychometric testing of the NPI-Q, and extend testing to include hospitalized older adults.Method:This was a descriptive study using data from 318 dyads in an ongoing cluster randomized clinical trial. Rasch analysis and hypothesis testing were done.Results:The majority of the participants were female (62%), non-Hispanic (98%), and black (50%) with a mean age of 81.62 (SD= 8.43). There was evidence of internal consistency and invariance across race and gender. The items fit with each subscale. Hypothesis testing was supported with a significant association between the NPI-Q and dementia and caregiver distress.Conclusions:The NPI-Q is short, easy to complete, and reliable and valid when used with hospitalized older adults.

Background and PurposeThe purpose of this study was to test the reliability and validity of the Knowledge of Person-Centered Behavioral Approaches for BPSD based on a Rasch analysis.MethodsThis study used baseline data from the Implementation of the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD) clinical trial.ResultsA total 1,071 nurses completed the test. There was evidence of reliability (alpha coefficient of .99), construct validity with INFIT and OUTFIT statistics in the .6 to 1.4 range, and hypothesis testing with a significant correlation between the Knowledge of Person-Centered Behavioral Approaches for BPSD and positive care interactions.ConclusionsFuture use of the measure should include more challenging items to differentiate those very high in knowledge of person-centered behavioral approaches for BPSD.

Background and PurposeThe Cohen-Mansfield Agitation Inventory (CMAI) is a widely used measure of agitation. The purpose of this study was to test the internal consistency, reliability, and validity of short-form CMAI in a sample of nursing home residents with cognitive impairment and examine if it is invariant across gender.MethodsThis study utilized baseline data from a randomized trial including 553 residents from 55 nursing homes. Data was analyzed using structural equation modeling.ResultsConfirmatory factory analysis supported the three-factor structure including aggressive (α = .794), physically nonaggressive (α = .617), and verbally agitated (α = .718) behaviors. Invariance testing confirmed that the shortened measure is invariant across gender.ConclusionsFindings provide validity evidence of short-form CMAI to assess agitation and gender differences in agitation in nursing home population.

Background and PurposeThe purpose of this study was to test the reliability and validity of the Quality of Interaction Survey (QuIS) using a quantification scoring approach.MethodsBaseline data from the Evidence Integration Triangle for Behavioral and Psychological Symptoms of Dementia (EIT-4-BPSD) study was used.ResultsA total of 553 residents participated. There was evidence of inter-rater reliability with Kappa scores of .86 to 1.00 and internal consistency based on the Rasch analysis (item reliability of .98). There was some support for validity based on item fit and hypothesis testing as resistiveness to care was significantly associated with total QuIS scores.ConclusionThis study supports the use of the quantified QuIS to evaluate the quality of interactions over time and to test interventions to improve interactions.

Background and Purpose: This study examines the underlying factor structure of the Self-Efficacy for Functional Abilities (SEFA) scale among older adults in long-term care settings. Methods: A secondary analysis of SEFA data for 568 residents in 16 long-term care facilities was applied. The sample was randomly split into 2 subsamples. A 2-level exploratory and confirmatory factor analysis adjusting for clustering effect of facilities was used to identify and determine the factor structures respectively. Results: There were 1- and 2-factor models that were identified. Both models demonstrated acceptably mixed model fit. The 2-factor model had poor discriminant validity with high correlation between factors (r = .92, p Keywords: factor analysis; long-term care; Self-Efficacy for Functional Abilities (SEFA) scale; older adultsThe ability to perform activities of daily living (ADLs) is the most basic function for older adults in long-term care settings, and decreased functional abilities has significant impact on health (Hjaltadottir, Hallberg, Ekwall, & Nyberg, 2011). Older adults demonstrate functional decline in performing various ADLs over time after admission to long-term care facilities (Carpenter, Hastie, Morris, Fries, & Ankri, 2006; Gillen, Spore, Mor, & Freiberger, 1996; Hjaltadottir, Hallberg, Ekwall, & Nyberg, 2012) and that functional decline is frequently beyond what is anticipated with aging-related deteriorations and various comorbidities (Wang, Kane, Eberly, Virnig, & Chang, 2009). Long-term care residents may experience risk of greater functional decline because of various personal and institutional factors. These factors included caregivers' perception that residents are unable to actively perform functional activities with or without assistance (Galik, Resnick, & Pretzer-Aboff, 2009), custodial care practice that focuses on task completion, which reinforces excessive dependence (Bowers, Esmond, & Jacobson, 2000), and institutional policies that restrict activities for safety reasons (Galik et al., 2009). It is imperative to evaluate residents' current confidence and motivation in doing ADLs so as to reduce excessive dependence and enhance autonomy in performing functional activities at appropriate time (Resnick, 1998b, 2000). Increased independence and participation in these activities not only improves and maintains function but also enhances physical and emotional health and quality of life (Galik et al., 2008; Resnick, Galik, Gruber-Baldini, & Zimmerman, 2009; Resnick, Gruber-Baldini, et al., 2009).The Self-Efficacy for Functional Abilities (SEFA) scale assesses individuals' confidence in doing daily functional activities. Previous studies that have used the SEFA scale employed the total score by summing up the responses of 11 items, instead of using the score of any single item or a subgroup of items, with the underlying assumption that the 11 items cluster together (Pretzer-Aboff, Galik, & Resnick, 2011; Resnick, Galik, et al., 2009; Resnick, Galik, Gruber-Baldini, & Zimmerman, 2011; Resnick, Gruber-Baldini, et al., 2009). Prior research also pointed out the need of continued testing of the scale to ensure that the items have a direct relationship with the latent variable of self-efficacy for functional abilities, indicating the need of factor analysis (Resnick, 2003). The purpose of this study is to examine the underlying factor structure of the 11 SEFA items among older adults in long-term care using factor analysis modeling approaches. We conducted two-level exploratory factor analysis (EFA) to identify initial empirical factor structures in one randomly selected half of the sample and then two-level confirmatory factor analysis (CFA) to evaluate the identified factor structures in the other half of sample. …

Purpose: The purpose of this study was to test the psychometric properties of the revised Self-Efficacy for Exercise With Epilepsy (SEE-E) and Outcome Expectations for Exercise with Epilepsy (OEE-E) when used with people with epilepsy. Methods: The SEE-E and OEE-E were given in face-to-face interviews to 26 persons with epilepsy in an epilepsy clinic. Results: There was some evidence of validity based on Rasch analysis INFIT and OUTFIT statistics. There was some evidence of reliability for the SEE-E and OEE-E based on person and item separation reliability indexes. Conclusions: These measures can be used to identify persons with epilepsy who have low self-efficacy and outcome expectations for exercise and guide design of interventions to strengthen these expectations and thereby improve exercise behavior.