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家长制和自主护理评估的发展和验证
Author(s) -
FernándezBallesteros Rocío,
SánchezIzquierdo Macarena,
Olmos Ricardo,
Huici Carmen,
Caprara María Giovanna,
Santacreu Marta,
Ribera Casado José Manuel,
CruzJentoft Alfonso
Publication year - 2019
Publication title -
journal of advanced nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.948
H-Index - 155
eISSN - 1365-2648
pISSN - 0309-2402
DOI - 10.1111/jan.14154
Subject(s) - paternalism , autonomy , context (archaeology) , psychology , nursing , social psychology , medicine , political science , paleontology , law , biology
Aim There is a need for a validated instrument to measure the type of care (paternalism or person‐centred) provided for older adults. Since paternalism and person‐centred care are the most important caregiving styles in the field of care and as they are usually opposed, the study aims to develop and establish psychometrics data of an instrument to identify paternalistic and autonomist behaviours in older adults care contexts, which can help to enhance care practice. Design Instrument development. Methods After observing and standardizing behaviours in formal care contexts in 2016, an instrument was developed and proceeding to a first validation using standard validation techniques among caregivers in two care settings during 2016–2017: senior citizen centres and older adult day care centres. Results The Paternalist/Autonomist Care Assessment (PACA) is a 30‐item, behaviour‐based instrument which measures both the appraisal of caregivers on elements of care (Care Appraisal Scale‐ PACA‐Appraisal) and the occurrence of behaviours (Occurrence of Care in Context‐ PACA‐Occurrence). The Paternalist/Autonomist Care Assessment (PACA) was validated in 160 professional caregivers and was able to discriminate two factors: paternalistic or overprotective behaviours and autonomist behaviours. However, these factors were not fully dichotomous and were shown to coexist to some degree. Conclusion The instrument displayed good psychometric properties to measure paternalism and autonomy in older adult care. Moreover, it showed that the two types of care are not antagonistic and can coexist, with overprotective behaviours being more frequent in contexts of care for more dependent persons. Impact There are no validated instruments to measure paternalism and person‐centred behaviour in care contexts. The two measures yielded by the PACA show good construct and concurrent empirical validity, internal consistency, and convergent and discriminant validity. Family caregiver, professional caregivers, nurses, older adults.