Development of visualized model expressing the relationship among factors involved in eldery home care

我们开发了一个模型来表达影响老年人居家养老的因素之间的关系。我们编制了问卷用于模型的构建，并调查了亲属和专业照顾者之间的问卷在评分者之间的信度。然后，我们收集了专业护理员对该模型的意见，建立的模型由四个要素组成：所需的护理水平、护理者的能力、护理者的负担以及被护理者的生活舒适度。为了衡量这些因素，我们编制了一份调查问卷，涵盖四个领域，每个领域包括四到五个问题。问卷共有20个项目。为了构建问卷，我们借鉴了医疗费用指数(日文版)中的问卷。为了检验问题在评分者之间的可靠性，被照顾的老人的亲属和专业照顾者都使用问卷独立地评估了他们所照顾的老人。采用Kappa系数和一致性比例进行分析。通过自填式问卷调查的方式收集了29名专业护理员对该模式的意见，除1项(护理者与被护理者之间的关系)外，其他项目的Kappa系数和一致性比例都很高。根据专业照顾者的意见，他们中的一些人接受了这种模式的简单性。他们也注意到了护理规划模型缺乏实用性、模型与养老现状不一致等问题，开发了模型来表达养老相关因素之间的关系。为了测量这些因素，我们制定了一份问卷，并检验了亲属和专业照顾者之间的项目在评分者之间的可靠性。模型的简单性和收集详细信息的难度引起了照顾者的注意。

We developed a model to express the relationship among factors involved in elderly home care. We made up a questionnaire for construction of the model, and investigated the inter-rater reliability of the questionnaire between relatives and professional caregivers. We then gathered opinions about the model from professional caregivers.The model developed consists of four elements: the level of care needed, ability of caregiver, caregiver burden, and the comfort of the life of the elderly cared for. To measure these elements, we made up a questionnaire covering four areas, each consisting of four or five questions. There were 20 items in the questionnaire. To construct the questionnaire, we drew upon the questionnaire from the Cost of Care Index (Japanese version). To test the inter-rater reliability of the questions, both relatives of the elderly cared for and the professional caregivers independently evaluated the elderly in their care using the questionnaire. Kappa coefficients and proportion of agreement were used for the analysis. We also gathered opinions about the model from 29 professional caregivers by self-administered questionnaire.With the exception of one item (the relationship between caregiver and cared elderly), the Kappa coefficients and proportion of agreement were quite high. Based on the opinions from the professional caregivers, some of them accepted the model for its simplicity. They also noted some problems: lack of utility of model for care planning, discrepancy between the model and present condition of the elderly cared for.We developed the model to express the relationship among factors involved in caring for the elderly. To measure these factors, we drew up a questionnaire, and examined the inter-rater reliability of the items between relatives and professional caregivers. The simplicity of the model and difficulty of assembling detailed information drew the attention of the caregivers.