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

我们发展了一个模型来表达老年人家庭护理的因素之间的关系。为构建该模型，我们编制了一份问卷，并在亲属和专业照顾者之间考察了问卷的评分者间信度。本研究收集专业照顾者对模式的意见，并将其归纳为照顾需求、照顾者能力、照顾者负担、照顾者生活舒适度四个因素。为了衡量这些要素，我们制作了一份涵盖四个领域的问卷，每个领域由四个或五个问题组成。问卷共20个项目。为了构建问卷，我们借鉴了护理成本指数（日文版）的问卷。为了检验评分者间的可靠性的问题，照顾老人的亲属和专业照顾者独立评估老年人在他们的照顾使用的问卷。Kappa系数和一致率用于分析。并以自填式问卷收集29位专业照顾者对该模式的意见，除照顾者与被照顾老人的关系一项外，其余各项目的Kappa系数及同意比例均较高。根据专业照顾者的意见，其中一些人接受的模式，其简单。他们还指出了一些问题：针对照护规划模式缺乏实用性、照护规划模式与被照护老人现况不符等问题，本研究发展照护规划模式，以表达照护老人相关因素间的关系。为了测量这些因素，我们编制了一份问卷，并检查了亲属和专业照顾者之间的项目的评分者间的信度。模型的简单性和收集详细信息的困难引起了护理人员的注意。

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.