Socially Supportive Activity Inventory: Reliability and Validity of a Social Activity Instrument for Long-Term Care Institutions

長期照護機構之社會支持型活動量表信度與效度之建構

10.1097/JNR.0b013e318229c479

許雅娟(Ya-Chuan Hsu)

老人 ； 社會活動 ； 長期照護 ； 信效度 ； elders ； social activity ； long-term care ； reliability and validity

The Journal of Nursing Research

19卷3期（2011 / 09 / 01）

161 - 172

英文

背景　在長期照護機構中，為使住民在機構化的生活中增添生活樂趣，進而提升住民身心健康，安排豐富又多元的活動是常見的方式；但活動情形之評估，尚缺乏具信效度之本土性量表。目的　為建構一份具文化敏感度之「社會支持型活動量表」及其信效度，以期日後能對長期照護機構評量住民參與社會活動的量與質有所助益。方法　此量表奠基於社會支持理論，在整合社會活動相關文獻與結合台灣文化背景下所發展。量表以專家效度與再測信度來檢驗，經由方便取樣方式，以台灣南部一所提供常規、多樣化活動之長期照護機構之10位非失智老年住民為對象進行前驅研究。結果　研究結果顯示，專家內容效度指標(content validity index, CVI)達.96。信度方面，本量表間隔兩週再測信度(test-retest reliability)係數分別為：整體量表.76-1.00；活動之頻率1.00；活動之意義性.76-1.00；活動之享樂性.78-1.00，顯示所有題目皆達顯著穩定性。結論　結果顯示，「社會支持型活動量表」無論是效度或信度上，可為長期照護機構在評估其住民參與社會活動之質與量的可靠及可信工具。由於此為前驅性研究，建議未來能夠增加長期照護機構研究地點、樣本數，以及利用不同方法比較、測量社會活動，以建立更完善、嚴謹之心理計量特質。

Background: Diverse social and recreational activities in elder care institutions have been provided to enrich a person's mental well-being amidst what is a relatively monotonous life. However, few instruments that measure the social activities of long-term care residents are available.Purpose: This study was designed to develop a culturally sensitive instrument (Socially Supportive Activity Inventory, SSAI) to assess quantity and quality of social activities for long-term care institutions and validate the instrument's psychometric properties.Methods: The SSAI was developed on the basis of the social support theory, a synthesis of literature, and Taiwanese cultural mores. The instrument was rigorously subjected to a two-stage process to evaluate its reliability and validity. In Stage 1, six experts from diverse backgrounds were recruited to evaluate instrument items and estimate the content validity of the instrument using a content validity questionnaire. Items were modified and refined on the basis of the responses of the expert panel and a set of criteria. After obtaining approval from a university institutional review board, in the second stage of evaluating test-retest reliability, a convenience sample of 10 Taiwanese institutionalized elders in a pilot study, recruited from a nursing home, completed the revised instrument at two separate times over 2 weeks.Results: Results showed a content validity of .96. Test-retest reliability from a sample of 10 participants yielded stability coefficients of .76-1.00. The stability coefficient was 1.00 for the component of frequency, .76-1.00 for the component of meaningfulness, and .78-1.00 for the component of enjoyment.Conclusion: The SSAI is a highly relevant and reliable culturally based instrument that can measure social activity in long-term care facilities. Because of the pilot nature of this study, future directions include further exploration of the SSAI instrument's psychometric properties. This should be done by enlarging the sample size to include more long-term care facilities and individual participants. Future studies can utilize diverse measures of social activity for comparison and validation of the SSAI.

1. Ministry of Interior, Department of Statistics, Taiwan, ROC. (2010b).Statistical yearbook of interior: Population of 15 years and over by educational attainment. Retrieved June 7, 2011, from http://sowf.moi.gov.tw/stat/year/elist.htm
2. Ministry of Interior, Department of Statistics, Taiwan, ROC.(2010a). Statistical yearbook of interior: Population by age. Retrieved June 7, 2011, from http://sowf.moi.gov.tw/stat/year/elist.htm
3. American Psychological Association(1999).Standards for educational and psychological tests.Washington, DC:American Psychological Association.
4. Barnes, L. L.,de Leon, M.,Wilson, R. S.,Bienias, J. L.,Evans,D. A.(2004).Social resources and cognitive decline in a population of older African Americans and Whites.Neurology,63(12),2322-2326.
5. Benson, J.,Clark, F.(1982).A guide for instrument development and validation.The American Journal of Occupational Therapy,36(12),789-800.
6. Berkman, L. F.(1984).Assessing the physical health effects of social networks and social support.Annual Reviews of Public Health,5(May),413-432.
7. Cobb, S.(1976).Social support as a moderator of life stress.Psychosomatic Medicine,38(5),300-314.
8. Cohen, S.(Ed.),Syme, S. L.(Ed.)(1985).Social support and health.Orlando, FL:Academic Press.
9. Cohen, S.,Wills, T. A.(1985).Stress, social support, and the buffering hypothesis.Psychological Bulletin,98(2),310-357.
10. Cummings, S. M.,Cockerham, C.(2004).Depression and life satisfaction in assisted living residents: Impact of health and social support.Clinical Gerontologist,27(1/2),25-42.
11. Ejaz, F. K.,Schur, D.,Noelker, L. S.(1997).The effect of activity involvement and social relationships on boredom among nursing home residents.Activities, Adaptation & Aging,21(4),53-65.
12. Gerritsen, D. L.,Steverink, N.,Frijters, D. H. M.,Hirdes, J. P.,Ooms, M. E.,Ribbe, M. W.(2008).A revised index for social engagement for long-term care.Journal of Gerontological Nursing,34(4),40-48.
13. Glass, T. A.,Mendes de Leon, C.,Morottoli, R. A.,Berkman,L. F.(1999).Population based study of social and productive activities as predictors of survival among elderly Americans.British Medical Journal,319(7208),478-483.
14. Heller, K.,Swindle, R. W.,Dusenbury, L.(1986).Component social support processes: Comments and integration.Journal of Consulting and Clinical Psychology,54(4),466-470.
15. Herzog, A. R.,Ofstedal, M. B.,Wheeler, L. M.(2002).Social engagement and its relationship to health.Clinics in Geriatric Medicine,18(3),593-609.
16. House, J. S.(1981).Work stress and social support.Reading, MA:Addison-Wesley.
17. House, J. S.,Robbins, C.,Metzner, H. L.(1982).The association of social relationships and activities with mortality: Prospective evidence from the Tecumseh Community Health Study.American Journal of Epidemiology,116(1),123-140.
18. Jenkins, K. R.,Pienta, A. M.,Horgas, A. L.(2002).Activity and health-related quality of life in continuing care retirement communities.Research on Aging,24(1),124-149.
19. Kelly, S.,McKenna, H.,Parahoo, K.,Dusoir, A.(2001).The relationship between involvement in activities and quality of life for people with severe and enduring mental illness.Journal of Psychiatric and Mental Health Nursing,8(2),139-146.
20. Klumb, P. L.,Maier, H.(2007).Daily activities and survival at older ages.Journal of Aging and Health,19(4),594-611.
21. Knapp, R. R.(1995).Ten measurement commandments that often should be broken.Research in Nursing and Health,18(5),465-469.
22. Lampinen, P.,Heikkinen, R. L.,Kauppinen, M.,Heikkinen, E.(2006).Activity as a predictor of mental well-being among older adults.Aging & Mental Health,10(5),454-466.
23. Lemke, S.,Moos, R. H.(1989).Personal and environmental determinants of activity involvement among elderly residents of congregate facilities.Journals of Gerontology: Social Sciences,44(4),S139-S148.
24. Lewis, M. A.,Kane, R. L.,Cretin, S.,Clark, V.(1985).The immediate and subsequent outcomes of nursing home residents.American Journal of Public Health,75(7),758-762.
25. Lin, N.(Ed.),Dean, A.(Ed.),Ensel, W.(Ed.)(1986).Social support, life events, and depression.Orlando, FL:Academic Press.
26. Lynn, M. R.(1986).Determination and quantification of content validity.Nursing Research,35(6),382-385.
27. Meeks, S.,Young, C. M.,Looney, S. W.(2007).Activity participation and affect among nursing home residents: Support for a behavioural model of depression.Aging & Mental Health,11(6),751-760.
28. Mor, V.,Branco, K.,Fleishman, J.,Hawes, C.,Phillips, C.,Morris, J.(1995).The structure of social engagement among nursing home residents.Journal of Gerontology,50B(1),1-8.
29. Patterson, B.(1997).Catalysts and barriers to social support in a nursing home.Health Care in Later Life,2(2),73-84.
30. Polit, D. F.,Beck, C. T.(2006).The content validity index: Are you sure you know what's being reported?.Research in Nursing and Health,29(5),489-497.
31. Riddoch, C.(2000).Social and productive activities in elderly people: Activities have been confused.British Medical Journal,320(7228),184.
32. Unger, J. B.,Johnson, C. A.,Marks, G.(1997).Functional decline in the elderly: Evidence for direct and stressbuffering protective effects of social interactions and physical activity.Annals of Behavioral Medicine,19(2),152-160.
33. Vaux, A.(1988).Social support: Theory, research, and intervention.New York:Praeger Publishers.
34. Yen, Y. C.,Yang, M. J.,Shih, C. H.,Lung, F. W.(2004).Cognitive impairment and associated risk factors among aged community members.International Journal of Geriatric Psychiatry,19(6),564-569.
35. Zimmerman, S.,Scott, A. C.,Park, N. S.,Hall, S. A.,Wetherby,M. M.,Gruber-Baldini, L.(2003).Social engagement and its relationship to service provision in residential care and assisted living.Social Work Research,27(1),6-18.