Developing the KAMA instrument (knowledge and management of abuse)

Area of Science:

• Gerontology
• Nursing Education
• Healthcare Quality Improvement

Background:

• Identifying and managing abuse in vulnerable older inpatients is critical.
• Existing assessment methods for staff knowledge and practice in this area may lack practicality or provide excessive cues.
• There is a need for a reliable instrument to measure applied knowledge and practice in preventing and managing elder abuse.

Purpose of the Study:

• To develop and validate an instrument measuring applied knowledge and practice in identifying and managing potentially abusive situations involving older inpatients.
• To create a tool capable of measuring changes in staff knowledge and practice following educational interventions.
• To utilize a vignette-based approach for assessing practical skills without over-cueing participants.

Main Methods:

• A parallel-form, vignette-based instrument was developed using scenarios from clinical practice and literature.
• The instrument was reviewed by senior nurses for suitability and piloted with healthcare staff.
• Data were collected from 79 healthcare staff working with older people in inner London.

Main Results:

• High participation rate (92%) with similar demographic distribution across parallel instrument versions.
• Strong internal consistency (Cronbach's alpha 0.89 and 0.79) and parallel form reliability (0.82).
• Significant concurrent validity and high inter-rater reliability (0.98); test-retest reliability (0.69) indicated stability and sensitivity to change.

Conclusions:

• The developed instrument is a valid tool for assessing applied knowledge and management skills related to elder abuse.
• It can effectively identify knowledge gaps in staff working with older vulnerable populations.
• The instrument supports the development of evidence-based knowledge in the field of elder abuse management.