Development of a Screening Scale for Community-dwelling Older Adults with Multiple Care Needs

Objectives: To develop a screening scale for community-dwelling older adults with multiple care needs.Methods: A modified Delphi was employed; 10 experts were invited to evaluate the relevancy, clarity, and suitability of the scale. A descriptive evaluation survey was tested on the screening scale users who were community volunteers to evaluate the clarity, relevance, and usefulness of the scale using a 10-point rating system. Confirmatory factor analysis was applied to determine the suitability of the factorial structure of the HCOASS. The internal consistency was examined using Kuder-Richardson Formula 20. A suitable cutoff point was developed using receiver operating characteristic analysis.Results: In the first round of the modified Delphi, the item-level content validity index (I-CVI) on the content relevance, item clarity, and suitability of the scale were all higher than .90, .80, and .80, respectively. In the second round, the scores for content relevancy, item clarity, and suitability were all 1.0. Community volunteers rated highly on the scale. The result of the confirmatory factor analysis indicated a good fit. The internal consistency reliability was satisfactory. The area under curve (AUC), sensitivity, and specificity for cutoff score of 6/7 were .91, 88%, and 81%, respectively.Conclusions: The screening scale demonstrated adequate reliability, content validity, and discriminant validity.Clinical Implications: The screening scale would serve as a reference for community volunteers in the identification of community-dwelling older adults with multiple care needs.