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Rasch analysis of a palliative care self-efficacy instrument for nursing assistants
Jinsook Kim1, Jennifer A Gray1
1School of Health Studies, Northern Illinois University, DeKalb, IL, 60115, USA.
Geriatric Nursing (New York, N.Y.)
|October 5, 2024
Summary
This study refined a palliative care self-efficacy tool for nursing assistants (NAs). The revised 12-item instrument effectively measures NA confidence in psychosocial palliative care, aiding targeted training improvements.
Area of Science:
- Geriatric Nursing
- Palliative Care
- Psychometrics
- Nursing Education
Background:
- Nursing assistants (NAs) require specialized skills in psychosocial palliative care.
- Existing self-efficacy instruments may not adequately capture NA competence in this area.
- Objective evaluation of palliative care self-efficacy is crucial for effective training.
Purpose of the Study:
- To evaluate the psychometric properties of a self-efficacy instrument for nursing assistants (NAs) in psychosocial palliative care.
- To refine the instrument for improved measurement accuracy and utility in training contexts.
- To assess the impact of a palliative care training intervention on NA self-efficacy.
Main Methods:
- Rasch models were employed to analyze the psychometric properties of the self-efficacy instrument.
- Data were collected from 102 nursing assistants across 6 skilled nursing facilities at baseline and 1-month follow-up.
- Instrument refinement involved adjusting response categories and item selection based on Rasch analysis.
Main Results:
- A 3-category response scale improved instrument structure compared to a 5-category scale.
- After removing 4 items, the instrument demonstrated unidimensionality and local independence, resulting in a 12-item measure.
- A ceiling effect was identified, and post-training changes in item difficulty were observed in the intervention group.
Conclusions:
- The refined 12-item Palliative Care Self-Efficacy for Nursing Assistants (PCSE-NA) instrument is an adequate measure of palliative care self-efficacy.
- The PCSE-NA tool can help geriatric nurses identify specific training needs and areas for improvement among NAs.
- This validated instrument supports evidence-based training development to enhance psychosocial palliative care delivery by nursing assistants.
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