Development and validation of assistance needs assessment scale of the home-dwelling older adults

With the acceleration of population aging, identifying and addressing the unmet assistance needs of home-dwelling older adults has become increasingly important. This study aimed to develop and validate a reliable and practical assessment tool to identify such needs.

A descriptive qualitative study was conducted using semi-structured interviews with home-dwelling older adults in two communities in Wuhan, China. Based on the qualitative findings and literature review, an initial item pool was developed, followed by expert consultation to construct a draft scale. A cross-sectional survey was then conducted in communities across four central Chinese cities. Item analysis and psychometric testing were performed to finalize the scale.

The finalized scale consists of 27 items across four dimensions: daily assistance, health maintenance, visitation and communication, and social interaction. A total of 380 older adults participated in the study, with 170 used for item screening and 210 for validation. Confirmatory factor analysis showed good model fit (CFI= 0.951, TLI = 0.946, RMSEA = 0.068). Standardized factor loadings ranged from 0.67 to 0.94. The scale demonstrated excellent internal consistency, with Cronbach's α ranging from 0.943 to 0.968, and met all reliability and validity standards.

The developed scale has sound psychometric properties and is a reliable tool for assessing the unpaid assistance needs of home-dwelling older adults. It holds promise for guiding community service planning, public welfare resource allocation, and policy development in the context of population aging.