Content Validation of the Dutch Version of the “Older Patients in Acute Care Survey”, an Instrument to Measure the Attitude of Hospital Nurses towards Older Patients

Abstract

Aims and objectives: The aim of this study is to validate the "Older Patients in Acute Care Survey" (OPACS) in the Netherlands. Background: Worldwide the population of older people with multimorbidity increases which results in an increase of older hospitalized patients. Literature shows that nurses have a negative attitude towards older patients. To get insight and improve the attitude of nurses, a validated measurement instrument is needed. The OPACS measures hospital nurses' attitudes towards older patients and has proven good content validity in the USA and good face validity and reliability in Australia. Design: A cross-sectional study. Methods: First the OPACS was translated using forward-backward method and testing clarity of wording with a pilot. Second content validity was determined using "Method Lynn" and clarity of wording and appropriateness for measuring attitude were identified. Results: The OPACS showed acceptable content validity (CVI ≥ 0.78) for 14 items (out of 36) of Section A and 22 items (out of 50) of Section B. The content validity for the entire OPACS was (CVI = 0.62). 89.2% of the participants scored "clear in wording" and 75.6% of the participants qualified the OPACS appropriate for measuring attitude. Conclusions: The OPACS has good clarity of wording and good appropriateness for measuring attitude. The content validity is low which makes the current Dutch version not appropriate for measuring attitude of nurses in Dutch hospitals. Relevance to clinical practice: A measurement instrument to * Corresponding author. A. R. van Schelven et al. 8 get insight in the attitude of nurses is a first step to improve a negative attitude. A positive attitude of nurses is important to provide good quality of care to the increasing population older people in hospitals. Working with reliable and validated scales is important. This study gives direction to make the OPACS suitable for the Dutch situation.

Structural Validity and Reliability of the Dutch Older Patient in Acute Care Survey (OPACS), Measuring Nurses Attitude towards Older Patients

“…The number and form of adjustments needed is so rigorous that this will result in a new instrument which means that 1) it will not be comparable with the OPACS-US or any other existing instrument making cross-national comparisons impossible and 2) might not be worth the effort with other existing instruments possibly more suited to the Dutch culture in its origin. The study by van Schelven et al [9] also presented low content validity scores for 60% of the items in section B: general opinion for comparible reasons as with section A. Results from the content validity study by van Schelven [9], combined with this study suggest that the translated version of the OPACS in the Netherlands should not be used.…”

“…The study by van Schelven et al [9] also presented low content validity scores for 60% of the items in section B: general opinion for comparible reasons as with section A. Results from the content validity study by van Schelven [9], combined with this study suggest that the translated version of the OPACS in the Netherlands should not be used.…”

“…In a previous study by van Schelven et al [9], low content validity scores for 20 (58.8%) of the 34 items were presented for subscale A: practice experiences. By assessment of items with low content validity, several cultural reasons were found explaining the low rating by experts.…”

“…Furthermore, structural validity and reliability outcomes for the American OPACS proved to be good [7]. After translation towards the Dutch language, however, a majority of items were considered "not to be relevant" by experts, resulting in low content validity scores even though translation was considered good [9]. Why the content was not considered relevant for the Netherlands, and whether or not this is reflected in the construct is unknown, making it difficult to adjust the OPACS to the Dutch context.…”

Psychometric testing of the Older Patients in Acute Care Survey (OPACS) in Australian final year nursing students

“…Given the need for a reliable and valid measure of nurses’ knowledge and attitudes towards older hospitalized patients, the OPACS has been the focus of studies undertaken in the Netherlands and the United States of America (USA). Studies have used both qualitative (Malmgreen, Graham, Shortridge‐Baggett, Courtney, & Walsh, ; van Schelven et al, ) and quantitative methodologies (Dikken, Hoogerduijn, Klaassen, & Schuurmans, ; Dikken, Hoogerduijn, Lagerwey, et al, ). These studies have clearly identified the importance of the cultural setting in assessing the validity of the survey, and whilst the OPACS was developed and has been used in Australia (Courtney et al, ; Deasey, Kable, & Jeong, ), no studies have examined the OPACS’ reliability or validity in the Australian context.…”