Psychometric Evaluation of the Making it CLEAR Questionnaire: A Resilience Measure for Older Adults

Abstract

Background and Objectives Previous efforts to develop a resilience measure for older adults have largely failed to consider the environmental influences on their resilience, and have primarily concentrated on the resilience of community dwelling older adults. Our objective was to validate a new multidimensional measure of resilience, the Making it CLEAR (MiC) questionnaire, for use with older adults at the point of discharge from hospital. Research Design and Methods This study tested the structure, validity and reliability of the MiC questionnaire. The questionnaire consists of 34 items, which assess the ‘individual determinants of resilience’ (IDoR) and the ‘environmental determinants of resilience’ (EDoR) across two subscales. 416 adults aged from 66 to 102 years participated. Exploratory factor analysis (EFA), item analysis, and linear regression were undertaken. Results The IDoR subscale contained six factors which were labelled ‘self-efficacy’, ‘values’, ‘interpersonal skills’, ‘life orientation’, ‘self-care ability’ and ‘process skills’. The EDoR subscale contained five factors related to ‘person-environment fit’, ‘friends’, ‘material assets’, ‘habits’ and ‘family’. Both subscales demonstrated acceptable convergent validity and internal consistency, while individual items showed acceptable levels of discrimination and difficulty. Discussion and Implications The study provides evidence supporting the validity and quality of the MiC questionnaire. The results suggest that the MiC questionnaire could be used to identify the resilience needs of older adults at the point of hospital discharge. However, future research should identify which items of the MiC questionnaire are associated with hospital readmission, in order to develop an easily applicable screening tool for clinical practice.

Self‐efficacy, resilience and healthy ageing among older people who have an acute hospital admission: A cross‐sectional study

“…The results confirm that co‐morbidities negatively contribute to healthy ageing among older people who have an acute admission, while greater self‐efficacy and resilience positively contribute to healthy ageing. Self‐efficacy was also positively associated with resilience, supporting previous literature identifying self‐efficacy as a key determinant of resilience (Whitehall et al, 2021 ). This suggests that increasing self‐efficacy may have the benefit of not only promoting healthy ageing but also enhancing resilience among older people in acute hospital settings.…”

“…Self‐efficacy is an intrinsic or personal resource that contributes to factors associated with healthy ageing and resilience among older people (Remm et al, 2021; Whitehall et al, 2021). It is defined as a person's belief in their capability to perform at a level required to succeed in an event that affects their life (Bandura, 1994).…”

Tools for measuring individual self-care capability: a scoping review

“…Table 1 presents the main characteristics of the 38 included self-care measurement tools. The majority ( n = 26; 68.4%) of tools originated from North America (24 from USA, two from Canada) while the remaining originated from the UK (SFS [ 25 ], MiC questionnaire [ 26 ]), Norway (LSCS [ 27 , 28 ]), Spain (ASA-R [ 29 ]), Finland (SCHDE [ 30 ]), the Netherlands (ASA-A) [ 31 ] SeMaS [ 32 ]) and Italy (SCI – Patient Version [ 33 ]). Four tools, the EQ-5D [ 34 ], SASS-14 [ 35 ], SSCII [ 36 ] and the SASE [ 26 ] resulted from international collaborations.…”

“… Self-reported / Staff System: 1–6-Likert scale (1: strongly disagree to 6 > strongly agree) Total points: 0–100 (obtained through linear regression from the initial 10–60). Higher score indicates higher activation 35 Making it CLEAR (MiC) questionnaire [ 26 ] 2021 UK Multidimensional measure of resilience for use with older adults at the point of discharge from hospital. 34 items assess individual determinants of resilience (IdoR, 21 items) & environmental determinants of resilience (EdoR, 13 items).…”

Longitudinal Associations Between Disaster Damage and Falls/Fear of Falling in Older Adults: 9-Year Follow-Up of Survivors of the 2011 Great East Japan Earthquake and Tsunami

“…With regards to community social capital, the results revealed that the effects of social cohesion were protective whereas social participation might increase fall risks. According to the person–environment fit theory, a harmonious social environment could enhance individual’s resilience ( Whitehall et al, 2021 ). However, social participation usually means venturing outside the home and facing more uncertainties, which easily increases the risk of falls.…”