Validity and reliability of the Norwegian Adult Social Care Outcomes Toolkit (ASCOT CH4 and INT4) in three long-term care settings
摘要
The Adult Social Care Outcomes Toolkit (ASCOT INT4 and CH4) for users of long-term care (LTC) services was translated into Norwegian. ASCOT assesses how LTC services may protect, improve or restore care recipients’ quality of life. The aim of this paper was to assess the psychometric properties of the Norwegian ASCOT for use in older adults in three LTC settings: nursing homes, sheltered housing and homecare.
MethodsCross-sectional data were collected between October 2022 and January 2024. The sample included 470 care recipients aged 65 years or older receiving LTC services in three municipalities in Norway. We used ASCOT INT4 and CH4 to collect information on eight domains of current and expected care related quality of life (CRQoL). We used exploratory factor analyses to assess the assumed one-dimensional structure of the ASCOT instruments and Cronbach’s alpha to describe internal consistency. Construct validity was examined using bivariate correlations of previously established associations among the different ASCOT domains and with health-related quality of life and sociodemographic factors. Differences between care settings were assessed with analyses of variance.
ResultsThe analytical sample comprised of 184 residents from nursing homes,138 from sheltered housing and 148 persons receiving homecare services. Factor analyses supported a single underlying factor but factor loadings for the Dignity domain were sub-optimal (< 0.30) in nursing homes and sheltered housing. Cronbach’s alpha for current CRQoL was 0.70 in the total sample and ranged from moderate (0.67 in nursing homes) to good (0.71 in sheltered housing and 0.75 in homecare services). Bivariate correlations of ASCOT with relevant variables were largely consistent with previous studies and associations were higher for expected than current CRQoL. This assessment provides evidence to support the validity and reliability of the Norwegian ASCOT.
ConclusionsCurrently there are no other instruments assessing care-related aspects of older adults’ quality of life available in Norway. ASCOT provides a satisfactory reliable and valid measure of CRQoL in older adults receiving LTC, which goes beyond assessing functional capacity and health. Future research assessing different aspects of validity and reliability will further strengthen its applicability for evaluation purposes of Norwegian LTC.