Abstract
Purpose
The purpose of this study was to test the reliability and validity of the Care Plan
Checklist for Evidence of Person-Centered Approaches for Behavioral and Psychological
Symptoms Associated with Dementia (BPSD).
Methods
This study used baseline data from the first cohort of a larger randomized clinical
trial testing the implementation of the Evidence of Integration Triangle for BPSD.
Fourteen settings volunteered to participate, 8 from Maryland and 6 from Pennsylvania,
and a total of 137 residents were recruited. In addition to completing the Care Plan
Checklist for Evidence of Person-Centered Approaches for BPSD, assessments of depressive
symptoms (Cornell Scale for Depression in Dementia), resistiveness to care (Resistiveness
to Care Scale), and agitation (Cohen-Mansfield Agitation Inventory) were also completed
on each participant. Reliability was tested based on evidence of internal consistency
and inter-rater reliability. Construct validity was tested using a Rasch measurement
model to determine item fit and hypothesis testing using bivariate correlations. Item
mapping was also performed.
Results
The majority of the sample was female (69%), Caucasian (69%), non-Hispanic (98%),
and not married (78%). The mean age of the sample was 82.01 years (standard deviation = 11.44).
There was evidence of reliability based on internal consistency with a Cronbach alpha
of 0.96 and inter-rater reliability with correlations between 2 evaluators of r = 0.93,
P = .001. There was evidence of validity of the scale based on item fit as the infit
statistics and outfit statistics were all within the acceptable range with the exception
of the outfit statistic for the item focused on sexually inappropriate behaviors.
Lastly, there was evidence of significant relationships between the Care Plan Checklist
for Evidence of Person-Centered Approaches for BPSD and the Cornell Scale for Depression
in Dementia (r = 0.38, P < .001) and the Cohen-Mansfield Agitation Inventory (r = 0.44, P < .001). There was not a significant relationship between resistiveness to care and
scores on the Care Plan Checklist for Evidence of Person-Centered Approaches for BPSD
(r = −0.02, P = .86). There were 78 care plans that were so low in evidence of using appropriate
interventions that they could not be differentiated.
Conclusions
There was sufficient evidence for the reliability and validity of the Care Plan Checklist
for Evidence of Person-Centered Approaches for BPSD. Additional items should be considered
to better differentiate those low on the Checklist for Evidence of Person-Centered
Approaches for BPSD.
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Article info
Publication history
Published online: November 28, 2017
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© 2017 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
