title: Thriving in long-term care facilities: instrument development, correspondence between proxy and residents' self-ratings and internal consistency in the Norwegian version.
abstract: OBJECTIVE
  To develop an instrument for measuring thriving among residents in long-term care facilities, to assess the correspondence between proxy ratings and self-report and the internal consistency of the Norwegian version.
  
  
  BACKGROUND
  The instrument was developed from the life-world concept of thriving and thereby has a different theoretical basis than existing 'dementia related' quality-of-life instruments. Thriving relates the experience of older persons to the place where they live. Proxy instruments need to be developed for residents in long-term care facilities who are not able to report their subjective experiences.
  
  
  METHODS
  Instrument development using cross-sectional survey design.
  
  
  METHODS
  The instrument was developed in three versions (resident, family and staff) from a theory on thriving. Forty-eight triads consisting of a resident, family member and primary nurse from 12 Norwegian nursing homes participated. Data collection took place between March-December 2011. Inter-rater agreement between the groups was assessed by Cohen's kappa coefficient (weighted). Internal consistency was evaluated by Cronbach's alpha. Homogeneity was explored through item-total correlations.
  
  
  RESULTS
  Agreement between residents, family members and staff was poor or fair (<0.41) in six of 38 items. These items were excluded. The 32-items instrument had satisfactory Cronbach's alpha values in each of the three samples and satisfactory homogeneity as item-total correlations was substantial without being excessive and thus indicated that items were measuring the same construct.
  
  
  CONCLUSIONS
  The instrument appears to have internal consistency and enable reliable proxy measures of the thriving construct. Further psychometric assessment including checking for possible item redundancy is needed.
authors: Lovisenberg Diaconal University College, Oslo, Norway.
authors: Ådel
authors: Å
authors: Bergland
authors: Marit
authors: M
authors: Kirkevold
authors: Per-Olof
authors: PO
authors: Sandman
authors: Dag
authors: D
authors: Hofoss
authors: Tove
authors: T
authors: Vassbø
authors: David
authors: D
authors: Edvardsson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D007297:Inpatients / Q000523:psychology*; D008134:Long-Term Care; D008297:Male; D009664:Norway; D009735:Nursing Homes
keywords: geriatric nursing; instrument development; long-term care; nurses; nursing home residents; proxy assessment; thriving