title: Development of two measures of client engagement for use in home aged care.
abstract: The aim of the study was to develop and validate measures of client engagement in aged homecare. The Homecare Measure of Engagement-Staff questionnaire (HoME-S) is a self-complete measure of six dimensions of client engagement: client acceptance, attention, attitude, appropriateness, engagement duration and passivity. The Homecare Measure of Engagement-Client/Family report (HoME-CF) is a researcher-rated interview which obtains client and/or family perspectives regarding frequency and valence of conversational and recreational engagement during care worker visits. Care workers (n = 84) completed the HoME-S and a measure of relationship bond with client. Researchers interviewed clients (n = 164) and/or their family (n = 117) and completed the HoME-CF, and measures of agitation, dysphoria, apathy and cognitive functioning. The HoME-S and HoME-CF demonstrated good test-retest and inter-rater reliability, and showed significant negative correlations with apathy, agitation and non-English-speaking background. Controlling for client and care service characteristics, a stronger care worker-client relationship bond and English-speaking background were independently associated with higher HoME-S scores, and apathy was independently associated with higher HoME-CF scores. In conclusion, the HoME-S and HoME-CF are psychometrically sound engagement measures for use in homecare. Clients who are apathetic or from non-English-speaking backgrounds may be less responsive to traditional care worker engagement strategies. Engagement may be augmented in clients who have stronger relationships with their care workers.
authors.affiliation: Dementia Collaborative Research Centre, School of Psychiatry, Faculty of Medicine, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Jess Rose
authors.initials: JR
authors.lastname: Baker
authors.affiliation: Dementia Collaborative Research Centre, School of Psychiatry, Faculty of Medicine, UNSW Australia, Sydney, New South Wales, Australia.
authors.forename: Fleur
authors.initials: F
authors.lastname: Harrison
authors.affiliation: Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Lee-Fay
authors.initials: LF
authors.lastname: Low
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001288:Attention; D019090:Case Management / Q000458:organization & administration*; D003142:Communication; D005260:Female; D006299:Health Services for the Aged / Q000458:organization & administration*; D006699:Home Care Services / Q000458:organization & administration*; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D010342:Patient Acceptance of Health Care; D010358:Patient Participation; D011369:Professional-Patient Relations; D015203:Reproducibility of Results; D012737:Sex Factors; D012959:Socioeconomic Factors
keywords: apathy; engagement; homecare; relationship bond