Development and Psychometric Evaluation of the Caring Scale for Institutionalized Elders

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A scale that measures the efficacy of care from the perspectives of institutionalized older adults is needed to meet the growing need for better caring knowledge and skills among nurses and caretakers working in long-term care facilities. The currently available tools are insufficient for measuring the caring-related interactions of caretakers with institutionalized older adults.


The aim of this study was to develop and explore the psychometric structure of a caring scale for institutionalized older adults.


The scale development process took place in two stages. In the first stage, a 34-item Caring Scale for Institutionalized Elders was generated using literature reviews and interviews with institutionalized older adults. Twenty-nine items were retained after item analysis and content validity testing, and then 19 items were retained after an exploratory factor analysis of 300 institution-dwelling older adults. The factor structure and reliability were further tested in 216 older adults using confirmatory factor analysis. The second stage provided evidence of the validity and reliability of the developed scale. This study was conducted between 2011 and 2013 in Taiwan.


Confirmatory factor analysis indicated that a 12-item scale with a two-factor structure best fits the data (χ2 =106.990, df = 53, p < .001, χ2/df ratio = 2.019, goodness-of-fit index = .926, comparative fit index = .958, Tucker–Lewis index = .948, root mean square error of approximation = .069). This scale had acceptable Cronbach’s α values (range = .827–.907).


This scale has satisfactory validity and reliability for measuring the efficacy of care that is provided to institutionalized older adults. Further studies are necessary to test the applicability of this scale to other populations.

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