高齢者のヘルスプロモーションにおけるエンパワーメント尺度の開発

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  • Development of the Empowerment Scale for the Elderly (ESE) in Health Promotion
  • コウレイシャ ノ ヘルス プロモーション ニ オケル エンパワーメント シャクド ノ カイハツ

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This study aimed 1) to construct an Empowerment Scale for the Elderly (ESE) in health promotion; and 2) to examine its validity and reliability. Empowerment for the elderly was defined as a concept consisting of three sub-constructs: 1) the perception of self-potential competence, 2) the recognized issues with interaction, and 3) an intention for positive action.<br> The study consisted of three phases. In the 1st phase, the focus-group interview data of 20 old persons who participated in an exercise-oriented health promotion program for the elderly were analyzed by a content analysis to develop question items of the scale. The content validity and the face validity of the scale were examined with public health nurses who supported the health promotion activities. In the 2nd phase, a provisional set of 23 items were selected by an exploratory factor analysis on another group of subjects (n=83). The 3rd phase tested the validity and the reliability of the scale based on the data of 383 old persons (aged 65-92 years) who participated in another health promotion program for the elderly in 29 small communities.<br> The results are as follows. 1) The exploratory factor analysis with promax rotation indicated three factors of the scale. As a result, this scale consisted of 12 items classified into 3 subscales. 2) The covariance structure analysis yielded a sufficient degree of fitness of the second-order structural equation model (χ2/df=2.234, GFI=0.942, AGFI=0.910, RMSEA=0.064). The factor structure of the scale generally agreed with Zimmerman’s concept of psychological empowerment, and hence the scale appears to have good construct validity. 3) The construct validity was supported by significant correlation between ESE and three scales (General self-efficacy scale, Helping effects scale, and Coping scale), with the correlation coefficients ranging from 0.74 to 0.22. 4) The Cronbach’s alpha coefficient for ESE and its three subscales ranged from 0.71 to 0.83, indicating sufficient reliability of the scale. The average of test-retest correlation coefficients was 0.71, which is an acceptable level of stability.<br> These results indicate that ESE is valid and reliable. This scale provides a useful tool for the evaluation of health promotion programs and nursing interventions for the elderly.

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