Development of a Delirium and Dementia Self Efficacy Scale

Tuesday, 19 November 2013: 10:00 AM

Linda Baas, PhD, CS-ACNP
Nursing Administration, The Christ Hospital, Cincinnati, OH
Joy Dienger, RN, PhD
Nursing Administration, Tri Health, Inc., Cincinnati, OH
Clarissa Rentz, RN, MSN, GCNS-BC
Alzheimer's Association, Cincinnati, OH
Janet Milne, RN, MSN, GNP
Cincinnati Chapter of the Alzheimer's Association, Cincinnati, OH

Learning Objective 1: identify 2 scales within the Delirium Dementia Self Efficacy Scale.

Learning Objective 2: identify 2 uses of the Delirium Dementia Self Efficacy Scale

With the increased number of elderly patients seen in practice, it is imperative that nursing staff feel confident caring for patients with delirium or dementia.  No published Delirium/Dementia Self-Efficacy (DDSE) tool could be found. For an intervention study, a chapter of the Alzheimer’s Association and two Magnet designated teaching hospitals developed the 24 item DDSE designed to assess confidence in ability to perform cognitive processes and skills required when caring for a patient at high risk for or experiencing delirium. The study was approved by the IRBs at both institutions and involved staff from four medical-surgical or telemetry adults units. The sample consisted of nurses (n=167) and patient care assistants (PCA) (n=67) who were primarily female (84.3%), Caucasian (81.4%) with a mean age of 33 (±9.9) years with 8.3 (±8) years in health care.  Reliability and validity of the DDSE are reported here.  Two items were deleted due to poor performance resulting in a Cronbach alpha of .92. Principal Components with varimax rotation was used to assess construct validity of the remaining 22 items. Two factors meeting accepted criteria for item loading emerged: (1) cognitive performance that included items related to obtaining data and planning care; (2) skill performance that included tasks and behavioral aspects of care and communication.  There was little difference when the analysis was performed for only for the RNs or the PCAs therefore the group was combined for the final configuration.  Of interest, there was a significant correlation between years in healthcare and overall self-efficacy (r=.19, p=.01) and the cognitive performance scale (r=.192, p=.001), but not on the skill performance scale. The DDSE is a psychometrically sound tool that others may find helpful in assessing the perceived ability of staff in providing care to patients at risk for delirium.