Advertisement

Reliability and validity of home-visit nursing quality indicators for children with medical complexity in Japan

Published:December 21, 2021DOI:https://doi.org/10.1016/j.pedn.2021.11.027

      Hightlight

      • Home-visit nursing plays important roles to support increasing number of CMC.
      • Home-visit nursing quality indicator guidelines exclusive to CMC are needed.
      • Developed Home-visit Nursing Quality Indicators for Children with medical complexity.

      Abstract

      Purpose

      This study aims to examine the reliability and validity of Home-visit Nursing Quality Indicators for Children (HNQIC) with medical complexity in Japan that will enable measuring the quality of services provided by home-visit nursing agencies (HNA) for children with medical complexity (CMC) and their families.

      Design and methods

      This study employed a model that measures medical quality as proposed by Donabedian in a conceptual framework. The HNQIC is comprised of a total of 42 items with responses in 5-point Likert scale: 8 items in “Structure”, 24 items in “Process”, and 10 items in “Outcome”. A self-rating questionnaire survey was administered and responses from 57 home-visit nursing agencies were analyzed. An exploratory factor analysis was performed to examine the validity of the construct, and a covariance structure analysis was performed to examine the structural validity of the model that measures medical quality.

      Results

      The “Structure” and “Process” sections included 28 items in 5 factors, and the “Outcome” section included 7 items in 3 factors. The Cronbach's α coefficient for all of the items of “Structure” and “Process” was 0.93, and that of “Outcome” was 0.76. As a result of a covariance structure analysis, we obtained following goodness-of-fit indices: χ2 / df = 1.41, GFI = .897, AGFI = .794, CFI = .926, and for the coefficient of determination .14 ≤ R2 ≤ .68.

      Conclusions

      As the statistical validity of the HNQIC was confirmed, we determined the goodness-of-fit indices of the model to be acceptable.

      Practice implications

      The findings suggested that the HNQIC can be used as a quality indicator to access care effects objectively to provide better support.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      References

        • Altman L.
        • Zurynski Y.
        • Breen C.
        • Hoffmann T.
        • Woolfenden S.
        A qualitative study of health care providers’ perceptions and experiences of working together to care for children with medical complexity (CMC).
        BMC Health Services Research. 2018; 18: 70-111
        • Arai Y.
        • Kumamoto K.
        • Sugiura M.
        • Washio M.
        • Miura H.
        • Kudo K.
        Development of the home care quality assessment index (HCQAI).
        The Japan Geriatrics Society. 2005; 42 (In Japanese): 432-443
        • Berry J.G.
        • Hall M.
        • Cohen E.
        • O’Neill M.
        • Feudtner C.
        Ways to identify children with medical complexity and the importance of why.
        The Journal of Pediatrics. 2015; 167: 229-237
        • Cohen E.
        • Lacombe-Duncan A.
        • Spaldong K.
        • Maclnnis J.
        • Nicholas D.
        • Nrayanan U.
        • Friedman J.N.
        Integrated complex care coordination for children with medical complexity: A mixed-methods evaluation of tertiary care-community collaboration.
        BMC Health Services Research. 2012; : 12
        • Develles R.F.
        Scale development: Theory and applications.
        2nd ed. Sage, Thousand Osaks, CA2003
        • Donabedian A.
        Quality of care: problems of measurement. II. Some issue in evaluating the quality of nursing care.
        American Journal of Public Health. 1969; 59: 1833-1836
        • Dondi R.
        • Casanova G.
        Quality assurance indicators of long-term care in European countries.
        in: ENEPRI research repot, no.110, April 2012. 2012
        • Fleming J.W.
        Home health care for children who are technology dependent.
        Springer Publishing, New York2004
        • Foster C.C.
        • Agrawal R.K.
        • Davis M.M.
        Home health care for children with medical complexity: Workforce gaps, policy, and future directions.
        Health Affairs. 2019; 38: 987-993
      1. Japan Visiting Nursing Foundation New manual for the establishment, operation, and assessment of home-visit nursing agencies. 3rd ed. National Association for Visiting Nurse Service Publishing, Tokyo, Japan2016: 163-171
        • Kaiser H.F.
        • Rice J.
        Little Jiffy Mark IV.
        Educational and Psychological Measurement. 1974; 34: 111-117
        • Kita M.
        • Itou K.
        Trends and issues in outcome research for home healthcare support for elderly persons requiring care in Japan.
        Journal of Japan Academy of Home Care. 2007; 11 (In Japanese): 72-77
        • Lawrence P.R.
        • Feinberg I.
        • Spratling R.
        The relationship of parental health literacy to health outcomes of children with medical complexity.
        Journal of Pediatric Nursing. 2021; 60: 65-70
        • Matsuzawa A.
        • Shiroki Y.
        • Arai J.
        • Hirasawa A.
        Care coordination for children with medical complexity in Japan: Caregivers' perspectives.
        Child: Care, Health and Development. 2020; 46: 436-444
        • Ministry of Health, Labour and Welfare
        “Nursing care service information disclosure system” for searches of nursing care service agencies and life related information.
        (Accessed on 5 June, 2019)
        • Ministry of Health, Labour and Welfare
        Outline of the 2019 survey of long-term nursing care service facilities and agencies.
        (Accessed on 16 October, 2021)
        • Ministry of Health, Labour and Welfare
        Special survey on the verification of results of the medical fee revision in 2016: Survey of implementation conditions in home medical care and home-visit nursing, including a survey of evaluation influence depending on severity and resident status.
        2020: 3-10 (Accessed on 3 March, 2021)
        • Ministry of Health, Labour and Welfare
        Trends in support programs for children with medical complexity (CMC).
        (Accessed on 10 March, 2021)
        • Nageswaran S.
        • Golden S.L.
        Improving the quality of home health care for children with medical complexity.
        Academic Pediatric. 2017; 17: 665-671
        • National Association for Visiting Nurse Service
        2018 Health promotion project for the elderly “Research project for improving the quality of services using ICT in long-term care insurance service providers”.
        in: Second edition of self-assessment guidelines for home-visit agencies. 2019 (Accessed on 29 March, 2021)
        • Nishi R.
        • Enomoto A.
        • Taguchi R.
        Supply and demand situation of home-visit nursing station for children requiring medical care at home by prefecture.
        Kyoritsu Journal of Nursing. 2015; 2 (In Japanese): 33-38
        • Nishi R.
        • Hakamada-Taguchi R.
        Actual conditions and related factors in which visiting nurses identify of information provision case might be abused scenes of at-home children with severe motor and intellectual disabilities.
        The Journal of Child Health. 2020; 79: 36-45
        • Oshio A.
        Psychological survey data analysis by SPSS and Amos.
        in: Factor analysis / covariance structure analysis. 3rd ed. Tokyo Tosho Co., Ltd, Tokyo, Japan2019: 157
        • Otsuki N.
        • Fukui S.
        • Sakaguchi Y.
        Measuring the benefits of respite care use by children with disabilities and their families.
        Journal of Pediatric Nursing. 2020; 53: 14-20
        • Polit D.F.
        • Beck C.T.
        Nursing research principles and laws.
        2nd ed. Igaku-Shoin, Tokyo, Japan2008: 435-436 (Translated by Kondo, J. (2010). in Japanese)
        • Robert J.R.
        The history of quality measurement in home health care.
        Clinical Geriatrics Medicare. 2009; 25: 121-134
        • Rogers J.
        • Reed M.P.
        • Blaine K.
        • Manning H.
        Children with medical complexity: A concept analysis.
        Nursing Forum. 2021; 2021: 1-8
        • Sakagami Y.
        • Kohira Y.
        • Shirai F.
        • Konishi K.
        Development of indices evaluating quality of care provided by in-home nursing facilities for children with constant medical care.
        The Journal of Child Health. 2021; 80: 583-593
        • Sawaguchi M.
        • Yamaji Y.
        • Ota E.
        • Tamura M.
        Survey on the use of home-visit nursing care services for children.
        Journal of Japan Academy of Home Care. 2019; 23 (In Japanese): 19-27
        • Shaughnessy P.W.
        • Crisler K.S.
        • Schelenker R.E.
        • Arnold A.G.
        Outcomes across the care continuum, home health care.
        Med Care. 1997; 35 (Supplement): NS115-N123
        • Shimanouchi S.
        Outcome evaluation of home care for use in the field - To improve the quality of the care.
        Minerva Shobo, Kyoto, Japan2018
        • Suzuki S.
        • Sato I.
        • Emoto S.
        • Kamibeppu K.
        Physio-psychological burdens and social restrictions on parents of children with technology dependency are associated with care coordination by nurses.
        Journal of Pediatric Nursing. 2017; 36: 124-131
        • Wojner A.W.
        Outcomes management: Applications to clinical practice.
        in: Application of scientific healthcare improvement considerations to clinical practice, Tokyo. Japanese Nursing Association Publishing Company, Japan2001: 47-49 (Translated by Ibe T and Hayano M (2003): Outcome management)
        • World Health Organization
        World health statistics.
        2018: 25 (Accessed on 20 March, 2021)