Instrument development of the confidence in home care services questionnaire for use with elders and caregivers of Mexican descent

Mexican American elders use home care services less than non-Hispanic white elders, and a larger study is testing whether lack of confidence in home care services, measured by the Community Service Attitude Inventory, is a factor. In order to further develop the questionnaire for use with Mexican American elders and caregivers, qualitative interviews were conducted with Mexican American elders (n=5), Mexican American caregivers (n=5), and home care providers (n=5). Content analysis of interviews supported 2 dimensions: confidence and fear/worry. The research team developed 29 items from the dimensions. Testing of the items (n=15) suggested content validity and two additional items. The revised questionnaire was translated and tested for language equivalence in Spanish and English, assisted by a local community advisory council (n=9). Through collaboration, bicultural/bilingual teams and community partners refined 1 instrument that can be used to measure one of many barriers to equity in health care services with vulnerable populations. Thematic findings may be incorporated into nurses' interventions as they offer home care services to families.