Evaluation of the psychometric properties of a modified Chinese version of the Caregiver Task Inventory--refinement and psychometric testing of the Chinese Caregiver Task Inventory: a confirmatory factor analysis.

AIM: To test the reliability and validity of the modified Chinese version of the Caregiver Task Inventory. BACKGROUND: The original Caregiver Task Inventory was developed in 1983 by Clark and Rakowski in the USA. It was used to measure Chinese family caregivers' needs in Hong Kong. Its failure to evaluate the psychometric properties of the instrument measuring the needs of family caregivers across cultures limited its scientific rigor. DESIGN: A quantitative study method was used to test the psychometrics of the modified Chinese version of the Caregiver Task Inventory. METHODS: A convenience sample of 114 family caregivers completed the Caregiver Task Inventory in 2005 to test different aspects of the validity and reliability and confirm items of the short form of the Chinese Caregiver Task Inventory-25. RESULTS: The content validity of the 25 items of the Chinese Caregiver Task Inventory was validated by six experts, who assessed the correlation between caregiving tasks and the five refined sub-scales. The construct validity was determined by confirmatory factor analysis (CFA). The χ(2) goodness-of-fit, χ(2): df ratio, goodness-of-fit index (GFI), adjusted GFI and root mean square residual were obtained and used to assess the fit of the model. The internal consistency and stability of the Chinese Caregiver Task Inventory-25 were determined by Cronbach's method (0·93) and the internal reliability (item total correlation) for the five refined sub-scales ranged from 0·67-0·86. CFA and internal consistency analysis showed a strong degree of fit between the conceptualisation and the development of the measurement. CONCLUSIONS: The Chinese Caregiver Task Inventory-25 is a relevant and culturally appropriate research instrument to measure the needs of Chinese family caregivers. RELEVANCE TO CLINICAL PRACTICE: This study reveals that stroke nurses should assess the impacts of caregiving tasks on caregivers' physical and psychological stress levels prior to planning relevant interventions.

Seeking harmony in the provision of care to the stroke-impaired: views of Chinese family caregivers.

AIMS: To explore the coping strategies of Chinese family caregivers of stroke-impaired older relatives. BACKGROUND: Many stroke-impaired patients rely heavily on support from their families, and the daily lives of such family caregivers are severely impacted. However, services and support for family caregivers of stroke-impaired relatives in the home setting have received little attention. Appropriate and relevant information and support to family caregivers are important in facilitating the care-giving task. It is, therefore, necessary to understand the nature and demands of care-giving before planning specific educational and support programmes. DESIGN: Grounded theory. METHODS: Fifteen Chinese family caregivers of stroke-impaired older relatives were recruited and interviewed in 2003 and 2004. Theoretical sampling and constant comparative analysis were used to recruit the sample and perform data analysis. RESULTS: Seeking harmony to provide care for the stroke-impaired was the core category for describing and guiding the family care-giving process, with five main stages: (1) living with ambiguity, (2) monitoring the recovery progress, (3) accepting the downfalls, (4) meeting family obligations and (5) reconciling with harmony. These issues were seldom discussed openly with health professionals. CONCLUSIONS: The findings indicated that Chinese family caregivers determine their own needs by seeking harmony to continue to provide care without thinking about getting help from others or their own health problems. These findings help to define some of the complex dynamics that have an impact on the development of partnership care and might challenge nurses practising in the community. RELEVANCE TO CLINICAL PRACTICE: Community nurses should assess and understand the coping strategies of family caregivers and assist them to engage in stress-reducing practices. This is an important partnership to be formed in stroke care for family caregivers in the community. The study findings will guide further development of family care-giving aspects in nursing practice.

Problem-based learning: ancient Chinese educational philosophy reflected in a modern educational methodology.

Problem-based learning (PBL) has been widely adopted as a strategy by nurse educators all over the world. Many studies have been carried out to examine its process and outcomes. There are few studies discussing the relevance of PBL to students with different cultural background. This study reports the experiences of Chinese students in Hong Kong using PBL and explores if their experiences were compatible with the educational philosophy documented in traditional Chinese literature. The phenomenological approach was used in the treatment of data. The informants were students enrolled in the post-registration nursing degree programme at a university in Hong Kong during 1997-1998. A total of 94 journals were included in the analysis. Seven main themes emerged from the phenomenological analysis. They were the integration of knowing and doing, critical reflection and debate, individuality of learning, self-motivated learning, critical inquiry and independent thinking, timeliness of instruction and cooperative learning. This study provides evidence to show that PBL is an approach that is compatible with the Chinese way of learning. The result of this study shows that aspects of the modern PBL process harken back to an ancient Chinese learning philosophy that underpins Chinese learning today.

Evaluating the use of developmental action inquiry in constructing a problem-based learning curriculum for pre-registration nursing education in Hong Kong: a student perspective.

BACKGROUND: Developmental action inquiry (DAI) was chosen as the change strategy for introducing problem-based learning (PBL) in a pre-registration nursing programme. The central task was to transform the tutor and student participants to become collaborators in this curriculum reconstruction project. AIM: This paper expounds the way in which the action inquiry was constructed and in light of students' feedback analysis, the way in which PBL has made a difference in student learning was evaluated. DESIGN: Taking into consideration the change context and different group characteristics, the DAI was conducted in terms of two dynamically interlinked circles that formed partnerships between PBL core group members and tutors, and between tutors and students in coconstructing knowledge useful for PBL curriculum development. FINDINGS: The findings of the student evaluation questionnaire reveal that the majority of students felt PBL made a difference to their expectations of self, the student group and the teacher role in creating a facilitative environment to enhance learning. However, there was a significant difference among individual student group responses. The students' positive and negative PBL experience in self-learning, tutor-student interaction, and group-learning were identified as crucial factors contributing to these group variations. CONCLUSION: The evaluation findings show that a paradigm shift from teacher-centred to student-centred learning, from valuing self-learning to co-operative group-learning, and from theory-based to practice-based learning occurred among the students. DAI was found to be an effective change strategy for transforming participants to become collaborators in searching for useful knowledge and coconstructing the PBL learning context.