Development of a competency scale for rehabilitation professionals supporting community-based activities for older residents in Japan

This study aimed to create a competency scale for rehabilitation professionals who support community-based activities for older residents.

A survey was mailed to 440 facilities selected via the Internet, and rehabilitation professionals supporting community-based activities for older residents were asked to respond. The survey was conducted using a self-administered, unmarked questionnaire regarding the basic participant attributes and proposed competency items to be acquired. The respondents were asked to respond on a six-point scale. The proposed competency items comprised 50 items in a tentative scale version established from keywords identified from a previous study. In creating the scale, a pretest was conducted by six physical and occupational therapists experienced in providing support for community-based activities for older residents to review the text’s plainness and validity, and repeated revisions were made to the scale. The obtained data were first reviewed for the presence or absence of ceiling or floor effects. Next, we conducted an Item-Total (I-T) correlation analysis to confirm the correlation coefficient between each item and the total score, followed by an exploratory factor analysis to examine the scale’s factor structure. Subsequently, the model fit of the obtained factor structure was confirmed using a covariance structure analysis, followed by verification of the created model’s construct validity. The goodness of fit of the model was determined using the GFI, AGFI, CFI, and residuals. Moreover, we assessed the model using RMSEA. To assess the scale’s reliability, Cronbach's α coefficient was calculated for the total score and the scores for each factor; moreover, internal consistency was verified.

Among the 440 facilities surveyed, 260 responded (response rate 59.1%), with 609 people from these facilities responding. The average (standard deviation) number of patients per facility was 2.3 (1.6) (range 0–10). Among them, responses from 607 people, excluding two who did not respond, were considered valid. Regarding occupations, 417, 157, and 28 were physical, occupational, and speech therapists, respectively. The final competency scale had a three-factor (knowledge and attitude, ability to mediate group activities, and clinical practice skills) structure comprising 20 items. Model fit and internal consistency were good and demonstrated good reliability and validity.

This study established a competency scale for rehabilitation professionals who provide support for community-based activities for older residents. Our findings indicate that rehabilitation professionals who support resident-oriented, community-based activities for older residents should have the attitude and knowledge of supporters, mediation skills, and the clinical skills of rehabilitation therapists.

Reference to the scale items could inform the provision of support by rehabilitation professionals for community-based activities as well as reduce among-rehabilitator differences in terms of the content and quality of support.