Knowledge And Attitudes Of Health Care Providers Toward Sexuality In The Institutionalized Elderly PDF Download

Healthcare provider practices around older adult sexuality are increasingly the focus of scholarship. Researchers use available scales to study health worker knowledge and behavior in their research. This dissertation argues the need for a new scale, because the available measures are dated and do not account for changes in attitudes and medical advances over three decades. After a review of the increasing role of physicians, social workers, and other health workers providing care for sexual issues throughout history, I describe available scales for measuring knowledge and behaviors about older adult sexuality and review research that employs them. The purpose of the dissertation was to develop a contemporary measure regarding older adult sexuality practices among health workers. I utilized a two-phase plan following Bowen and Guo's 12-step mixed-method approach for scale development (2012). Phase I included a literature review and qualitative interviews with experts on older adult sexuality regarding the construct. Then I created a universe of items, reviewed them with the experts, and revised items. In Phase II, I tested the items with 155 healthcare providers and conducted analysis for reliability and validity. Based on the analysis, I culled items to create a shortened scale. I proposed a scale consisting of 52 items with three subscales: a 25-item Knowledge subscale, a 13-item Attitude subscale, and a 14-item Behavior subscale. The Knowledge subscale showed poor internal reliability (KR-20 = .625). The Attitudes (alpha = .825), and Behavior (alpha = .837) subscales showed good internal reliability. I also evaluated content validity and criterion-related validity for the subscales. Flaws in the methods and analysis make the 52-item proposed scale conceptually unsound. Limitations in generating the pool of items, evaluating the items, and testing reliability and validity did not produce a viable scale. I analyze problems with the methodological approach and propose a redesign that corrects for flaws in the approach employed here. I will use an inductive, social justice model that expands scale development to include interviews with practitioners and older adults. I conclude with a number of research, practice, and policy implications that will result from a redesigned scale.