Multidimensional measure of instrumental support in transitional care – design and pilot test of a questionnaire assessing instrumental support among older adults with chronic diseases

Background Previous studies indicated that poor quantity and quality of instrumental support are one of the main barriers in the application of transitional care. Instrumental support, as one common function of social support, is the provision of financial assistance, material goods, or services. The purpose of our study is to develop an Instrumental Support in Transitional Care Questionnaire (ISTCQ) and use this questionnaire to make an assessment among older adults with chronic diseases. Methods The draft questionnaire was examined by 18 experts from different professional fields performing three rounds of content validity testing with the Delphi method. Afterward, we conducted a pilot test recruiting 174 participants as a convenience sample in Nantong, China. The construct validity was confirmed via exploratory factor analysis and reliability was assessed using Cronbach's alpha. Results The authority coefficient of experts was 0.74-0.99 and Kendall harmony coefficient W was 0.381. The exploratory factor analysis indicated that the questionnaire can be interpreted by three factors: namely, anticipated support (items 1, 2, 3, 4), received support (items 5, 6, 7, 8) and support satisfaction (items 9, 10, 11, 12). These three factors (eigenvalues > 1 and factor loading > 0.4) explained 69.128% of the total variance. Furthermore, the calculation of Cronbach's alpha and test-retest reliability have shown good reliability among each dimension of the 12-item questionnaire (Cronbach's alpha 0.711-0.827, test-retest reliability 0.704-0.818). Conclusion Results from the pilot test demonstrated excellent reliability and validity of ISTCQ through each dimension and as an entire. Keywords: Transitional care, Instrumental support, Older adult, Chronic disease, Questionnaire