Development and validation of assistance needs assessment scale of the home-dwelling older adults.

BACKGROUND: With the acceleration of population aging, identifying and addressing the unmet assistance needs of home-dwelling older adults has become increasingly important. This study aimed to develop and validate a reliable and practical assessment tool to identify such needs. METHODS: A descriptive qualitative study was conducted using semi-structured interviews with home-dwelling older adults in two communities in Wuhan, China. Based on the qualitative findings and literature review, an initial item pool was developed, followed by expert consultation to construct a draft scale. A cross-sectional survey was then conducted in communities across four central Chinese cities. Item analysis and psychometric testing were performed to finalize the scale. RESULTS: The finalized scale consists of 27 items across four dimensions: daily assistance, health maintenance, visitation and communication, and social interaction. A total of 380 older adults participated in the study, with 170 used for item screening and 210 for validation. Confirmatory factor analysis showed good model fit (CFI= 0.951, TLI = 0.946, RMSEA = 0.068). Standardized factor loadings ranged from 0.67 to 0.94. The scale demonstrated excellent internal consistency, with Cronbach's α ranging from 0.943 to 0.968, and met all reliability and validity standards. DISCUSSION: The developed scale has sound psychometric properties and is a reliable tool for assessing the unpaid assistance needs of home-dwelling older adults. It holds promise for guiding community service planning, public welfare resource allocation, and policy development in the context of population aging.