2.1. Development of the Elderly Care Capacity Needs Questionnaire (ECCNQ)
Since the purpose of the tool is to assess the effectiveness and usefulness of geriatric nursing education, it is necessary to identify the capacity needs of geriatric nursing institutions and a set of curricula needed for geriatric nursing education. To ensure that all contents are included in the ECCNQ, a comprehensive review of the existing questionnaire's literature and content analysis are carried out.
An interview survey conducted in elderly care institutions in China pointed out that geriatric nursing development includes improving the professional quality of elderly nursing staff and professional nursing construction . The study points out that the improvement of elderly nursing quality mainly depends on professional nursing education. Systematic courses in geriatric nursing include life care, dementia care, dietary care, geriatric care, rehabilitation care, habilitation techniques, psychological care, communication skills, and intellectual management skills. From the perspective of the clinical needs of elderly care in China, another study believed that elderly nursing staff's core competencies were basic nursing knowledge, professional nursing competence, and professional qualifications . Meanwhile, professional ethics, psychological nursing, professional nursing, dementia nursing, rehabilitation nursing, and diet nursing should be highlighted. Based on the current situation of geriatric nursing teaching in China Vocational College, another research team suggests that the curriculum of geriatric nursing includes six modules: basic medical courses, basic nursing courses, nursing humanities courses, professional nursing courses, public elective courses, and practical courses . Among them, nursing professional course modules include nursing foundation, elderly nursing skills operation, geriatric clinical nursing, nursing interpersonal communication skills, community nursing, rehabilitation nursing for the elderly, psychological and spiritual nursing for the elderly, emergency nursing for the elderly, nutrition and diet therapy for the elderly.
According to Croft's study on the capacity needs of Australian nurses in geriatric care, it was found that geriatric nurses need specialized skills such as wound management skills, injection therapy, and palliative care . Japanese nurses need three years of formal learning experience, including basic medical courses, professional nursing courses, and the nursing practice process. Basic medical courses include an introduction to social welfare, welfare theory of the elderly, welfare theory of the disabled, rehabilitation exercise theory, social welfare assistance technology, psychological nursing for the elderly, introduction to home economics, medicine, mental health, introduction to nursing, nursing skills and disabled nursing . Japan's elderly specialist nurses have been thoroughly trained in their comprehensive abilities, including diagnosis and treatment, nursing, physical therapy, pharmacology, diet and nutrition, and nursing management. At the same time, they pay attention to multidisciplinary and interdisciplinary training. The training courses cover geriatrics, palliative care, psychological nursing, nursing research, geriatric health care, elderly acute and chronic disease management, and elderly wound care . Nursing education for the elderly in the United States started early, mainly with a bachelor's degree. Courses in elderly care include health assessment, basic nursing skills, supplementary courses (such as life cycle development, nutrition, pathophysiology, pharmacology), psychology, clinical care, community and public health care, ethics, and law [10, 11]. These curriculum systems combine basic knowledge with professional skills conducive to training practical nursing talents for the elderly.
Based on the literature review at home and abroad, combined with the suggestions of textbooks and monographs, a questionnaire item pool containing 40 items was initially formed after discussion with the research group [12, 13]. These items include professional ethics, organizational skills, dietary care, basic nursing skills, knowledge of human body structure, physiological knowledge, IT skills, nursing home management capability, equipment improvement skills, knowledge of introduction to social welfare, mental health care, geriatric care, professional standards, research skills, sociology, aesthetics, English and physical education, geriatric economics and property management. Laws and regulations related to the elderly, computer applications, ideology and politics, home design, pathology, microbiology, medical nursing, surgical nursing, five senses nursing, nurse-patient communication skills, rehabilitation, dementia care skills, psychological care skills, emergency care, hospital infection prevention and control, hospice care, health assessment, communication skills, organizational skills, safety and security, and Chinese health care skills.
Five nursing staff with more than five years of working experience in medical and health elderly care institutions were selected for a structured interview. Questions were reviewed by them to remove duplicates, combine concepts, and remove nonrelevant or outdated items. Finally, the ECCNQ is summarized into 12 dimensions, making the questions concise and quick to answer. The 12 dimensions include emergency care, health assessment, safety protection, knowledge of nosocomial infection, rehabilitation care, communication skills, cognitive impairment care, diet care, professional ethics, specialized care, hospice care, organizational skills.