Instruments to assess self-neglect among older adults: A systematic review of measurement properties

Objective: To critically appraise, compare, and summarize the measurement properties of existing instruments that assess self-neglect among older adults. Methods: Eight electronic databases (PubMed, Scopus, Embase, CINAHL Plus with Full Text, Web of Science, PsycINFO, China National Knowledge Infrastructure, and WanFang Data) were searched from their inception to September 6, 2020. The methodological qualities of the included studies on measurement properties were assessed by using the COnsensus-based Standards for selection of health Measurement INstruments (COSMIN) methodology for systematic reviews of Patient-Reported Outcome Measures (PROMs). Results: Among the 1184 studies identified, 47 full-text studies were assessed further for their eligibilities. A total of 8 studies were eventually included. The methodological quality of content validity for relevance, comprehensiveness, and comprehensibility of all instruments in this review was doubtful or inadequate. The methodological quality of structural validities in the majority of the studies were very good, while the quality of hypothesis testing for construct validity was doubtful. The internal consistency was assessed by calculating Cronbach's alpha coefficient in all studies. Some measurement properties (e.g., cross-cultural validity/measurement invariance, measurement error, and responsiveness) were not assessed in the reviewed studies. Conclusions: This systematic review provides a comprehensive overview of the measurement properties of elder self-neglect instruments. Among the eight instruments identified, none of them demonstrate better properties than any other. Future studies are suggested to use COSMIN methodology as guideline to examine the measurement properties of the developed instruments. Instruments with rigid measurement properties are urgently needed to assess self-neglect among older adults to provide the necessary and valuable information on this particular phenomenon. (c) 2021 Elsevier Ltd. All rights reserved.

Automated summary

This systematic review critically evaluated the measurement properties of instruments assessing self-neglect among older adults. Most instruments demonstrated methodological issues with content validity, while structural validity was generally good. Future studies should consider using the COSMIN methodology for evaluating instrument properties.