Staff perceptions of the health care environment influence the delivery of person-centred care. Little research has examined staff perceptions of health care environments, in part because of a lack of validated instruments. This study reports the development and initial validation of the Staff Perception Of Residential care Environments (SPORE) instrument for use in residential care facilities for older people (RCFs).
Items developed in a British project on the design of care environments were translated and adapted for the Swedish care context as SPORE (24 items, 5 sub-scales). In a study of the physical environment and quality of care, 200 staff recruited from 20 RCFs sampled from across Sweden completed a questionnaire containing SPORE, the Person-centred Care Assessment Tool (PCAT), the Person-centred Climate Questionnaire – staff version (PCQ-S), and the Sheffield Care Environment Assessment Matrix –Sweden (SCEAM-S).
All SPORE sub-scales were normally distributed with good internal consistency reliability (Cronbach αs=.85-.88). Correlations between SPORE and PCAT sub-scales ranged from .301-.503, and between SPORE and PCQ-S sub-scales from .353-.557. RCF-level analyses (N=20) indicated that scores on SCEAM overall environment quality correlated significantly with all SPORE sub-scales (range=.496-.700). The SCEAM Comfort sub-scale was correlated with all SPORE sub-scales (range=.509-.721), while the SCEAM Privacy sub-scale was correlated (r=.428) with the SPORE Staff Facilities sub-scale. The SPORE Working and Caring for Residents sub-scale was correlated with SCEAM cognitive support (r=.502) and physical support (r=.566) sub-scales.
The SPORE instrument demonstrated good psychometric properties and its sub-scales an excellent range of associations with staff perceptions of person-centred care and with objective assessments of the physical environment. Further validation is required, but the SPORE instrument has potential for understanding how staff perceptions of the RCF environment relate to the delivery of person-centred care.