Psychometric evaluation of the current geriatric Institutional assessment profile: a tool for age-friendly care evaluation

Background: Assessing institutional readiness and geriatric care practices is critical for hospitals striving to become age-friendly. The Geriatric Institutional Assessment Profile (GIAP) evaluates hospital-based age-friendly care, emphasizing nurses’ knowledge, attitudes, and practice environment. However, the development of new versions and translations of the instrument requires a re-evaluation of its factor structure and psychometric properties to ensure effectiveness in evolving healthcare systems and applicability across diverse settings. Objective: To evaluate the psychometric properties of the current updated GIAP, using the Hebrew translation version, including construct validity, reliability, and item-level performance. Methods: A survey-based design was employed, involving 346 nurses from two hospitals, employed in departments caring for patients aged 65 and older. Psychometric evaluations included exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) to assess construct validity for the Geriatric Care Environment (GCE) scale and item analysis comprising difficulty, discrimination, and distractor effectiveness analysis for the general Geriatric Knowledge (GK) scale and Clinical Geriatric Knowledge (CGK) scale. Results: EFA identified four factors explaining 46.5% of the variance in the GCE scale: organizational values, age-sensitive care, and resource availability (human-related and operational). CFA confirmed the model’s fit (CFI = 0.901, RMSEA = 0.049). Item analysis of GK and CGK revealed moderate difficulty (mean DIF I = 51.9 and 60.4, respectively), and reliability indices (KR-20 = 0.58 for GK and 0.52 for CGK) were moderate for pilot testing of the dichotomized type of knowledge tests. Conclusions: The Geriatric Institutional Assessment Profile (GIAP) is valuable for the development and assessment of age-friendly hospitals. Examination of the modern GIAP’s factor structure and psychometric properties highlights its continuing adaptability and relevance. The current GIAP demonstrated robust construct validity and reliability for assessing geriatric-specific practices and knowledge among nursing staff, as well as reliability in a new language and cultural setting. This new examination of the GIAP’s psychometric properties and factor structure may help facilitate future research and more widespread practical use of the GIAP in additional populations and settings.