Development and psychometric properties of the Joy-of-Life Scale in cognitively intact nursing home patients

Aim To develop and psychometrically test the Joy-of-Life Scale. The research question addressed evidence related to the dimensionality, reliability and construct validity, all of which considered inter-related measurement properties. Methods Cross-sectional data were collected during 2017-2018, in 27 nursing homes representing four different Norwegian municipalities, located in Western and Mid-Norway. The total sample comprised 188 of 204 (92% response rate) long-term nursing home patients who met the inclusion criteria: (i) local authority's decision of long-term nursing home care; (ii) residential time 3 months or longer; (iii) informed consent competency recognised by responsible doctor and nurse; and (iv) capable of being interviewed. Results Exploratory and confirmative factor analyses clearly suggested a unidimensional solution. Five of the original 18 items showed low reliability and validity; excluding these items revealed an acceptable model fit for the one-dimensional 13-item measurement model. Reliability and construct validity were acceptable, indicating good internal consistency. Conclusion Significant factor loadings, several goodness-of-fit indices and significant correlations in the expected directions with the selected constructs (anxiety, depression, self-transcendence, meaning-in-life, sense of coherence, nurse-patient interaction and quality of life) supported the psychometric properties of the Joy-of-Life Scale. Impact The 'Joy-of-Life-Nursing-Home' is a national strategy for promoting quality of life, meaning and quality of life among nursing home patients in Norway. Therefore, exploring the essence of the Joy-of-Life phenomenon and developing a measurement scale assessing joy-of-life in this population is important for the further development of care quality in nursing homes.