Emotional Tone Coding Using an Abbreviated Rating Scale

Abstract

Introduction: The Emotional Tone Rating Scale (ETRS) is used to evaluate nursing communication with older adults in dimensions of care, respect, and control. Psychometric analysis of the original scale indicates that several of the 12 items overlap and that two, instead of three factors are indicated (control and person-centered). A scale was reduced to 8 items to diminish redundancy and reduce burden for raters. Background: This Pilot Study is part of a larger research study entitled Changing Talk to Reduce Resistiveness to Dementia Care. The specific aim of the larger study is to improve staff communication with nursing home residents who have dementia to reduce resistiveness to care (RTC). The intervention is a three-session staff training program on communication skills associated with avoiding RTC. The ETRS is used to evaluate the communication skills. Purpose: This study was conducted to evaluate whether the 8 and 12 item scales measure the same factors. Theoretical Framework: The ETRS is designed to measure nursing communication based on concepts and theories of person-centered care for older adults. Methodology: Twenty raters each listened to 20, 1 minute audio recordings of nursing home care, presented in a powerpoint presentation. These clips were previously rated using the 12-item scale. They rated the nurse's communication on the ETRS. Factor analysis was used to compare similarities of the original and abbreviated scales. Findings: Factor analysis revealed that the 12-item scale data and the 8-item scale data resulted in highly comparable negative correlations between person-centered and controlling scales. Factor analyses of the original 12-item scale and the 8-item scale produce similar solutions. Discussion: The two factors person-centered communication and controlling communication are similar with the shortened 8-item tool as with the previous 12-item scale the shortened version and will be used for future use. This shortened scale will help to reduce redundancies and rater burden.