The Turkish Version of Hydration Risk Assessment Tool in Older Patients: Cross-Cultural Adaptation and Psychometric Evaluation

Abstract

Objective: Dehydration is a common and serious issue among older adults, with significant implications for their health and well-being. Preventing dehydration in older adults requires a multifaceted approach that involves early identification of risk factors, accurate detection methods, targeted interventions, and ongoing monitoring to ensure adequate hydration. For this reason, the study was designed to assess the validity and reliability of the Turkish adaptation of the Northumbria Assessment of Hydration (T-NoAH) among older patients. Materials and Methods: A methodological and descriptive approach was utilized in this investigation. After establishing linguistic validity, the study was conducted with a convenience sample of 360 older patients within 24 hours of admission to the hospital, using a descriptive information form and T-NoAH for data collection. The analyses performed included exploratory factor analysis, confirmatory factor analysis (CFA), discriminant validity assessment, internal consistency evaluation via Cronbach’s alpha, item-total correlation analysis, examination of ceiling and floor effects, and Hotelling’s T-squared test. Predictive accuracy was examined in the sample using a receiver operating characteristic curve, with serum osmolality as the reference test. Results: The tool had sufficient linguistic validity. The instrument consisting of 8 items and one factor was identified. This factor explained 39.24% of the total variance. Model fit indices were ≥0.90, as per CFA. Cronbach’s alpha was determined to be 0.73. There was no response bias identified, and there were no floor or ceiling effects. The optimal cut-off point (5 or more) showed sensitivity (70%) and specificity (89%) (area under the curve =0.795, 95% confidence interval, p<0.001) compared to non-dehydration group. Conclusion: This tool is a short, easily understandable and applicable measurement for assessing older patients’ hydration risk. It can be used by nurses to evaluate the risk of dehydration in older patients and to implement and evaluate effective interventions according to risk situations.