Mobility impairment affects the physical,
psychological, and social aspects of a care-dependent person’s life. Nursing
staff require competence to provide mobility care that is mobilitypromoting and
safe. Kinaesthetics is an approach taking into account these requirements. However,
it is unclear how competence in mobility care based on kinaesthetics is
defined, no suitable instruments are yet available to assess this competence
and no data exist about nursing staff’s levels of competence in mobility care.
Therefore, the purpose of this study was to develop and evaluate an assessment
of nursing staff’s competence in mobility care based on kinaesthetics to
finally improve care recipients' mobility and thereby quality of life and
nursing staff’s musculoskeletal health.

The study was carried out in three phases:
Phase I involved a concept development on nurses’ competence in kinaesthetics
including a literature review and a workshop with kinaesthetics experts (n=7)
as well as a systematic literature review about instruments assessing nurses’ skills
in patient mobilisation. In phase II, two assessment instruments, the
Kinaesthetics Competence Observation (KCO, score from 4-16) and the
Kinaesthetics Competence Self-Evaluation (KCSE, score from 4-16) were developed
and tested regarding content validity with kinaesthetics experts (n=23). In
phase III, a cross-sectional observational study (nursing staff=48,
residents=31) using the KCO and a survey (nursing staff=180) using the KCSE was
applied in three Swiss nursing homes. The data analysis methods used in this
study were content analysis, descriptive and inferential statistics including
factor and multivariate analysis.

Results of phase I revealed that competence
in mobility care based on kinaesthetics includes  knowledge, skills, attitude and a dynamic
state. In the systematic review, 16 observation instruments were described.
Phase II: The KCO (4 domains: interaction, support of the person, nurses’ own
movement, environment) and KCSE (4 domains: attitude, dynamic state, knowledge,
self-perceived skills) were developed based on the results obtained in Phase I.
Their content validity index was very good (KCO=1.0, KCSE=0.93). Phase III
results demonstrated acceptable preliminary psychometric properties of the new
instruments. Nursing staff’s self-assed average level of competence in mobility
care was very good (13, SD 1.44) and the observed average competence level was
good (10.8, SD 2.44). Higher competence levels in mobility care based on
kinaesthetics were positively correlated with amount of completed kinaesthetics
training, experience in nursing home care and rate of employment.

In conclusion, nursing staff’s competence
in mobility care can be self-evaluated efficiently using the KCSE. In order to
glean a more objective assessment, the KCO should be used alongside the KCSE.
Future research is necessary concerning psychometrics of both assessment instruments
and in the area of nursing staff’s competence development in kinaesthetics in
practice. Furthermore, inter-professional and international research on
guideline development is needed to enhance basic and continuing education in
mobility care for nursing staff. More advanced approaches of mobility care
could fundamentally change the quality of nursing care in the future.