Development of an Assessment Tool for Vertical Accessibility in Spanish Homes

PMCID: PMC12173148

PMID: 40526819

DOI: 10.1002/nop2.70243

Journal: Nursing open

Publication Date: 2025-6-17

Authors: Jiménez–Arberas E, Fernández Méndez I, Varela GR, Fernández FF

Key Points

• First validated, comprehensive accessibility assessment tool adaptable across diverse populations and environments
• Achieved excellent psychometric properties with global fit indices (CFI = 0.999, RMSEA ≤ 0.001)
• Enables personalized intervention strategies based on individual environmental interactions rather than diagnostic categorization

Summary

This study addresses a critical gap in accessibility assessment by developing and validating the Home Environmental Scale of Accessibility (HESA), a comprehensive instrument designed to evaluate vertical accessibility across different home environments. Unlike existing tools that focus on specific disabilities or elderly populations, the HESA provides a holistic, context-independent approach to assessing environmental barriers and facilitators that impact individual occupational performance.

Through a rigorous psychometric validation process involving exploratory and confirmatory factor analyses, researchers developed a 48-item scale with four key subscales: exterior and building entrance, horizontal mobility, vertical mobility, and home interior access. The instrument demonstrated excellent statistical properties, with robust fit indices and reliability measures (Cronbach's α ranging from 0.700-0.780), suggesting it can be a valuable tool for occupational therapists, healthcare professionals, and rehabilitation specialists to systematically evaluate home accessibility and design targeted intervention strategies.