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Caronni A, Ramella M, Arcuri P, Salatino C, Pigini L, Saruggia M, Folini C, Scarano S, Converti RM. The Rasch Analysis Shows Poor Construct Validity and Low Reliability of the Quebec User Evaluation of Satisfaction with Assistive Technology 2.0 (QUEST 2.0) Questionnaire. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1036. [PMID: 36673791 PMCID: PMC9859407 DOI: 10.3390/ijerph20021036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 01/02/2023] [Accepted: 01/03/2023] [Indexed: 06/17/2023]
Abstract
This study aims to test the construct validity and reliability of the Quebec User Evaluation of Satisfaction with assistive Technology 2.0 (QUEST)-device, an eight-item questionnaire for measuring satisfaction with assistive devices. We collected 250 questionnaires from 79 patients and 32 caregivers. One QUEST was completed for each assistive device. Five assistive device types were included. QUEST was tested with the Rasch analysis (Many-Facet Rating Scale Model: persons, items, and device type). Most patients were affected by neurological disabilities, and most questionnaires were about mobility devices. All items fitted the Rasch model (InfitMS range: 0.88-1.1; OutfitMS: 0.84-1.28). However, the ceiling effect of the questionnaire was large (15/111 participants totalled the maximum score), its targeting poor (respondents mean measure: 1.90 logits), and its reliability was 0.71. The device classes had different calibrations (range: -1.18 to 1.26 logits), and item 3 functioned differently in patients and caregivers. QUEST satisfaction measures have low reliability and weak construct validity. Lacking invariance, the QUEST total score is unsuitable for comparing the satisfaction levels of users of different device types. The differential item functioning suggests that the QUEST could also be problematic for comparing satisfaction in patients and caregivers.
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Affiliation(s)
- Antonio Caronni
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20122 Milan, Italy
| | - Marina Ramella
- IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy
| | - Pietro Arcuri
- IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy
| | | | - Lucia Pigini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy
| | | | - Chiara Folini
- IRCCS Fondazione Don Carlo Gnocchi Onlus, 20148 Milan, Italy
| | - Stefano Scarano
- IRCCS Istituto Auxologico Italiano, Department of Neurorehabilitation Sciences, Ospedale San Luca, 20122 Milan, Italy
- Department of Biomedical Sciences for Health, Università Degli Studi di Milano, 20129 Milan, Italy
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Teresi JA, Ocepek-Welikson K, Ramirez M, Kleinman M, Ornstein K, Siu A, Luchsinger J. Evaluation of measurement equivalence of the Family Satisfaction with the End-of-Life Care (FAMCARE): Tests of differential item functioning between Hispanic and non-Hispanic White caregivers. Palliat Support Care 2020; 18:544-556. [PMID: 32189607 PMCID: PMC8104328 DOI: 10.1017/s1478951520000152] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE Although the psychometric properties of the Family Satisfaction with End-of-Life Care measure have been examined in diverse settings internationally; little evidence exists regarding measurement equivalence in Hispanic caregivers. The aim was to examine the psychometric properties of a short-form of the FAMCARE in Hispanics using latent variable models and place information on differential item functioning (DIF) in an existing family satisfaction item bank. METHOD The graded form of the item response theory model was used for the analyses of DIF; sensitivity analyses were performed using a latent variable logistic regression approach. Exploratory and confirmatory factor analyses to examine dimensionality were performed within each subgroup studied. The sample included 1,834 respondents: 317 Hispanic and 1,517 non-Hispanic White caregivers of patients with Alzheimer's disease and cancer, respectively. RESULTS There was strong support for essential unidimensionality for both Hispanic and non-Hispanic White subgroups. Modest DIF of low magnitude and impact was observed; flagged items related to information sharing. Only 1 item was flagged with significant DIF by both a primary and sensitivity method after correction for multiple comparisons: "The way the family is included in treatment and care decisions." This item was more discriminating for the non-Hispanic, White responders than for the Hispanic subsample, and was also a more severe indicator at some levels of the trait; the Hispanic respondents located at higher satisfaction levels were more likely than White non-Hispanic respondents to report satisfaction. SIGNIFICANCE OF RESULTS The magnitude of DIF was below the salience threshold for all items. Evidence supported the measurement equivalence and use for cross-cultural comparisons of the short-form FAMCARE among Hispanic caregivers, including those interviewed in Spanish.
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Affiliation(s)
- Jeanne A. Teresi
- Research Division, Hebrew Home at Riverdale, Riverdale, New York, USA
- Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, New York, NY, USA
- Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, USA
| | | | - Mildred Ramirez
- Research Division, Hebrew Home at Riverdale, Riverdale, New York, USA
- Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, New York, NY, USA
- Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, USA
| | - Marjorie Kleinman
- Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA
| | - Katherine Ornstein
- Department of Geriatrics and Palliative Medicine, Institute for Translational Epidemiology Mount Sinai School of Medicine, New York, NY, USA
| | - Albert Siu
- Department of Geriatrics and Palliative Medicine, General Internal Medicine, Health Evidence and Policy, Mount Sinai Medical Center, New York, NY, USA
| | - Jose Luchsinger
- Columbia University Department of Medicine; PH9 Center, room 210; 630 West 168th Street; New York, NY, USA 10032
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Teresi JA, Ocepek-Welikson K, Ramirez M, Ornstein KA, Bakken S, Siu A, Luchsinger JA. Psychometric Properties of a Spanish-Language Version of a Short-Form FAMCARE: Applications to Caregivers of Patients With Alzheimer's Disease and Related Dementias. JOURNAL OF FAMILY NURSING 2019; 25:557-589. [PMID: 31423925 PMCID: PMC6891123 DOI: 10.1177/1074840719867345] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Although family satisfaction is recognized as a critical indicator of quality care for persons with serious illness, Spanish-language measures are limited. The study aims were to develop a Spanish translation of the short-form Family Satisfaction With End-of-Life Care (FAMCARE), investigate its psychometric properties in Hispanic caregivers to patients with Alzheimer's disease and related dementias (ADRD; N = 317; 209 interviewed in Spanish), and add parameters to an existing item bank. Based on factor analyses, the measure was found to be essentially unidimensional. Reliabilities from a graded item response theory model were high; the average estimate was 0.93 for the total and Spanish-language subsample. Discrimination parameters were high, and the model fit adequate. This is the first study to examine the performance of the short-form FAMCARE measure among Hispanics and caregivers to patients with ADRD. The short-form measure can be recommended for Hispanics and caregivers to patients with ADRD.
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Affiliation(s)
- Jeanne A. Teresi
- Hebrew Home at Riverdale Research Division, Bronx, NY, USA
- Stroud Center, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
- Weill Cornell Medical Center, New York, NY, USA
| | | | - Mildred Ramirez
- Hebrew Home at Riverdale Research Division, Bronx, NY, USA
- Weill Cornell Medical Center, New York, NY, USA
| | | | - Suzanne Bakken
- Columbia University School of Nursing, New York, NY, USA
| | - Albert Siu
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
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Ornstein KA, Penrod J, Schnur JB, Smith CB, Teresi JA, Garrido MM, McKendrick K, Siu AL, Meier DE, Morrison RS. The Use of a Brief 5-Item Measure of Family Satisfaction as a Critical Quality Indicator in Advanced Cancer Care: A Multisite Comparison. J Palliat Med 2017; 20:716-721. [PMID: 28186833 DOI: 10.1089/jpm.2016.0442] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although family satisfaction is recognized as a critical indicator of quality for patients with advanced cancer, it is rarely assessed as part of routine clinical care. Measurement burden may be one barrier to widespread use of family satisfaction measures. OBJECTIVE The goal of this study was to test the ability of a new, brief 5-item measure of family satisfaction with care to accurately capture differences across hospital settings. DESIGN Using data from the Palliative Care for Cancer Patients study, a prospective study of 1979 patients and caregivers, we used multivariate regression analysis to detect significant differences across five sites. SETTINGS Hospitalized patients with advanced cancer and their caregivers Methods: We used both the shortened 5-item version of the FAMCARE scale (previously developed using Item Response Theory) and the original 20-item FAMCARE to measure family satisfaction. RESULTS On the 5-item FAMCARE, sites ranged from mean scores of 5.5-6.9 out of a possible high score of 10. Family members at one care site (n = 783) were significantly (p < 0.05) less satisfied with their care than family members at four other care sites. The original 20-item measure failed to differentiate satisfaction levels between all hospital sites. DISCUSSION Variability in family satisfaction with advanced cancer care across hospital settings can be more sensitively detected using a brief 5-item questionnaire versus longer measures. The development of less lengthy and burdensome measures for monitoring family satisfaction, which are still valid, can facilitate routine assessments to maintain and promote high-quality care across care settings.
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Affiliation(s)
- Katherine A Ornstein
- 1 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.,2 Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai , New York, New York
| | - Joan Penrod
- 1 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.,3 James J Peters Veterans Affairs Medical Center , Bronx, New York
| | - Julie B Schnur
- 4 Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai , New York, New York
| | - Cardinale B Smith
- 1 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.,5 Department of Medicine, Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai , New York, New York
| | - Jeanne A Teresi
- 6 Columbia University Stroud Center , New York State Psychiatric Institute, New York, New York.,7 Research Division, Hebrew Home at Riverdale , RiverSpring Health, Bronx, New York
| | - Melissa M Garrido
- 1 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.,3 James J Peters Veterans Affairs Medical Center , Bronx, New York
| | - Karen McKendrick
- 1 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York
| | - Albert L Siu
- 1 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.,3 James J Peters Veterans Affairs Medical Center , Bronx, New York
| | - Diane E Meier
- 1 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York
| | - R Sean Morrison
- 1 Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai , New York, New York.,3 James J Peters Veterans Affairs Medical Center , Bronx, New York
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Adams LS, Miller JL, Grady PA. The Spectrum of Caregiving in Palliative Care for Serious, Advanced, Rare Diseases: Key Issues and Research Directions. J Palliat Med 2016; 19:698-705. [PMID: 27249541 DOI: 10.1089/jpm.2015.0464] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Rare diseases are often life-limiting conditions, the majority of which require constant caregiving needs. The realization of a spectrum of palliative care throughout the trajectory of rare diseases could ensure individualized and caregiver-focused approaches to the care of patients and families. In June 2015, the National Institute of Nursing Research (NINR), the lead institute at the National Institutes of Health for end-of-life research, in conjunction with the National Center for Advancing Translational Sciences, Office of Rare Diseases Research (ORDR) held an interdisciplinary workshop on the unique challenges of caregiving and palliative care in adult and pediatric rare diseases. The panel identified gaps in current knowledge, and afforded suggestions for research opportunities in palliative care science to improve the care of individuals with serious, advanced, rare diseases and their caregivers. This meeting provided an in-depth opportunity to incorporate new concepts into palliative and end-of-life care for individuals with a range of rare diseases and their caregivers. This report presents a summary of the workshop.
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Affiliation(s)
- Lynn S Adams
- National Institute of Nursing Research, National Institutes of Health , Bethesda, Maryland
| | - Jeri L Miller
- National Institute of Nursing Research, National Institutes of Health , Bethesda, Maryland
| | - Patricia A Grady
- National Institute of Nursing Research, National Institutes of Health , Bethesda, Maryland
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Ornstein KA, Teresi JA, Ocepek-Welikson K, Ramirez M, Meier DE, Morrison RS, Siu AL. Use of an Item Bank to Develop Two Short-Form FAMCARE Scales to Measure Family Satisfaction With Care in the Setting of Serious Illness. J Pain Symptom Manage 2015; 49:894-903.e1-4. [PMID: 25546287 PMCID: PMC4441836 DOI: 10.1016/j.jpainsymman.2014.10.017] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/19/2014] [Revised: 10/07/2014] [Accepted: 10/22/2014] [Indexed: 11/23/2022]
Abstract
CONTEXT Family satisfaction is an important and commonly used research measure. Yet current measures of family satisfaction are lengthy and may be unnecessarily burdensome--particularly in the setting of serious illness. OBJECTIVES To use an item bank to develop short forms of the Family Satisfaction with End-of-Life Care (FAMCARE) scale, which measures family satisfaction with care. METHODS To shorten the existing 20-item FAMCARE measure, item response theory parameters from an item bank were used to select the most informative items. The psychometric properties of the new short-form scales were examined. The item bank was based on data from family members from an ethnically diverse sample of 1983 patients with advanced cancer. RESULTS Evidence for the new short-form scales supported essential unidimensionality. Reliability estimates from several methods were relatively high, ranging from 0.84 for the five-item scale to 0.94 for the 10-item scale across different age, gender, education, ethnic, and relationship groups. CONCLUSION The FAMCARE-10 and FAMCARE-5 short-form scales evidenced high reliability across sociodemographic subgroups and are potentially less burdensome and time-consuming scales for monitoring family satisfaction among seriously ill patients.
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Affiliation(s)
- Katherine A Ornstein
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA.
| | - Jeanne A Teresi
- Research Division, Hebrew Home at Riverdale, New York, New York, USA; Measurement and Data Management Core, Mount Sinai Medical Center, New York, New York, USA; Columbia University Stroud Center, New York State Psychiatric Institute, New York, New York, USA
| | | | - Mildred Ramirez
- Research Division, Hebrew Home at Riverdale, New York, New York, USA; Measurement and Data Management Core, Mount Sinai Medical Center, New York, New York, USA; Division of Geriatrics and Palliative Care, Weill Cornell Medical Center, New York, New York, USA
| | - Diane E Meier
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - R Sean Morrison
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Albert L Siu
- Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York, USA
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