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Performance of the Family Satisfaction with the End-of-Life Care (FAMCARE) measure in an ethnically diverse cohort: psychometric analyses using item response theory.

ABSTRACT: The Family Satisfaction with End-of-Life Care (FAMCARE) has been used widely among caregivers to individuals with cancer. The aim of this study was to evaluate the psychometric properties of this measure using item response theory (IRT).The analytic sample was comprised of caregivers to 1,983 patients with advanced cancer. Among the patients, 56 % were females, with mean age 59.9 years (s.d.?=?11.8), 20 % were non-Hispanic Black. The majority were family members either living with (44 %) or not living with (35 %) the patient. Factor analyses and IRT were used to examine the dimensionality, information, and reliability of the FAMCARE.Although a bi-factor model fit the data slightly better than did a unidimensional model, the loadings on the group factors were very low. Thus, a unidimensional model appears to provide adequate representation for the item set. The reliability estimates, calculated along the satisfaction (theta) continuum, were adequate (>0.80) for all levels of theta for which subjects had scores. Examination of the category response functions from IRT showed overlap in the lower categories with little unique information provided; moreover, the categories were not observed to be interval. Based on these analyses, a three-response category format was recommended: very satisfied, satisfied, and not satisfied. Most information was provided in the range indicative of either dissatisfaction or high satisfaction.These analyses support the use of fewer response categories and provide item parameters that form a basis for developing shorter-form scales. Such a revision has the potential to reduce respondent burden.

SUBMITTER: Teresi JA

PROVIDER: S-EPMC4151612 | biostudies-literature | 2014 Feb

REPOSITORIES: biostudies-literature

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Performance of the Family Satisfaction with the End-of-Life Care (FAMCARE) measure in an ethnically diverse cohort: psychometric analyses using item response theory.

Teresi Jeanne A JA Ornstein Katherine K Ocepek-Welikson Katja K Ramirez Mildred M Siu Albert A

Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer 20131005 2

<h4>Objective</h4>The Family Satisfaction with End-of-Life Care (FAMCARE) has been used widely among caregivers to individuals with cancer. The aim of this study was to evaluate the psychometric properties of this measure using item response theory (IRT).<h4>Methods</h4>The analytic sample was comprised of caregivers to 1,983 patients with advanced cancer. Among the patients, 56 % were females, with mean age 59.9 years (s.d. = 11.8), 20 % were non-Hispanic Black. The majority were family members ...[more]

PMID: 24091717

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Project description:BackgroundThe investigation of patient-reported outcomes and psycho-oncological interventions mainly focuses on psychological distress or psychopathology. However, the recognition of the equal importance of positive mental health (PMH) has increased lately. The PMH-scale is a brief questionnaire allowing to assess well-being in individuals in the general population and in patients. Previous studies evaluated the psychometric properties of the PMH-scale using classical test theory (CTT). This study is the first to investigate the PMH-scale in patients with cancer using item analysis according to the Rasch model.MethodsIn total, N = 357 cancer patients participated in the study. A Rasch analysis of the PMH-scale was conducted including testing of unidimensionality, local independence, homogeneity and differential item functioning (DIF) with regard to age, gender, type of cancer, the presence of metastases, psycho-oncological support, and duration of disease. Additionally, the ordering of the item thresholds as well as the targeting of the scale were investigated.ResultsAfter excluding one misfitting item and accounting for local dependence by forming superitems, a satisfactory overall fit to the Rasch model was established (χ2 = 30.34, p = 0.21). The new PMH-8 scale proved to be unidimensional, and homogeneity of the scale could be inferred. All items showed ordered thresholds, there was no further item misfit. DIF was found for age, but as the impact of DIF was not substantial, no adjustment related to the age-DIF had to be made. The Person Separation Index (PSI = 0.89) was excellent, indicating excellent discriminatory power between different levels of positive mental health. Overall, the targeting of the PMH-8 was good for the majority of the present sample. However, at both ends of the scale item thresholds are missing as indicated by a slight floor effect (1.4%) and a considerable ceiling effect (9.8%).ConclusionsOverall, the results of the analysis according to the Rasch model support the use of the revised PMH-scale in a psycho-oncological context.

Dataset Information

Performance of the Family Satisfaction with the End-of-Life Care (FAMCARE) measure in an ethnically diverse cohort: psychometric analyses using item response theory.

Publications

Performance of the Family Satisfaction with the End-of-Life Care (FAMCARE) measure in an ethnically diverse cohort: psychometric analyses using item response theory.

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