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A Psychometric Evaluation of the Staff‐Reported EOLD‐CAD Measure Among Nursing Home Residents With Cognitive Impairment

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Název: A Psychometric Evaluation of the Staff‐Reported EOLD‐CAD Measure Among Nursing Home Residents With Cognitive Impairment
Autoři: John G. Cagle, Timothy E. Stump, Wanzhu Tu, Mary Ersek, Alexander Floyd, Lieve Van den Block, Peiyan Zhang, Todd D. Becker, Kathleen T. Unroe
Přispěvatelé: Brussels Photonics, Family Medicine and Chronic Care, End-of-life Care Research Group, Brussels Interdisciplinary Research centre on Migration and Minorities, Clinical sciences
Zdroj: International Journal of Geriatric Psychiatry. 40
Informace o vydavateli: Wiley, 2025.
Rok vydání: 2025
Témata: Male, Psychometrics/instrumentation, Psychometrics, Cognitive Dysfunction/diagnosis, nursing homes, Surveys and Questionnaires, Humans, Homes for the Aged, Multicenter Studies as Topic, Cognitive Dysfunction, Quality Of Life, Aged, Aged, 80 and over, Surveys and Questionnaires/standards, Terminal Care, Terminal Care/psychology, Dementia/psychology, Reproducibility of Results, Middle Aged, Nursing Homes, Quality of Life, Female, Dementia, reproducibility of results, aged, 80 and over, Factor Analysis, Statistical
Popis: ObjectivesThe End‐of‐Life Dementia—Comfort Assessment in Dying (EOLD‐CAD) scale is one of the few outcome instruments designed to capture symptom burden and well‐being among nursing home residents with dementia; however, psychometric evaluations of the EOLD‐CAD are limited. Although the instrument is often used to assess outcomes prospectively, it was originally developed and tested as a postmortem assessment. The purpose of this study is to evaluate the instrument properties of the EOLD‐CAD using staff reports from a large sample of nursing home residents with cognitive impairment prior to death.MethodsUsing data from the multi‐state UPLIFT clinical trial, this study evaluated the psychometric properties of the EOLD‐CAD from 168 nursing home staff members reporting outcomes for 611 living residents with moderate to severe cognitive impairment. Staff also reported on resident quality‐of‐life using two different single item measures. We conducted confirmatory factor analysis (CFA) and assessed construct validity, inter‐item reliability, and observer report bias.ResultsCFA produced a four‐factor solution. All factor loadings were > 0.40, ranging from 0.61–0.95 for Physical Distress, 0.71–0.91 for Dying Symptoms, 0.61–0.78 for Emotional Distress, and 0.89–0.94 for Well‐Being. Model indices suggest a good fit to the data with root mean square error of approximation (RMSEA) = 0.053 (95% CI = (0.044, 0.062)), comparative fit index (CFI) = 0.971, and standardized root mean square residual (SRMR) = 0.093, with the SRMR slightly above the conventional threshold of > 0.08. Based on intraclass correlation coefficients (ICC), patterns of observer reports were identified among staff who provided data for multiple residents. ICCs were notably high (> 0.60) for Well‐Being items. The EOLD‐CAD elicited a Cronbach's alpha of 0.73, and the instrument was negatively correlated with items measuring resident quality of life.ConclusionsWe found that when the EOLD‐CAD was completed by nursing home staff familiar with the respective residents, observer‐based patterns were detectable. Such patterns were adjusted for in our CFA, from we found that the EOLD‐CAD exhibited multidimensionality with a four‐factor structure capturing: Physical Distress, Emotional Distress, Dying Symptoms, and Well‐Being. In addition to the CFA, the EOLD‐CAD demonstrated generally valid and reliable psychometric properties in our population of long‐stay nursing home residents with moderate to severe cognitive impairment.Trial RegistrationClinicalTrials.gov: NCT04520698
Druh dokumentu: Article
Jazyk: English
ISSN: 1099-1166
0885-6230
DOI: 10.1002/gps.70037
Přístupová URL adresa: https://pubmed.ncbi.nlm.nih.gov/39743326
https://biblio.vub.ac.be/vubir/a-psychometric-evaluation-of-the-staffreported-eoldcad-measure-among-nursing-home-residents-with-cognitive-impairment(ff5a845c-f05c-4b00-b9c0-7521d0bd9f7e).html
Rights: Wiley Online Library User Agreement
Přístupové číslo: edsair.doi.dedup.....5cb15feb7ac2551b04ae5c30d910c2c4
Databáze: OpenAIRE
Popis
Abstrakt:ObjectivesThe End‐of‐Life Dementia—Comfort Assessment in Dying (EOLD‐CAD) scale is one of the few outcome instruments designed to capture symptom burden and well‐being among nursing home residents with dementia; however, psychometric evaluations of the EOLD‐CAD are limited. Although the instrument is often used to assess outcomes prospectively, it was originally developed and tested as a postmortem assessment. The purpose of this study is to evaluate the instrument properties of the EOLD‐CAD using staff reports from a large sample of nursing home residents with cognitive impairment prior to death.MethodsUsing data from the multi‐state UPLIFT clinical trial, this study evaluated the psychometric properties of the EOLD‐CAD from 168 nursing home staff members reporting outcomes for 611 living residents with moderate to severe cognitive impairment. Staff also reported on resident quality‐of‐life using two different single item measures. We conducted confirmatory factor analysis (CFA) and assessed construct validity, inter‐item reliability, and observer report bias.ResultsCFA produced a four‐factor solution. All factor loadings were > 0.40, ranging from 0.61–0.95 for Physical Distress, 0.71–0.91 for Dying Symptoms, 0.61–0.78 for Emotional Distress, and 0.89–0.94 for Well‐Being. Model indices suggest a good fit to the data with root mean square error of approximation (RMSEA) = 0.053 (95% CI = (0.044, 0.062)), comparative fit index (CFI) = 0.971, and standardized root mean square residual (SRMR) = 0.093, with the SRMR slightly above the conventional threshold of > 0.08. Based on intraclass correlation coefficients (ICC), patterns of observer reports were identified among staff who provided data for multiple residents. ICCs were notably high (> 0.60) for Well‐Being items. The EOLD‐CAD elicited a Cronbach's alpha of 0.73, and the instrument was negatively correlated with items measuring resident quality of life.ConclusionsWe found that when the EOLD‐CAD was completed by nursing home staff familiar with the respective residents, observer‐based patterns were detectable. Such patterns were adjusted for in our CFA, from we found that the EOLD‐CAD exhibited multidimensionality with a four‐factor structure capturing: Physical Distress, Emotional Distress, Dying Symptoms, and Well‐Being. In addition to the CFA, the EOLD‐CAD demonstrated generally valid and reliable psychometric properties in our population of long‐stay nursing home residents with moderate to severe cognitive impairment.Trial RegistrationClinicalTrials.gov: NCT04520698
ISSN:10991166
08856230
DOI:10.1002/gps.70037