title: Validation study of the Camberwell Assessment of Need for the Elderly (CANE) in Portugal.
abstract: BACKGROUND
  The Camberwell Assessment of Need for the Elderly (CANE) is widely used for multidimensional evaluation of older people with mental health problems. The aim of this study was to evaluate reliability and validity of a Portuguese version of CANE.
  
  
  METHODS
  A cross-sectional multicenter study was designed using a convenience sample of elderly mental health services' users. CANE was compared with EASYCare, GHQ12, MMSE, Barthel Index and GDS15 to assess criterion and construct validity. Inter-rater and test-retest reliability were also assessed.
  
  
  RESULTS
  79 patients (76% female), with mean age of 74 (+/- 6.6) years were included. Most patients lived at home with a family caregiver, generally female. Only 32% had no carer. Dementia was the commonest psychiatric diagnosis (61%) and somatic comorbidity was very prevalent (85%). Kappa values (kappa) for inter-rater item reliability ranged from 0.72 to 1.00 (mean values: 0.96 patient, 0.93 carer, 0.90 staff). The intraclass correlation coefficient (ICC) for total scores ranged from 0.95 to 0.98.For test-retest item reliability, the mean kappa value was: 0.80 patient, 0.77 carer, 0.81 staff. ICC for total scores ranged from 0.82 to 0.92. Given the absence of a gold standard, criterion validity was assessed by comparing CANE with EASYCare (rs 0.460; p < or = 0.01), GDS (rs 0.615; p < or = 0.01), GHQ (rs 0.581; p < or = 0.01) and Barthel Index (rs-0.435; p < or = 0.01). Overall, inter-item and item-total correlations for CANE and item comparison with other measures indicated reasonable construct validity.
  
  
  CONCLUSIONS
  The psychometric proprieties of CANE seem to be consistently good, in accordance with other studies. Robust results on ecological, face, content, criterion and construct validity, as well as good reliability, were achieved. This version is a promising tool for research and practical use in Portuguese old age settings.
authors.affiliation: Psychiatry Service of Hospital S. João, UNIFAI/ICBAS, University of Oporto, Portugal. lia.fernandes@mail.telepac.pt
authors.forename: Lia
authors.initials: L
authors.lastname: Fernandes
authors.forename: Manuel
authors.initials: M
authors.lastname: Gonçalves-Pereira
authors.forename: António
authors.initials: A
authors.lastname: Leuschner
authors.forename: Sónia
authors.initials: S
authors.lastname: Martins
authors.forename: Margarida
authors.initials: M
authors.lastname: Sobral
authors.forename: Luís F
authors.initials: LF
authors.lastname: Azevedo
authors.forename: Cláudia
authors.initials: C
authors.lastname: Dias
authors.forename: Raimundo
authors.initials: R
authors.lastname: Mateos
authors.forename: Martin
authors.initials: M
authors.lastname: Orrell
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease / Q000453:epidemiology; D015897:Comorbidity; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D003704:Dementia / Q000453:epidemiology* / Q000628:therapy; D004185:Disability Evaluation; D005260:Female; D006299:Health Services for the Aged / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology* / Q000628:therapy; D008605:Mental Health Services / Q000592:standards*; D020380:Needs Assessment / Q000706:statistics & numerical data*; D015588:Observer Variation; D010865:Pilot Projects; D011174:Portugal; D015203:Reproducibility of Results; D014175:Translating