title: Psychometric testing of the modified Care Dependency Scale (Neuro-CDS).
abstract: BACKGROUND
  Effective measures of nursing care dependency in neurorehabilitation are warranted to plan nursing interventions to help patients avoid increasing dependency.
  
  
  OBJECTIVE
  The Care Dependency Scale (CDS) is a theory-based, comprehensive tool to evaluate functional disability. This study aimed to modify the CDS for neurological and neurorehabilitation patients (Neuro-CDS) and to test its psychometric properties in adult neurorehabilitation inpatients.
  
  
  METHODS
  Exploratory factor analysis (EFA) was performed using a Maximum Likelihood robust (MLR) estimator. The Barthel Index (BI) was used to evaluate concurrent validity. Stability was measured using the Intra-class Correlation Coefficient (ICC).
  
  
  RESULTS
  The sample included 124 patients (mean age = 69.7 years, 54% male). The EFA revealed a two-factor structure with good fit indexes, Factor 1 (Physical care dependence) loaded by 11 items and Factor 2 (Psycho-social care dependence) loaded by 4 items. The correlation between factors was 0.61. Correlations between Factor 1 and the BI and between Factor 2 and the BI were r = 0.843 and r = 0.677, respectively (p <  0.001). The Cronbach's alpha coefficients were 0.99 and 0.88 (Factor 1 and 2). The ICC was 0.98.
  
  
  CONCLUSIONS
  The Neuro-CDS is multidimensional, valid, reliable, straightforward, and able to measure care dependence in neurorehabilitation patients as a basis for individualized and holistic care.
authors.affiliation: Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy.
authors.forename: Michela
authors.initials: M
authors.lastname: Piredda
authors.affiliation: School of Nursing, Faculty of Medicine, Department of Biomedicine and Prevention, Tor Vergata University, Rome, Italy.
authors.forename: Valentina
authors.initials: V
authors.lastname: Biagioli
authors.affiliation: Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy.
authors.forename: Giulia
authors.initials: G
authors.lastname: Gambale
authors.affiliation: Clinical Nurse "San Giovanni Battista" Hospital, Rome, Italy.
authors.forename: Elisa
authors.initials: E
authors.lastname: Porcelli
authors.affiliation: Department of Psychology, Faculty of Medicine and Psychology, Sapienza University of Rome, Rome Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Barbaranelli
authors.affiliation: School of Nursing, Udine University, Udine, Italy.
authors.forename: Alvisa
authors.initials: A
authors.lastname: Palese
authors.affiliation: Research Unit Nursing Science, Campus Bio-Medico di Roma University, Rome, Italy.
authors.forename: Maria Grazia
authors.initials: MG
authors.lastname: De Marinis
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers; D004522:Educational Status; D005163:Factor Analysis, Statistical; D005190:Family; D005260:Female; D006801:Humans; D007297:Inpatients; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000534:rehabilitation*; D011594:Psychometrics; D012046:Rehabilitation / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012959:Socioeconomic Factors
keywords: Rehabilitation; adult; nervous system diseases; psychometrics; statistical factor analysis