title: The Caregiver Contribution to Heart Failure Self-Care (CACHS): Further Psychometric Testing of a Novel Instrument.
abstract: Caregivers (CGs) contribute important assistance with heart failure (HF) self-care, including daily maintenance, symptom monitoring, and management. Until CGs' contributions to self-care can be quantified, it is impossible to characterize it, account for its impact on patient outcomes, or perform meaningful cost analyses. The purpose of this study was to conduct psychometric testing and item reduction on the recently developed 34-item Caregiver Contribution to Heart Failure Self-care (CACHS) instrument using classical and item response theory methods. Fifty CGs (mean age 63 years ±12.84; 70% female) recruited from a HF clinic completed the CACHS in 2014 and results evaluated using classical test theory and item response theory. Items would be deleted for low (<.05) or high (>.95) endorsement, low (<.3) or high (>.7) corrected item-total correlations, significant pairwise correlation coefficients, floor or ceiling effects, relatively low latent trait and item information function levels (<1.5 and p > .5), and differential item functioning. After analysis, 14 items were excluded, resulting in a 20-item instrument (self-care maintenance eight items; monitoring seven items; and management five items). Most items demonstrated moderate to high discrimination (median 2.13, minimum .77, maximum 5.05), and appropriate item difficulty (-2.7 to 1.4). Internal consistency reliability was excellent (Cronbach α = .94, average inter-item correlation = .41) with no ceiling effects. The newly developed 20-item version of the CACHS is supported by rigorous instrument development and represents a novel instrument to measure CGs' contribution to HF self-care. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Associate Professor, College of Nursing, University of South Florida, 12901 Bruce B. Downs Blvd. MDC22, Tampa, FL, 33612-4766.
authors.forename: Harleah G
authors.initials: HG
authors.lastname: Buck
authors.affiliation: Assistant Clinical Professor, Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON.|Nurse Clinician, Heart Function Clinic, Hamilton Health Sciences, Hamilton, ON.
authors.forename: Karen
authors.initials: K
authors.lastname: Harkness
authors.affiliation: Clinical Epidemiologist, Department of Clinical Epidemiology & Biostatistics, Faculty of Health Sciences, McMaster University, Hamilton, ON.
authors.forename: Muhammad Usman
authors.initials: MU
authors.lastname: Ali
authors.affiliation: Associate Professor, Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON.|Associate Scientist, Population Health Research Institute, Hamilton, ON.
authors.forename: Sandra L
authors.initials: SL
authors.lastname: Carroll
authors.affiliation: Associate Professor, School of Nursing, And Centre for Health Services and Policy Research, University of British Columbia, Vancouver, BC.|Research Scientist, British Columbia Centre for Palliative Care, Vancouver, BC.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Kryworuchko
authors.affiliation: Associate Professor, Faculty of Health Sciences, School of Nursing, McMaster University, Hamilton, ON.|Heart and Stoke Foundation/Michael G. DeGroote, Endowed Chair of Cardiovascular Nursing, Associate Scientist, Population Health Research Institute, Hamilton, ON.
authors.forename: Michael
authors.initials: M
authors.lastname: McGillion
mesh_terms: D000368:Aged; D017028:Caregivers / Q000706:statistics & numerical data*; D005260:Female; D006333:Heart Failure / Q000175:diagnosis / Q000451:nursing*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011594:Psychometrics / Q000706:statistics & numerical data*; D015203:Reproducibility of Results; D012648:Self Care / Q000379:methods*; D011795:Surveys and Questionnaires
keywords: caregivers; heart failure, self care; instrument development; item response theory; psychometric