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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

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Abstract

Objective

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).

Methods

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.

Results

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.

Conclusions

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.

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Acknowledgments

This project was funded by the National Cancer Institute, Grant #: 5R01CA116227-05. Support for these analyses was provided by the Claude Pepper Older Americans Independence Center: National Institute on Aging, P30, AG028741.

Conflict of Interest

The authors do not have a financial relationship with the sponsoring organization. The authors have full control of the primary data and can provide the data for a full review if requested.

Author information

Authors and Affiliations

  1. Research Division, Hebrew Home at Riverdale, Riverdale, NY, USA

    Jeanne A. Teresi, Katja Ocepek-Welikson & Mildred Ramirez

  2. Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mt. Sinai Medical Center, New York, NY, USA

    Jeanne A. Teresi & Mildred Ramirez

  3. Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA

    Jeanne A. Teresi

  4. Department of Geriatrics and Palliative Medicine, Institute for Translational Epidemiology Mount Sinai School of Medicine, New York, NY, USA

    Katherine Ornstein

  5. Division of Geriatrics and Palliative Care, Weill Cornell Medical Center, New York, NY, USA

    Mildred Ramirez

  6. Divisions of Geriatrics and Palliative Medicine, General Internal Medicine, Health Evidence and Policy, Mount Sinai Medical Center, New York, NY, USA

    Albert Siu

Authors
  1. Jeanne A. Teresi
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  2. Katherine Ornstein
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  3. Katja Ocepek-Welikson
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  4. Mildred Ramirez
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  5. Albert Siu
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Corresponding author

Correspondence to Mildred Ramirez.

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Teresi, J.A., Ornstein, K., Ocepek-Welikson, K. et al. Performance of the Family Satisfaction with the End-of-Life Care (FAMCARE) measure in an ethnically diverse cohort: psychometric analyses using item response theory. Support Care Cancer 22, 399–408 (2014). https://doi.org/10.1007/s00520-013-1988-z

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  • DOI: https://doi.org/10.1007/s00520-013-1988-z

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