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Evaluation of measurement equivalence of the Family Satisfaction with the End-of-Life Care (FAMCARE): Tests of differential item functioning between Hispanic and non-Hispanic White caregivers

Published online by Cambridge University Press:  19 March 2020

Jeanne A. Teresi ,
Katja Ocepek-Welikson ,
Mildred Ramirez Open the ORCID record for Mildred Ramirez [Opens in a new window] ,
Marjorie Kleinman ,
Katherine Ornstein ,
Albert Siu  and
Jose Luchsinger
Jeanne A. Teresi
Affiliation:
Research Division, Hebrew Home at Riverdale, Riverdale, New York, NY Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, and Analytic Core, Columbia University Alzheimer's Disease Resource Center for Minority Aging Research, New York, NY Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY
Katja Ocepek-Welikson
Affiliation:
Research Division, Hebrew Home at Riverdale, Riverdale, New York, NY
Mildred Ramirez*
Affiliation:
Research Division, Hebrew Home at Riverdale, Riverdale, New York, NY Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, and Analytic Core, Columbia University Alzheimer's Disease Resource Center for Minority Aging Research, New York, NY Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY
Marjorie Kleinman
Affiliation:
Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY
Katherine Ornstein
Affiliation:
Department of Geriatrics and Palliative Medicine, Institute for Translational Epidemiology Mount Sinai School of Medicine, New York, NY
Albert Siu
Affiliation:
Department of Geriatrics and Palliative Medicine, General Internal Medicine, Health Evidence and Policy, Mount Sinai Medical Center, New York, NY
Jose Luchsinger
Affiliation:
Department of Medicine, Columbia University Medical Center, PH9 Center, New York, NY10032
*
Author for correspondence: Mildred Ramirez, Research Division, Hebrew Home at Riverdale in RiverSpring Health, 5901 Palisade Avenue, Riverdale, New York, NY10471, USA. E-mail: [email protected]
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Abstract

Objective

Although the psychometric properties of the Family Satisfaction with End-of-Life Care measure have been examined in diverse settings internationally; little evidence exists regarding measurement equivalence in Hispanic caregivers. The aim was to examine the psychometric properties of a short-form of the FAMCARE in Hispanics using latent variable models and place information on differential item functioning (DIF) in an existing family satisfaction item bank.

Method

The graded form of the item response theory model was used for the analyses of DIF; sensitivity analyses were performed using a latent variable logistic regression approach. Exploratory and confirmatory factor analyses to examine dimensionality were performed within each subgroup studied. The sample included 1,834 respondents: 317 Hispanic and 1,517 non-Hispanic White caregivers of patients with Alzheimer's disease and cancer, respectively.

Results

There was strong support for essential unidimensionality for both Hispanic and non-Hispanic White subgroups. Modest DIF of low magnitude and impact was observed; flagged items related to information sharing. Only 1 item was flagged with significant DIF by both a primary and sensitivity method after correction for multiple comparisons: “The way the family is included in treatment and care decisions.” This item was more discriminating for the non-Hispanic, White responders than for the Hispanic subsample, and was also a more severe indicator at some levels of the trait; the Hispanic respondents located at higher satisfaction levels were more likely than White non-Hispanic respondents to report satisfaction.

Significance of results

The magnitude of DIF was below the salience threshold for all items. Evidence supported the measurement equivalence and use for cross-cultural comparisons of the short-form FAMCARE among Hispanic caregivers, including those interviewed in Spanish.

Keywords

Differential item functioningEthnic diversityFamily satisfaction with end-of-life careItem response theoryPalliative care
Type
Original Article
Information
Palliative & Supportive Care , Volume 18 , Issue 5 , October 2020 , pp. 544 - 556
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Copyright
Copyright © Cambridge University Press 2020

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