245085 Development of a Measure of Informal Caregiving Skills in Effective Medication Management for Hospice Patients (CG-SEMM): Interim Results

Wednesday, November 2, 2011: 12:30 PM

Denys T. Lau, PhD , Department of Pharmacy Administration, University of Illinois at Chicago, Chicago, IL
Cheryl T. Coon, PhD , Director of Psychometrics, RTI Health Solutions, Research Triangle Park, NC
Brian Joyce, BA , Division of Epidemiology and Biostatistics, University of Illinois at Chicago, School of Public Health, Chicago, IL
A. Simon Pickard, PhD , Departments of Pharmacy Practice & Pharmacy Administration, University of Illinois at Chicago, College of Pharmacy, Chicago, IL
Chih-Hung Chang, PhD , Buehler Center on Aging, Health & Society, Northwestern University, Feinberg School of Medicine, Chicago, IL
OBJECTIVE: Managing medications for home hospice elderly patients is an important and complex responsibility for informal (unpaid) caregivers. This study reports the interim results on the development of a new instrument to measure informal caregiving skills in effective medication management (CG-SEMM) for hospice patients. METHODS: Interim results are based on 60 informal caregivers with medication responsibilities from 5 hospice agencies in Chicagoland. The piloted CG-SEMM instrument contains 52 objectively-measured skill items hypothesized to capture 5 conceptual domains: teamwork, organization, medications, symptoms, and personhood. Additionally, 5 self-rated skill items, one corresponding to each domain, were assessed. To examine the structure of each domain, principal components analysis, exploratory factor analyses, internal consistency, and item response theory were examined. RESULTS: The 5 self-rated skill items appear to function as a unidimensional scale that measures caregiver self-efficacy in managing medications (factor loadings=0.55-0.84; alpha=0.84). Among the 52 objectively-measured skill items, there appears to be one organization domain related to how medication information should be recorded (factor loadings=0.51-0.79; Cronbach's coefficient alpha=0.74) and one medications domain related to understanding basics of pharmacology and medication administration (factor loadings=0.37-0.67; alpha=0.70). Item response theory informed the scoring of the response categories and the appropriateness of these items for identifying caregivers who could benefit from training. Structures for teamwork, personhood, and symptoms domains are inconclusive; additional subject recruitment and scale refinement are needed. CONCLUSION: Interim findings suggest that the CG-SEMM instrument may be a promising, psychometrically-valid tool for assessing caregiving skills necessary for managing medications effectively in hospice patients.

Learning Areas:
Assessment of individual and community needs for health education
Public health or related research
Social and behavioral sciences

Learning Objectives:
1) Describe the steps necessary to develop a psychometrically valid instrument to measure informal caregiving skills in effective medication management (CG-SEMM) for home hospice patients. 2) Explain the analytic assessments needed to evaluate the psychometric properties of the CG-SEMM tool. 3) Identify ways to refine and improve the structure of CG-SEMM tool to assess informal caregiver's skill levels in managing medications.

Keywords: End-of-Life Care, Caregivers

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am the PI of the grant award that is the basis of this abstract submission and have provided oversight to all phases of this project.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.