A Psychometric Evaluation of the Staff‐Reported EOLD‐CAD Measure Among Nursing Home Residents With Cognitive Impairment

作者：John G. Cagle, Timothy E. Stump, Wanzhu Tu, Mary Ersek, Alexander Floyd, Lieve Van den Block, Peiyan Zhang, Todd Becker, Kathleen T. Unroe · 发表于：International Journal of Geriatric Psychiatry · 年份：2025 · DOI：10.1002/gps.70037 · 被引用次数：2 · 研究领域：Dementia and Cognitive Impairment Research、Geriatric Care and Nursing Homes、Palliative Care and End-of-Life Issues

OBJECTIVES: The End-of-Life Dementia-Comfort Assessment in Dying (EOLD-CAD) scale is one of the few outcome instruments designed to capture symptom burden and well-being among nursing home residents with dementia; however, psychometric evaluations of the EOLD-CAD are limited. Although the instrument is often used to assess outcomes prospectively, it was originally developed and tested as a postmortem assessment. The purpose of this study is to evaluate the instrument properties of the EOLD-CAD using staff reports from a large sample of nursing home residents with cognitive impairment prior to death. METHODS: Using data from the multi-state UPLIFT clinical trial, this study evaluated the psychometric properties of the EOLD-CAD from 168 nursing home staff members reporting outcomes for 611 living residents with moderate to severe cognitive impairment. Staff also reported on resident quality-of-life using two different single item measures. We conducted confirmatory factor analysis (CFA) and assessed construct validity, inter-item reliability, and observer report bias. RESULTS: CFA produced a four-factor solution. All factor loadings were > 0.40, ranging from 0.61-0.95 for Physical Distress, 0.71-0.91 for Dying Symptoms, 0.61-0.78 for Emotional Distress, and 0.89-0.94 for Well-Being. Model indices suggest a good fit to the data with root mean square error of approximation (RMSEA) = 0.053 (95% CI = (0.044, 0.062)), comparative fit index (CFI) = 0.971, and standardized root mean s...