J Clin Outcomes Manage
Validation of a total score for the critical care family satisfaction survey
Wasser T, Matchett S, Ray D, Baker K
Objective: To establish the validity of a total score for the Critical Care Family Satisfaction Survey (CCFSS). Design: Instrument validation study. Setting and participants: 2494 family members of patients admitted to 10 critical care units over a 3-year period. Methods: A total score was computed by summing the 5 subscales of the survey, providing a score in the range of 5 to 25. Total score validation techniques included comparison of a model developed from the recently collected survey data with the model developed for initial validation of the survey (n = 145). Goodness-of-fit analyses included calculation and comparison of internal consistency estimates (Cronbach’s alpha) from both models using Fisher’s r-to-z transformations as well as construct validation using r-to-z transformation and comparisons of standardized regression weights from both models. A scree plot was generated to demonstrate the similarity between the model’s eigenstructures, and a chi-square goodness-of-fit analysis was performed to compare the percentage of variance explained by each model. Results: Internal consistency estimates from the 2 models were not significantly different (z score P values > 0.10). Statistical differences between standardized regression weights were observed, and these were caused by the large sample size in this study. However, the patterns of differences between these weights across the 4- and 5-construct model were nearly identical. Goodness-of-fit analysis of the percentage of variance explained by each model demonstrated agreement of the underlying eigenstructure of the models (P = 0.80). Conclusion: Comparison of the models showed significant agreement and no meaningful differences, demonstrating the validity of a total score for the CCFSS. Evidence of a single latent construct being estimated from both models provides additional support for the computation of a total score.
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