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Reassessing construct validity of a Brazilian version of the instrument Caregiver Abuse Screen (CASE) used to identify risk of domestic violence against the elderly
  1. Michael Eduardo Reichenheim1,
  2. Carlos Montes Paixão, Jr.2,
  3. Claudia Leite Moraes1
  1. 1 Epidemiology Department, Institute of Social Medicine (IMS), Rio de Janeiro State University (UERJ), Brazil;
  2. 2 Geriatrics Sector – Univ Hospital Clementino Fraga Filho (HUCFF), Federal Univ of Rio de Janeiro, Brazil
  1. * Corresponding author; email: michael{at}


Background: Domestic violence against the elderly (DVAE) is an increasingly recognized problem and its appropriate detection is imperative. As part of an ongoing cross-cultural adaptation process, this study evaluates the construct validity of a Brazilian Portuguese version of the instrument Caregiver Abuse Screen (CASE).

Methods: A cross-sectional study comprising 507 pairs of caregivers/elderly patients was carried out in three geriatric outpatient units. A multidimensional questionnaire was completed for each pair of interviewees covering DVAE, socio-demographic characteristics, and several theory related variables (alcohol misuse, burden, depression, social support, cognitive status, IADL, general health status and living arrangements). Sequential Confirmatory and Exploratory Factor Analyses (CFA/EFA) were implemented to assess construct validity through an in depth exploration of the instrument’s dimensional structure. Construct validity was also assessed through relationships with other variables.

Results: The initial CFA did not support the postulated two factor solution. A one dimensional solution suggested by an EFA was followed by a CFA, which showed adequate fit (WRMR=0.985, RMSEA=0.056, CFI=0.967 and TLI=0.969), internal consistency ( ρcr=0.85) and temporal stability ( κw=0.77). Yet, convergent validity was not achieved (average variance extracted < 0.50; ρve=0.45). Using Kendall’s Tau b correlations, the CASE was positively associated with two other instruments assessing DVAE (H/S-EAST: τb=0.13 and CTS 1 subscales: τb=0.15-0.37); caregiver burden (Zarit BI: τb=0.40); and depression (GDS: τb=0.32).

Conclusion: In spite of the some remaining dimensionality issues needing refinement and the relatively restricted correlations with expected variables, the CASE may be re affirmed as a promising detection tool for risk of abuse in clinical practice and applied research.

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