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.