Cross-validation of the Care Dependency Scale in intensive care unit (ICU-CDS)

Abstract

Objectives: The Care Dependency Scale is a theory-based, comprehensive tool widely used in low-intensity care settings to evaluate patients' dependency. This study aimed to test the psychometric properties of the Care Dependency Scale in intensive care units.

Research methodology/design: A multicentre cross-sectional validation study was conducted. Exploratory factor analysis and confirmatory factor analysis were performed using a Maximum Likelihood robust estimator with Geomin oblique rotation.

Setting: Adult patients admitted to intensive care units of four Italian hospitals.

Results: The sample included 453 patients (mean age = 68 years, 62% male). The exploratory factor analysis, conducted on a subsample of 227 patients, revealed a two-factor structure (Physical care dependency and Psychosocial care dependency) with good fit indexes. The confirmatory factor analysis was conducted on another subsample of 226 patients and a second-order factor was specified. The model tested yielded adequate fit indexes. Concurrent and known-groups validity, and reliability, were also adequate.

Conclusion: The Care Dependency Scale is a multidimensional, valid and reliable tool able to assess the care dependency of critically ill patients. It can help to distinguish between physical and psychosocial needs and to create a base for patient-customised and holistic care.

Keywords: Adult; Care dependency; Intensive care unit; Nursing care; Psychometrics; Statistical Factor Analysis; Validation studies.