Abstract
OBJECTIVETo develop and evaluate the psychometric properties of a family caregiver-reported survey that assesses family-centeredness of care in the context of pediatric emergency department (ED) encounters. METHODSWe created a caregiver-reported scale, incorporated content expert feedback, and iteratively revised it based on cognitive interviews with caregivers. We then field tested the scale in a survey with caregivers. We dichotomized items using top-box scoring and obtained a summary score per respondent. Using a sample of 191 caregivers recruited from nine EDs, we analyzed internal consistency reliability, dimensionality via item response theory modeling, and convergent validity with the ED Consumer Assessment of Healthcare Providers and Systems (CAHPS) survey. RESULTSFeedback from the nine experts led us to remove four items. We conducted 16 cognitive interviews and revised the survey in four rounds. An 11-item survey was field tested. Mean (SD) respondent 11-item summary score was 77.2 (26.6). We removed two items given inconsistent response patterns, poor variability, and poor internal consistency, which increased coefficient alpha from 0.85 to 0.88 for the final scale. A multidimensional model fit the data best, but factor scores correlated strongly with summary scores, suggesting the latter are sufficient for quality improvement and future research. Regarding convergent validity, adjusted partial correlation between our scale's nine-item summary score and the ED CAHPS summary score was 0.75 (95% CI 0.67-0.81). CONCLUSIONSPsychometric analyses demonstrated strong item performance, reliability, and convergent validity for the nine-item scale. This survey can be used to assess family-centered care in the ED for research and quality improvement purposes. WHAT'S NEWNo family-centered care assessment tool is designed for a pediatric emergency department encounter. This survey demonstrated good item performance, reliability, and validity, supporting its use to assess family-centeredness of care in this setting for research and quality improvement purposes.