Development and validation of a carer need screening tool (CNST-11) for carers of older adults: a need-stratified tool for services matching

Abstract

Background and objectives: Carers play an imperative role in enabling older adults to age in place. Enhancing support for carers is increasingly recognized as essential to the social welfare system. The study aims to develop and validate a short self-administration Carer Need Screening Tool (CNST-11) to enable carers' understanding of their needs in caring for older adults and inform service providers for need-stratified intervention matching.

Research design and methods: The scale was developed through a three-phase approach. Items were generated via literature review, two rounds of Delphi study with 48 experts and a focus group with 10 carers of older adults at Phase I. Survey data of 803 carers was used to perform item reduction analysis at Phase II. Need stratification and psychometric property analysis were performed at Phase III.

Results: The CNST-11 consists of 11 items from the 37 items generated at Phase I. A revised two-factor model considering clinical applicability was adapted based on exploratory factor analysis (EFA) and supported by confirmatory factor analysis (CFA) with excellent fit (CFI=0.955, RMSEA=0.052). Cronbach's alpha of the CNST-11 was 0.818. Concurrent and divergent validity were achieved.

Discussion and implications: The CRNT-11 is the first screening tool for carers of older adults, developed by considering both stakeholders' opinions and validated empirical data, that adopted an outcome-oriented approach in item selection. It provides helping professionals with a brief and reliable tool for quick screening and need stratification, which enables the provision of timely and accurate support services to carers in different caregiving stages.

Keywords: brief scale; caregiving burden; family caregivers; psychometrics; scale development.

Figure 1.

Cumulative area under the curve (AUC) of the 11 selected items.