Teresi Jeanne A, Ocepek-Welikson Katja, Ramirez Mildred, Kleinman Marjorie, Ornstein Katherine, Siu Albert
Research Division, The Hebrew Home at Riverdale, Riverdale, NY, USA Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, New York, NY, USA Columbia University Stroud Center, New York State Psychiatric Institute, New York, NY, USA.
Research Division, The Hebrew Home at Riverdale, Riverdale, NY, USA.
Palliat Med. 2015 Jan;29(1):83-96. doi: 10.1177/0269216314545802. Epub 2014 Aug 26.
The Family Satisfaction with End-of-Life Care is an internationally used measure of satisfaction with cancer care. However, the Family Satisfaction with End-of-Life Care has not been studied for equivalence of item endorsement across different socio-demographic groups using differential item functioning.
The aims of this secondary data analysis were (1) to examine potential differential item functioning in the family satisfaction item set with respect to type of caregiver, race, and patient age, gender, and education and (2) to provide parameters and documentation of differential item functioning for an item bank.
A mixed qualitative and quantitative analysis was conducted. A priori hypotheses regarding potential group differences in item response were established. Item response theory and Wald tests were used for the analyses of differential item functioning, accompanied by magnitude and impact measures.
Very little significant differential item functioning was observed for patient's age and gender. For race, 13 items showed differential item functioning after multiple comparison adjustment, 10 with non-uniform differential item functioning. No items evidenced differential item functioning of high magnitude, and the impact was negligible. For education, 5 items evidenced uniform differential item functioning after adjustment, none of high magnitude. Differential item functioning impact was trivial. One item evidenced differential item functioning for the caregiver relationship variable.
Differential item functioning was observed primarily for race and education. No differential item functioning of high magnitude was observed for any item, and the overall impact of differential item functioning was negligible. One item, satisfaction with "the patient's pain relief," might be singled out for further study, given that this item was both hypothesized and observed to show differential item functioning for race and education.
《临终关怀家庭满意度》是一项国际上用于衡量癌症护理满意度的指标。然而，尚未使用项目功能差异法研究不同社会人口学群体在《临终关怀家庭满意度》项目认可方面的等效性。
本次二次数据分析的目的是：（1）研究家庭满意度项目集中在照顾者类型、种族、患者年龄、性别和教育程度方面潜在的项目功能差异；（2）为题库提供项目功能差异的参数和文档。
进行了定性与定量相结合的分析。建立了关于项目反应潜在群体差异的先验假设。使用项目反应理论和Wald检验分析项目功能差异，并辅以大小和影响度量。
在患者年龄和性别方面，几乎未观察到显著的项目功能差异。对于种族，13个项目在多重比较调整后显示出项目功能差异，其中10个具有非一致的项目功能差异。没有项目显示出高程度的项目功能差异，影响可忽略不计。对于教育程度，5个项目在调整后显示出一致的项目功能差异，均未达到高程度。项目功能差异的影响微不足道。有一个项目在照顾者关系变量上显示出项目功能差异。
主要在种族和教育程度方面观察到项目功能差异。未观察到任何项目有高程度的项目功能差异，项目功能差异的总体影响可忽略不计。鉴于“患者疼痛缓解”这一项目在种族和教育程度方面既有假设又被观察到显示出项目功能差异，可能值得进一步研究。
