RESUMO
BACKGROUND: Domestic violence against the elderly (DVAE) is an increasingly recognised 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, sociodemographic characteristics and several theory-related variables (alcohol misuse, burden, depression, social support, cognitive status, instrumental activities of daily living, 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 (rho(cr) = 0.85) and temporal stability (kappa(w) = 0.77). Yet, convergent validity was not achieved (average variance extracted <0.50; rho(ve) = 0.45). Using Kendall's Tau-b correlations, the CASE was positively associated with two other instruments assessing DVAE (H/S-EAST: tau(b) = 0.13; and CTS-1 subscales: tau(b) = 0.15-0.37); caregiver burden (Zarit BI: tau(b) = 0.40); and depression (GDS: tau(b) = 0.32). CONCLUSION: In spite of some remaining dimensionality issues needing refinement and the relatively restricted correlations with expected variables, the CASE may be reaffirmed as a promising detection tool for risk of abuse in clinical practice and applied research.
