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Abstract
Objective: To assess the feasibility, reliability, and construct validity of the Camberwell Assessment of Need for the Elderly (CANE) in identifying needs among community-dwelling older adults in South Lebanon with a view towards expanding ageing research in the country.
Methods: A cross-sectional study was undertaken with 322 individuals, using the CANE, the EQ5d and a socio-demographic questionnaire. Reliability was determined through measuring internal consistency of the CANE. Construct validity was performed through examining CANE inter-item correlations, and comparing correlations with the EQ5d and socio-demographic indicators. A factor analysis was conducted using varimax orthogonal rotation.
Results: Cronbach alpha was 0.71. For construct validity, correlations were highest in items measuring needs in looking after the house and food (r = 0.557); company and intimate relationships (r = 0.572); and medication and written/verbal information (r = 0.586). Moderate correlations were found with EQ5d items assessing the same measure, including: EQ5d ‘problems taking care of self’ and CANE self-care (r = 0.578) and daytime activities (r = 0.523); EQ5d ‘problems performing usual activities’ and CANE daytime activities (r = 0.553), self-care (r = 0.511) and mobility (r = 0.500); and EQ5d ‘problems while walking’ and CANE mobility/falls (r = 0.509). Corresponding items of the CANE and EQ-5d were significantly correlated with similar socio-demographic variables. The factor analysis supported results obtained in the CANE inter-item correlations.
Conclusions: The Arabic version of the CANE appears acceptable in assessing needs of older adults in South Lebanon. Given that the CANE is an interesting tool that promotes the integration of older persons’ perspectives for appropriate interventions, further research is recommended to establish its validity and applicability in other communities in Lebanon and the region.
Acknowledgements
The authors gratefully acknowledge funding provided by the Lebanon Country Office of the World Health Organization, and the generous assistance of the University of Balamand. Particular thanks are due to Prof Martin Orrell and Dr Juanita Hoe of the Department of Mental Health Sciences, University College, London for their support during the process of developing and pilot testing the tools, to Joelle Hallak of the University of Illinois at Chicago and Prof Stephen Gehlbach of the University of Massachusetts at Amherst for helpful comments during the writing up, and to Rita Kharrat for technical assistance. The study has had the support and help of many colleagues and students at the Faculty of Health Sciences of the University; their efforts have contributed in large part to the success of the work.
Notes
1. The Faculty carried out a study in the Caza of Nabatiyeh in 2004/5 as part of a wider project with the Italian Cooperation and the Ministry of Public Health of Lebanon: Basic Health Services Reform. The present study benefited from consulting the estimated population numbers for the Caza used by that study, and from the results of a survey by International Handicap Organization, carried out in 2005 in the whole governate of Nabatiyeh, and communicated to the research team by Nada Ismail, of International Disability Organization, Lebanon, by fax in November 2006.
2. The research team took the decision not to administer the EQ-VAS part of the EQ5d, as preliminary data collection efforts revealed that most participants were unable to complete it unassisted.