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Validation study of the Camberwell Assessment of Need for the Elderly (CANE) in Portugal

  • Lia Fernandes (a1), Manuel Gonçalves-Pereira (a2), António Leuschner (a3), Sónia Martins (a4), Margarida Sobral (a3), Luís F. Azevedo (a5), Cláudia Dias (a5), Raimundo Mateos (a6) and Martin Orrell (a7)...

Background: The Camberwell Assessment of Need for the Elderly (CANE) is widely used for multidimensional evaluation of older people with mental health problems. The aim of this study was to evaluate reliability and validity of a Portuguese version of CANE.

Method: A cross-sectional multicenter study was designed using a convenience sample of elderly mental health services' users. CANE was compared with EASYCare, GHQ12, MMSE, Barthel Index and GDS15 to assess criterion and construct validity. Inter-rater and test-retest reliability were also assessed.

Results: 79 patients (76% female), with mean age of 74 (± 6.6) years were included. Most patients lived at home with a family caregiver, generally female. Only 32% had no carer. Dementia was the commonest psychiatric diagnosis (61%) and somatic comorbidity was very prevalent (85%). Kappa values (κ) for inter-rater item reliability ranged from 0.72 to 1.00 (mean values: 0.96 patient, 0.93 carer, 0.90 staff). The intraclass correlation coefficient (ICC) for total scores ranged from 0.95 to 0.98.

For test-retest item reliability, the mean κ value was: 0.80 patient, 0.77 carer, 0.81 staff. ICC for total scores ranged from 0.82 to 0.92. Given the absence of a gold standard, criterion validity was assessed by comparing CANE with EASYCare (rs0.460; p ≤ 0.01), GDS (rs0.615; p ≤ 0.01), GHQ (rs0.581; p ≤ 0.01) and Barthel Index (rs-0.435; p ≤ 0.01). Overall, inter-item and item-total correlations for CANE and item comparison with other measures indicated reasonable construct validity.

Conclusion: The psychometric proprieties of CANE seem to be consistently good, in accordance with other studies. Robust results on ecological, face, content, criterion and construct validity, as well as good reliability, were achieved. This version is a promising tool for research and practical use in Portuguese old age settings.

Corresponding author
Correspondence should be addressed to: Lia Fernandes, Rua de Ceuta, 53-1°, 4050-191 Porto, Portugal. Phone: +351 228 319890. Email:
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

J. Pill (1971). The Delphi method: substance, context, a critique and an annotated bibliography. Socio-Economic Planning Science, 5, 5771.

T. Reynolds (2000). Camberwell Assessment of Need for the Elderly: development, validity and reliability. British Journal of Psychiatry, 176, 444452.

G. Rowe , B. Wright and F. Bolger (1991). Delphi: a re-evaluation of research and theory. Technological Forecasting and Social Change, 39, 235251.

J. Yesavage , T. Brunk , T. Rose , V. Huang , M. Adey and V. Leirer (1983). Development and validation of a geriatric depression screening scale: a preliminary report. Journal of Psychiatric Research, 17, 3749.

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International Psychogeriatrics
  • ISSN: 1041-6102
  • EISSN: 1741-203X
  • URL: /core/journals/international-psychogeriatrics
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Supplementary Materials

Fernandes supplementary material
Table 1.doc

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Supplementary Materials

Fernandes supplementary material
Table 2.doc

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