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The Preparedness Assessment for the Transition Home after Stroke (PATH-s) instrument
Care transitions for individuals with disabling conditions, such as stroke, are often ineffective and inefficient, resulting in unmet patient and caregiver needs, increased safety risks, readmissions, and increased healthcare costs. An assessment instrument designed to evaluate caregiver’s preparation to assume the caregiving role is needed to facilitate the development of tailored care plans and interventions to mitigate the risks of poorly prepared caregivers, and associated health effects on caregiver and stroke survivor. The purpose of this dissertation was to develop and then evaluate selected psychometric properties of the proposed Preparedness Assessment for the Transition Home after Stroke (PATH-s), a 25-item self-administered instrument to assess the commitment and capacity of caregivers based on the Improving Stroke Caregiver Readiness Model. We utilized a sequential, multi-method approach, which included item generation from qualitative data, review of items by expert clinicians, and cognitive interviews of caregivers of stroke survivors. This was followed by a cross-sectional study of 183 caregiver-stroke survivor dyads during IRF admission to identify the factor structure, and to evaluate the internal consistency reliability, construct validity, and criterion-related validity of the PATH-s. Data were collected using a self-administered questionnaire to describe participant characteristics, the PATH-s, Preparedness for Caregiving Scale (PCS), PHQ-9, Perceived Stress Scale, and Global Health Survey (GHS). Factor analysis revealed 8 factors aligned with the Improving Stroke Caregiver Readiness Model, upon which the PATH-s was developed. The PATH-s demonstrated excellent internal consistency (Cronbach’s α = 0.90). Criterion related validity of the PATH-s with the PCS was demonstrated (R = 0.79; p ...