Investigating the Effects of Communication Problems on Caregiver Burden

Principles for reporting analyses using structural equation modeling are reviewed, with the goal of supplying readers with complete and accurate information. It is recommended that every report give a detailed justification of the model used, along with plausible alternatives and an account of identifiability. Nonnormality and missing data problems should also be addressed. A complete set of parameters and their standard errors is desirable, and it will often be convenient to supply the correlation matrix and discrepancies, as well as goodness-of-fit indices, so that readers can exercise independent critical judgment. A survey of fairly representative studies compares recent practice with the principles of reporting recommended here.

The aging of the population of the United States and a concern for the well-being of older people have hastened the emergence of measures of functional health. Among these, measures of basic activities of daily living, mobility, and instrumental activities of daily living have been particularly useful and are now widely available. Many are defined in similar terms and are built into available comprehensive instruments. Although studies of reliability and validity continue to be needed, especially of predictive validity, there is documented evidence that these measures of self-maintaining function can be reliably used in clinical evaluations as well as in program evaluations and in planning. Current scientific evidence indicates that evaluation by these measures helps to identify problems that require treatment or care. Such evaluation also produces useful information about prognosis and is important in monitoring the health and illness of elderly people.