Translation, Adaptation, and Criterion Validation of the Family Caregiver Assessment Tool for French-Speaking Cardiovascular Patients in Canada (FAM-CAM-Fr)

BackgroundDelirium is a common yet underdiagnosed condition in hospitalized older adults, particularly challenging to detect early in cardiology settings. Although delirium assessment tools improve detection rates, observations by family caregivers of patients' cognitive changes can offer valuable insights, supplementing assessments by healthcare professionals. However, validated French-language tools for family caregivers to assess delirium in acute care settings in Canada are lacking.PurposeTranslate, culturally adapt, and validate the Family Confusion Assessment Method for French-speaking cardiovascular patients and their caregivers (FAM-CAM-Fr).MethodsThe translation and cultural adaptation of the FAM-CAM were conducted following the guidelines of Sousa and Rojjanasrirat (2011). Criterion validation involved 100 dyads of family caregivers and hospitalized cardiovascular patients. The FAM-CAM-Fr's performance was assessed by comparing it to the Confusion Assessment Method (CAM) and the DSM-5 diagnostic criteria for delirium. Measures of sensitivity, specificity, and agreement with the CAM were calculated.ResultsThe FAM-CAM-Fr showed high specificity (92.6%) but low sensitivity (58%) in detecting delirium. Cohen's Kappa indicated a moderate agreement (>0.50) between the FAM-CAM-Fr and the CAM. Despite family caregivers using the tool without prior training, indicating its usability in real-world settings, sensitivity was lower compared to studies that included caregiver training, though specificity was similar.ConclusionThe FAM-CAM-Fr is promising as a specific tool for screening delirium in cardiovascular patients. Despite its low sensitivity, its high specificity indicates that it is effective at ruling out delirium. Future research should focus on further validation across various settings.