The Clinical Assessment of Confusion-A (CAC-A) is an observational checklist developed for practicing nurses to measure the presence and level of confusion in hospitalized adults. In a previous study, the following dimensions were found using principal factor analysis: cognition, general behavior, motor activity, orientation, psychotic/neurotic behavior, and two uninterpretable factors. A replication study was conducted to evaluate the validity of a statistically derived model for confusion suggested by the CAC-A. Data from a sample of 566 nurses were analyzed. Three theoretically justified statistical models for the structure of confusion were estimated and compared using a model selection approach to covariance structures analysis: a single-factor unidimensional model, an orthogonal six-factor model, and an oblique six-factor model similar to the structure suggested in the development study. The oblique six-factor model provided the best fit in the predictive sense and was the most satisfactory from a theoretical perspective.
Patricia E. Hadley Vermeersch, PhD, RN, is an associate professor, College of Nursing, University of North Dakota, Grand Forks, ND.
Susan J. Henly, PhD, RN, is an associate professor, College of Nursing, University of North Dakota, Grand Forks, ND.
Accepted for publication December 12, 1996.
Supported in part by grants from the Women's Equity Committee, the Faculty Research Committee, and the College of Nursing at the University of North Dakota.
Address reprint requests to Patricia Vermeersch, PhD, RN, College of Nursing, University of North Dakota, Box 9025, Grand Forks, ND 58202-9025.