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Developing a scale to measure family dynamics related to long-term care, and testing that scale in a multicenter cross-sectional study.

Kusaba T, Sato K, Matsui Y, Matsuda S, Ando T, Sakushima K, Wakita T, Fukuma S, Fukuhara S - BMC Fam Pract (2014)

Bottom Line: The results were analyzed by factor analysis.The results of factor analysis indicated that the scale was unidimensional.The scale's scores are reliable and the results of validation testing were generally good.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Health Outcomes and Process Evaluation Research, Akinonocho, Nakagyo Ward, Kyoto, Japan. fukuhara.shunichi.6m@kyoto-u.ac.jp.

ABSTRACT

Background: As Japan's population ages, more frail elderly people are cared for by members of their family. The dynamics within such families are difficult to study, in part because they are difficult to quantify. We developed a scale for assessing family dynamics related to long-term care. Here we report on the development of that scale, and we present the results of reliability testing and validation testing.

Methods: Two primary-care specialists drafted questions about family dynamics, and discussed them with other primary-care physicians and clinical researchers. The final questionnaire asked about four problems or undesirable situations: disengagement (emotional distance), scapegoating (inappropriate blame), transfer of problems across generations (transfer of unnecessary burden from older to younger generations, trans-generationally displaced revenge), and undesirable behavior (co-dependence). Next, at six general-medicine clinics, doctors evaluated families that had a caregiver and a patient requiring long-term care. The results were analyzed by factor analysis. Cronbach's α was computed, and criterion-related validation tests were done with three types of criteria: relationship before caregiving, ability to do activities of daily living (ADL), and the duration of care.

Results: Results were obtained from 199 families. Among the caregivers, 79% were women and their mean age was 63 years. Among the patients, 71% were women and their mean age was 84 years. The results of factor analysis indicated that the scale was unidimensional. Cronbach's α was 0.73. Not having a good relationship before caregiving was associated with significantly worse family dynamics scores, as was greater dependence regarding ADL.

Conclusions: We developed a scale that enables physicians to assess the dynamics of families with a patient and a family caregiver. The scale's scores are reliable and the results of validation testing were generally good. This scale holds promise as a tool both for research and for primary-care practice.

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Related in: MedlinePlus

Distribution of IF-Long scores.
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Figure 1: Distribution of IF-Long scores.

Mentions: A total of 199 families were included. Among the patients, 71% were women and their mean age was 84 years. Among the caregivers, 79% were women and their mean age was 63 years. Personal attributes of the patients and caregivers are shown in Table 1. The mean duration of care was 5.2 years. The means of all four IF-Long items were less than 1.75 on the 0–3 scale (Table 2). From factor analysis, the four eigenvalues were 2.24, 0.76, 0.68, and 0.32, which indicates that the scale is unidimensional. Cronbach’s α was 0.73. The distribution of mean IF-Long scores is shown in Figure 1. The mean score was 0.61 with a standard deviation of 0.53.


Developing a scale to measure family dynamics related to long-term care, and testing that scale in a multicenter cross-sectional study.

Kusaba T, Sato K, Matsui Y, Matsuda S, Ando T, Sakushima K, Wakita T, Fukuma S, Fukuhara S - BMC Fam Pract (2014)

Distribution of IF-Long scores.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4109784&req=5

Figure 1: Distribution of IF-Long scores.
Mentions: A total of 199 families were included. Among the patients, 71% were women and their mean age was 84 years. Among the caregivers, 79% were women and their mean age was 63 years. Personal attributes of the patients and caregivers are shown in Table 1. The mean duration of care was 5.2 years. The means of all four IF-Long items were less than 1.75 on the 0–3 scale (Table 2). From factor analysis, the four eigenvalues were 2.24, 0.76, 0.68, and 0.32, which indicates that the scale is unidimensional. Cronbach’s α was 0.73. The distribution of mean IF-Long scores is shown in Figure 1. The mean score was 0.61 with a standard deviation of 0.53.

Bottom Line: The results were analyzed by factor analysis.The results of factor analysis indicated that the scale was unidimensional.The scale's scores are reliable and the results of validation testing were generally good.

View Article: PubMed Central - HTML - PubMed

Affiliation: Institute for Health Outcomes and Process Evaluation Research, Akinonocho, Nakagyo Ward, Kyoto, Japan. fukuhara.shunichi.6m@kyoto-u.ac.jp.

ABSTRACT

Background: As Japan's population ages, more frail elderly people are cared for by members of their family. The dynamics within such families are difficult to study, in part because they are difficult to quantify. We developed a scale for assessing family dynamics related to long-term care. Here we report on the development of that scale, and we present the results of reliability testing and validation testing.

Methods: Two primary-care specialists drafted questions about family dynamics, and discussed them with other primary-care physicians and clinical researchers. The final questionnaire asked about four problems or undesirable situations: disengagement (emotional distance), scapegoating (inappropriate blame), transfer of problems across generations (transfer of unnecessary burden from older to younger generations, trans-generationally displaced revenge), and undesirable behavior (co-dependence). Next, at six general-medicine clinics, doctors evaluated families that had a caregiver and a patient requiring long-term care. The results were analyzed by factor analysis. Cronbach's α was computed, and criterion-related validation tests were done with three types of criteria: relationship before caregiving, ability to do activities of daily living (ADL), and the duration of care.

Results: Results were obtained from 199 families. Among the caregivers, 79% were women and their mean age was 63 years. Among the patients, 71% were women and their mean age was 84 years. The results of factor analysis indicated that the scale was unidimensional. Cronbach's α was 0.73. Not having a good relationship before caregiving was associated with significantly worse family dynamics scores, as was greater dependence regarding ADL.

Conclusions: We developed a scale that enables physicians to assess the dynamics of families with a patient and a family caregiver. The scale's scores are reliable and the results of validation testing were generally good. This scale holds promise as a tool both for research and for primary-care practice.

Show MeSH
Related in: MedlinePlus