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The Birmingham Relationship Continuity Measure: the development and evaluation of a measure of the perceived continuity of spousal relationships in dementia

Published online by Cambridge University Press:  30 October 2012

Gerard A. Riley*
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
Gemma Fisher
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
Barbara F. Hagger
Life and Health Sciences, University of Aston, Aston, Birmingham, UK
Amy Elliott
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
Hannah Le Serve
IAPT Team, Norfolk and Waveney Mental Health NHS Foundation Trust, Fermay Unit, Queen Elizabeth Hospital, Norfolk, UK
Jan R. Oyebode
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
Correspondence should be addressed to: Dr. Gerard A. Riley, School of Psychology, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK. Phone: +44 (0)121 414 4923; Fax: +44 (0)121 414 4897. Email:


Background: Qualitative research has suggested that spousal carers of someone with dementia differ in terms of whether they perceive their relationship with that person as continuous with the premorbid relationship or as radically different, and that a perception of continuity may be associated with more person-centered care and the experience of fewer of the negative emotions associated with caring. The aim of the study was to develop and evaluate a quantitative measure of the extent to which spousal carers perceive the relationship to be continuous.

Methods: An initial pool of 42 questionnaire items was generated on the basis of the qualitative research about relationship continuity. These were completed by 51 spousal carers and item analysis was used to reduce the pool to 23 items. The retained items, comprising five subscales, were then administered to a second sample of 84 spousal carers, and the questionnaire's reliability, discriminative power, and validity were evaluated.

Results: The questionnaire showed good reliability: Cronbach's α for the full scale was 0.947, and test–retest reliability was 0.932. Ferguson's δ was 0.987, indicating good discriminative power. Evidence of construct validity was provided by predicted patterns of subscale correlations with the Closeness and Conflict Scale and the Marwit–Meuser Caregiver Grief Inventory.

Conclusion: Initial psychometric evaluation of the measure was encouraging. The measure provides a quantitative means of investigating ideas from qualitative research about the role of relationship continuity in influencing how spousal carers provide care and how they react emotionally to their caring role.

Research Article
Copyright © International Psychogeriatric Association 2012

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