Hostname: page-component-848d4c4894-nmvwc Total loading time: 0 Render date: 2024-06-14T23:01:22.815Z Has data issue: false hasContentIssue false

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*
Affiliation:
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
Gemma Fisher
Affiliation:
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
Barbara F. Hagger
Affiliation:
Life and Health Sciences, University of Aston, Aston, Birmingham, UK
Amy Elliott
Affiliation:
School of Psychology, University of Birmingham, Edgbaston, Birmingham, UK
Hannah Le Serve
Affiliation:
IAPT Team, Norfolk and Waveney Mental Health NHS Foundation Trust, Fermay Unit, Queen Elizabeth Hospital, Norfolk, UK
Jan R. Oyebode
Affiliation:
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: G.A.Riley@bham.ac.uk.

Abstract

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.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Ablitt, A., Jones, G. V. and Muers, J. (2009). Living with dementia: a systematic review of the influence of relationship factors. Aging and Mental Health, 13, 497511. doi:10.1080/13607860902774436.CrossRefGoogle ScholarPubMed
Betts-Adams, K. and Sanders, S. (2004). Alzheimer's caregiver differences in experience of loss, grief reactions and depressive symptoms across stage of disease. Dementia: The International Journal of Social Research and Practice, 3, 195210. doi:10.1177/1471301204042337.CrossRefGoogle Scholar
Blieszner, R. and Shifflett, P. A. (1990). The effects of Alzheimer's disease on close relationships between patients and caregivers. Family Relations, 39, 5762.CrossRefGoogle Scholar
Burgener, S. and Twigg, P. (2002). Relationships among caregiver factors and quality of life in care recipients with irreversible dementia. Alzheimer Disease and Associated Disorders, 16, 88102. doi:10.1097/01.WAD.0000015567.76518.5C.CrossRefGoogle ScholarPubMed
Chesla, C., Martinson, I. and Muwaswes, M. (1994). Continuities and discontinuities in family members’ relationships with Alzheimer's patients. Family Relations, 43, 39.CrossRefGoogle Scholar
Collins, C., Liken, M. and Kokinakis, C. (1993). Loss and grief among family caregivers of relatives with dementia. Qualitative Health Research, 3, 236253.CrossRefGoogle Scholar
Costello, A. B. and Osborne, J. (2005). Best practices in exploratory factor analysis: four recommendations for getting the most from your analysis. Practical Assessment, Research and Evaluation, 10, 19. Available at: http://pareonline.net/getvn.asp?v=10&n=7.Google Scholar
Gladstone, J. W. (1995). The marital perceptions of elderly persons living of having a spouse living in a long-term care institution in Canada. The Gerontologist, 35, 5260.CrossRefGoogle Scholar
Hankins, M. (2007). Questionnaire discrimination: (re)-introducing coefficient delta. BMC Medical Research Methodology, 7, 19. doi:10.1186/1471-2288-7-19.CrossRefGoogle ScholarPubMed
Hellstrom, I., Nolan, M. and Lundh, U. (2005). ‘We do things together’: a case study of ‘couplehood’ in dementia. Dementia: The International Journal of Social Research and Practice, 4, 722. doi:10.1177/1471301205049188.CrossRefGoogle Scholar
Hellstrom, I., Nolan, M. and Lundh, U. (2007). Sustaining ‘couplehood’: spouses’ strategies for living positively with dementia. Dementia: The International Journal of Social Research and Practice, 6, 383409. doi:10.1177/1471301207081571.CrossRefGoogle Scholar
Kaplan, L. (2001). A couplehood typology for spouses of institutionalized persons with Alzheimer's disease: perceptions of ‘We’-‘I’. Family Relations, 50, 8798.CrossRefGoogle Scholar
Keady, J. and Nolan, M. R. (2003). The dynamics of dementia: working together, working separately, or working alone? In Nolan, M. R., Lundh, U., Grant, G. and Keady, J. (eds.), Partnerships in Family Care: Understanding the Caregiving Carer (pp. 1532). Maidenhead, UK: Open University Press.Google Scholar
Kline, P. (2000). A Psychometrics Primer. London, UK: Free Association Books.Google Scholar
Lewis, R. D. H. (1998). The impact of the marital relationship on the experience of caring for an elderly spouse with dementia. Ageing and Society, 18, 209231.CrossRefGoogle Scholar
Martin, M., Peter-Wight, M., Braun, M., Hornung, R. and Scholz, U. (2009). The 3-phase-model of dyadic adaptation to dementia: why it might sometimes be better to be worse. European Journal of Ageing, 6, 291301. doi:10.1007/s10433-009-0129-5.CrossRefGoogle ScholarPubMed
Marwit, S. J. and Meuser, T. M. (2002). Development and initial validation of an inventory to assess grief in caregivers of persons with Alzheimer's disease. The Gerontologist, 42, 751765.CrossRefGoogle ScholarPubMed
Mausbach, B. T.et al. (2004). Ethnicity and time to institutionalization of dementia patients: a comparison of Latina and Caucasian female family caregivers. Journal of the American Geriatrics Society, 52, 10771084.CrossRefGoogle ScholarPubMed
McGraw, K. O. and Wong, S. P. (1996). Forming inferences about some intraclass correlation coefficients. Psychological Methods, 1, 3046.CrossRefGoogle Scholar
Murray, J. and Livingston, G. (1998). A qualitative study of adjustment to caring for an older spouse with psychiatric illness. Ageing and Society, 18, 659671.CrossRefGoogle Scholar
Preacher, K. J. and MacCallum, R. C. (2002). Exploratory factor analysis in behavior genetics research: factor recovery with small samples. Behavior Genetics, 32, 153161.CrossRefGoogle Scholar
Sandberg, J. and Eriksson, H. (2007). ‘The hard thing is the changes’: the importance of continuity for older men caring for their wives. Quality in Ageing – Policy, Practice and Research, 8, 515.CrossRefGoogle Scholar
Schofield, H. L., Murphy, B., Herrman, H. E., Bloch, S. and Singh, B. (1997). Family caregiving: measurement of emotional well-being and various aspects of the caregiving role. Psychological Medicine, 27, 647657.CrossRefGoogle ScholarPubMed
Steadman, P. L., Tremont, G. and Davis, J. D. (2007). Premorbid relationship satisfaction and caregiver burden in dementia. Journal of Geriatric Psychiatry and Neurology, 20, 115119. doi:10.1177/0891988706298624.CrossRefGoogle ScholarPubMed
Terluin, B., Knol, D. L., Terwee, C. B. and de Vet, H. C. W. (2009). Understanding Ferguson's delta: time to say good-bye? Health and Quality of Life Outcomes, 7, 38. doi:10.1186/1477-7525-7-38.CrossRefGoogle ScholarPubMed
Walters, A. H., Oyebode, J. R. and Riley, G. A. (2010). The dynamics of continuity and discontinuity for women caring for a spouse with dementia. Dementia: The International Journal of Social Research and Practice, 9, 169189. doi:10.1177/1471301209354027.CrossRefGoogle Scholar