Skip to main content
Top
Published in: Health and Quality of Life Outcomes 1/2009

Open Access 01-12-2009 | Research

Development and preliminary evaluation of a quality of life measure targeted at dementia caregivers

Authors: Barbara G Vickrey, Ron D Hays, Michele L Maines, Stefanie D Vassar, Jaime Fitten, Tony Strickland

Published in: Health and Quality of Life Outcomes | Issue 1/2009

Login to get access

Abstract

Background

Providing care for individuals with a progressive, debilitating condition such as dementia can adversely impact the quality of life (QOL) of informal caregivers. To date, there is no existing caregiver quality of life measure for dementia caregivers with breadth of coverage or that is applicable to caregivers of diverse ethnic backgrounds. The purpose of this study was to develop and evaluate a caregiver-targeted quality-of-life measure (CGQOL) for informal caregivers of persons with dementia that can be used with caregivers from a variety of ethnicities.

Methods

91 items were field tested by telephone interviews with 179 English-speaking and 21 monolingual Spanish-speaking caregivers of persons with dementia. Repeat interviews were conducted with 71 caregivers. Administration time, scale score distributions, item-scale correlations, reliability, and associations of scales with patient and caregiver demographic and caregiving characteristics were estimated. Structure of associations among scales was examined using exploratory factor analysis.

Results

Item analysis yielded 80 items distributed across 10 scales, with median administration time of 17 minutes [IQR 13.5–22 minutes] and minimal missing data. There were few floor or ceiling effects in scale score distributions. Internal consistency reliability was ≥ 0.78 for all scales; test-retest reliability (intraclass correlation) estimates exceeded 0.70 for 6 scales. More hours weekly spent in caregiving was uniquely associated with worse quality of life on 8 scales (p's ≤ 0.05). Three higher-order dimensions of caregiving assistance, emotional and social concerns, and spirituality and benefits were identified.

Conclusion

These preliminary results support subsequent evaluation of test-retest reliability, construct validity, and responsiveness to change of this quality-of-life measure for caregivers from diverse ethnicities.
Appendix
Available only for authorised users
Literature
1.
go back to reference Hebert LE, Scherr PA, Bienias JL, Bennett DA, Evans DA: Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch Neurol 2003, 60: 1119–1122. 10.1001/archneur.60.8.1119CrossRef Hebert LE, Scherr PA, Bienias JL, Bennett DA, Evans DA: Alzheimer disease in the US population: prevalence estimates using the 2000 census. Arch Neurol 2003, 60: 1119–1122. 10.1001/archneur.60.8.1119CrossRef
2.
go back to reference National Institute on Aging: Progress Report on Alzheimer's Disease 2004–2005. (NIH Publication No. 05–5724). Washington, DC: US Government Printing Office; 2005. National Institute on Aging: Progress Report on Alzheimer's Disease 2004–2005. (NIH Publication No. 05–5724). Washington, DC: US Government Printing Office; 2005.
3.
go back to reference Thomas P, Lalloue F, Preux P, Hazif-Thomas C, Pariel S, Inscale R, Belmin J, Clement J: Dementia patients caregivers quality of life: the PIXEL study. Int J Geriatr Psychiatry 2006, 21: 50–56. 10.1002/gps.1422CrossRef Thomas P, Lalloue F, Preux P, Hazif-Thomas C, Pariel S, Inscale R, Belmin J, Clement J: Dementia patients caregivers quality of life: the PIXEL study. Int J Geriatr Psychiatry 2006, 21: 50–56. 10.1002/gps.1422CrossRef
4.
go back to reference Schulz R, Martire LM: Family caregiving of persons with dementia: prevalence, health effects, and support strategies. Am J Geriatr Psychiatry. 2004,12(3):240–249.CrossRef Schulz R, Martire LM: Family caregiving of persons with dementia: prevalence, health effects, and support strategies. Am J Geriatr Psychiatry. 2004,12(3):240–249.CrossRef
5.
go back to reference Pinquart M, Sörensen S: Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2003,58(2):P112-P128.CrossRef Pinquart M, Sörensen S: Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. J Gerontol B Psychol Sci Soc Sci. 2003,58(2):P112-P128.CrossRef
6.
go back to reference Chang B: Cognitive-behavioral intervention for homebound caregivers of persons with dementia. Nurs Res 1999, 48: 173–182. 10.1097/00006199-199905000-00007CrossRef Chang B: Cognitive-behavioral intervention for homebound caregivers of persons with dementia. Nurs Res 1999, 48: 173–182. 10.1097/00006199-199905000-00007CrossRef
7.
go back to reference Gilliard J: Ripples of stress across the generations. J Dementia Care 1996, 4: 16–18. Gilliard J: Ripples of stress across the generations. J Dementia Care 1996, 4: 16–18.
8.
go back to reference Bass D, McClendon M, Deimling G, Mukherjee S: The influence of a diagnosed mental impairment on family caregiver strain. J Gerontol 1994, 49: S146–155.CrossRef Bass D, McClendon M, Deimling G, Mukherjee S: The influence of a diagnosed mental impairment on family caregiver strain. J Gerontol 1994, 49: S146–155.CrossRef
9.
go back to reference Zarit SH, Todd PA, Zarit JM: Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986, 26: 260–266.CrossRef Zarit SH, Todd PA, Zarit JM: Subjective burden of husbands and wives as caregivers: a longitudinal study. Gerontologist 1986, 26: 260–266.CrossRef
10.
go back to reference Zarit SH, Reever KE, Bach-Peterson J: Relatives of impaired elderly: correlates of feelings of burden. Gerontologist 1980, 20: 649–655.CrossRef Zarit SH, Reever KE, Bach-Peterson J: Relatives of impaired elderly: correlates of feelings of burden. Gerontologist 1980, 20: 649–655.CrossRef
11.
go back to reference Radloff LS: The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977, 1: 385–401. 10.1177/014662167700100306CrossRef Radloff LS: The CES-D Scale: a self-report depression scale for research in the general population. Appl Psychol Meas 1977, 1: 385–401. 10.1177/014662167700100306CrossRef
12.
go back to reference Yesavage J: Geriatric Depression Scale. Psychopharmacol Bull 1988, 24: 709–711. Yesavage J: Geriatric Depression Scale. Psychopharmacol Bull 1988, 24: 709–711.
13.
go back to reference Zung WW: A self-rating depression scale. Arch Gen Psychiatry 1965, 12: 63–70.CrossRef Zung WW: A self-rating depression scale. Arch Gen Psychiatry 1965, 12: 63–70.CrossRef
14.
go back to reference Chappell NL, Reid RC: Burden and well-being among caregivers: examining the distinction. Gerontologist 2002, 42: 772–780.CrossRef Chappell NL, Reid RC: Burden and well-being among caregivers: examining the distinction. Gerontologist 2002, 42: 772–780.CrossRef
15.
go back to reference Vellone E, Piras G, Talucci C, Cohen M: Quality of life for caregivers of people with Alzheimer's disease. J Adv Nurs 2008, 61: 222–231.CrossRef Vellone E, Piras G, Talucci C, Cohen M: Quality of life for caregivers of people with Alzheimer's disease. J Adv Nurs 2008, 61: 222–231.CrossRef
16.
go back to reference Euroqol Group: Euroqol: a new facility for the measurement of health related quality of life. Health Policy 1990, 16: 199–208. 10.1016/0168-8510(90)90421-9CrossRef Euroqol Group: Euroqol: a new facility for the measurement of health related quality of life. Health Policy 1990, 16: 199–208. 10.1016/0168-8510(90)90421-9CrossRef
17.
go back to reference Torrance G, Feeny D, Furlong W, Barr R, Zhang Y, Wang Q: Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. Med Care 1996, 34: 702–722. 10.1097/00005650-199607000-00004CrossRef Torrance G, Feeny D, Furlong W, Barr R, Zhang Y, Wang Q: Multiattribute utility function for a comprehensive health status classification system. Health Utilities Index Mark 2. Med Care 1996, 34: 702–722. 10.1097/00005650-199607000-00004CrossRef
18.
go back to reference Ware J: SF-36 health survey: manual and interpretation guide. The Health Institute, New England Medical Center; 1993. Ware J: SF-36 health survey: manual and interpretation guide. The Health Institute, New England Medical Center; 1993.
19.
go back to reference Vickrey BG, Strickland TL, Fitten LJ, Adams GR, Ortiz F, Hays RD: Ethnic variation in dementia caregiving experiences: insights from focus groups. J Hum Behav Soc Environ 2007,15(2/3):233–250. 10.1300/J137v15n02_14CrossRef Vickrey BG, Strickland TL, Fitten LJ, Adams GR, Ortiz F, Hays RD: Ethnic variation in dementia caregiving experiences: insights from focus groups. J Hum Behav Soc Environ 2007,15(2/3):233–250. 10.1300/J137v15n02_14CrossRef
20.
go back to reference Beekly DL, Ramos EM, Lee WW, Deitrich WD, Jacka ME, Wu J, Hubbard JL, Koepsell TD, Morris JC, WA K, NIA Alzheimer's Disease Centers: The National Alzheimer's Coordinating Center (NACC) database: the uniform data set. Alzheimer Dis Assoc Disord 2007, 21: 249–258. 10.1097/WAD.0b013e318142774eCrossRef Beekly DL, Ramos EM, Lee WW, Deitrich WD, Jacka ME, Wu J, Hubbard JL, Koepsell TD, Morris JC, WA K, NIA Alzheimer's Disease Centers: The National Alzheimer's Coordinating Center (NACC) database: the uniform data set. Alzheimer Dis Assoc Disord 2007, 21: 249–258. 10.1097/WAD.0b013e318142774eCrossRef
21.
go back to reference Stewart AL, Greenfield S, Hays RD, Wells K, Rogers WH, Berry SD, McGlynn EA, Ware JE Jr: Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA 1989, 262: 907–913. 10.1001/jama.262.7.907CrossRef Stewart AL, Greenfield S, Hays RD, Wells K, Rogers WH, Berry SD, McGlynn EA, Ware JE Jr: Functional status and well-being of patients with chronic conditions. Results from the Medical Outcomes Study. JAMA 1989, 262: 907–913. 10.1001/jama.262.7.907CrossRef
22.
go back to reference Hui CH, Triandis HC: Measurement in cross-cultural psychology: a review and comparison of strategies. J Cross Cult Psychol 1985, 16: 131–152. 10.1177/0022002185016002001CrossRef Hui CH, Triandis HC: Measurement in cross-cultural psychology: a review and comparison of strategies. J Cross Cult Psychol 1985, 16: 131–152. 10.1177/0022002185016002001CrossRef
23.
go back to reference Sudman S, Bradburn NM, Schwarz N: Thinking about Answers: The Application of Cognitive Processes to Survey Methodology. San Francisco: Jossey-Bass Publishers; 1996. Sudman S, Bradburn NM, Schwarz N: Thinking about Answers: The Application of Cognitive Processes to Survey Methodology. San Francisco: Jossey-Bass Publishers; 1996.
24.
go back to reference Stewart AL, Hays RD, Ware JE Jr: Methods of Constructing Health Measures. In Measuring Functioning and Well-Being. Edited by: Stewart A, Ware JE Jr. Durham, NC: Duke University Press; 1992. Stewart AL, Hays RD, Ware JE Jr: Methods of Constructing Health Measures. In Measuring Functioning and Well-Being. Edited by: Stewart A, Ware JE Jr. Durham, NC: Duke University Press; 1992.
25.
go back to reference Hays RD, Wang E: Multitrait scaling program: MULTI. Proceedings of the Seventeenth Annual SAS Users Group International Conference. Honolulu, HI 1992. Hays RD, Wang E: Multitrait scaling program: MULTI. Proceedings of the Seventeenth Annual SAS Users Group International Conference. Honolulu, HI 1992.
26.
go back to reference Cronbach L: Coefficient alpha and the internal structure of tests. Psychometrika 1951, 16: 297–334. 10.1007/BF02310555CrossRef Cronbach L: Coefficient alpha and the internal structure of tests. Psychometrika 1951, 16: 297–334. 10.1007/BF02310555CrossRef
27.
go back to reference Baumgarten M, Battista R, Infante-Rivard C, Hanley J, Becker R, Gauthier S: The psychological and physical health of family members caring for an elderly person with dementia. J Clin Epidemiol 1992, 45: 61–70. 10.1016/0895-4356(92)90189-TCrossRef Baumgarten M, Battista R, Infante-Rivard C, Hanley J, Becker R, Gauthier S: The psychological and physical health of family members caring for an elderly person with dementia. J Clin Epidemiol 1992, 45: 61–70. 10.1016/0895-4356(92)90189-TCrossRef
28.
go back to reference Hays RD, Revicki D: Reliability and validity (including responsiveness). In Assessing Quality of Life in Clinical Trials. 2nd edition. Edited by: Fayers P, Hays RD. New York: Oxford University Press; 2005. Hays RD, Revicki D: Reliability and validity (including responsiveness). In Assessing Quality of Life in Clinical Trials. 2nd edition. Edited by: Fayers P, Hays RD. New York: Oxford University Press; 2005.
Metadata
Title
Development and preliminary evaluation of a quality of life measure targeted at dementia caregivers
Authors
Barbara G Vickrey
Ron D Hays
Michele L Maines
Stefanie D Vassar
Jaime Fitten
Tony Strickland
Publication date
01-12-2009
Publisher
BioMed Central
Published in
Health and Quality of Life Outcomes / Issue 1/2009
Electronic ISSN: 1477-7525
DOI
https://doi.org/10.1186/1477-7525-7-56

Other articles of this Issue 1/2009

Health and Quality of Life Outcomes 1/2009 Go to the issue