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Reconstruction of a Caregiver Burden Scale: Identifying Culturally Sensitive Items in Saudi Arabia

Published online by Cambridge University Press:  02 April 2018

Eradah O. Hamad ,
Ahmad N. AlHadi ,
Paul F. Tremblay ,
Marie Y. Savundranayagam ,
Elizabeth Anne Kinsella ,
Jeffrey D. Holmes ,
Christopher J. Lee  and
Andrew M. Johnson
Eradah O. Hamad
Affiliation:
Department of Psychology, Faculty of Arts and Humanities, King Abdulaziz University, Jeddah, Saudi Arabia Graduate Program in Health and Rehabilitation Sciences, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
Ahmad N. AlHadi
Affiliation:
Department of Psychiatry, King Saud University Medical City, College of Medicine, King Saud University, Riyadh, Saudi Arabia SABIC Psychological Health Research and Applications Chair (SPHRAC), College of Medicine, King Saud University, Riyadh, Saudi Arabia
Paul F. Tremblay
Affiliation:
Department of Psychology, Faculty of Social Science, The University of Western Ontario, London, ON, Canada
Marie Y. Savundranayagam
Affiliation:
School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
Elizabeth Anne Kinsella
Affiliation:
School of Occupational Therapy, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
Jeffrey D. Holmes
Affiliation:
School of Occupational Therapy, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
Christopher J. Lee
Affiliation:
School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
Andrew M. Johnson*
Affiliation:
School of Health Studies, Faculty of Health Sciences, The University of Western Ontario, London, ON, Canada
*
†La correspondance et les demandes de tirés-à-part doivent être adressées à : / Correspondence and requests for reprints should be sent to: Andrew M. Johnson, Ph.D. School of Health Studies The University of Western Ontario Arthur and Sonia Labatt Health Sciences Building, Room 330 London, ON, N6A 5B9 <ajohnson@uwo.ca>
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Abstract

For this study, we adapted the Montgomery Borgatta Caregiver Burden Scale, used widely in the United States, to the Saudi Arabian context. To produce an Arabic, culturally sensitive version of the scale, we conducted semi-structured interviews with 20 Saudi family caregivers. The Arabic version of the scale was tested, and participants were asked to comment on the appropriateness of items for the construct of “caregiver burden” using the repertory grid technique and laddering procedure – two constructivist methods derived from personal construct theory. From interview findings, we examined the content of the items and the caregiver burden construct itself. Our findings suggest that the use of constructivist methods to refine constructs and quantitative instruments is highly informative. This strategy is feasible even when little is known about the investigated constructs in the target culture and further elucidates our understanding of cross-cultural variations or invariance of different versions of the scale.

Résumé

Le Montgomery Borgatta Caregiver Burden Scale, une échelle fréquemment utilisée aux États-Unis, a été adapté au contexte de l’Arabie Saoudite. En vue de produire une version de cette échelle qui soit compatible avec la culture arabe, des entretiens semi-structurés ont été menés auprès d’un échantillon de convenance de 20 aidants familiaux saoudiens. La version arabe de l’échelle a été administrée, et les participants ont été invités à donner leurs commentaires sur la pertinence des questions portant sur le construit du fardeau de l’aidant. Deux méthodes constructivistes associées à la théorie des construits personnels ont été utilisées, soit la technique de la grille-répertoire et la procédure d’échelonnage. Les rapports d’entretiens ont servi à évaluer le contenu des questions et du construit associé au fardeau de l’aidant. Nos résultats indiquent que les méthodes constructivistes peuvent être très utiles pour affiner des construits et des instruments quantitatifs. Ces stratégies ont une bonne faisabilité même dans les cas où l’on dispose de peu d’indices sur le construit étudié dans un milieu culturel donné, et permettent d’approfondir nos connaissances sur les variations interculturelles de différentes versions de l’échelle.

Keywords

agingfamily caregivingAlzheimer’s diseaseArab regioncaregiver burdenpersonal construct theoryvieillissementsoins dispensés par les aidants familiauxmaladie d’Alzheimerrégion arabefardeau de l’aidantthéorie des construits personnels
Type
Article
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 37 , Issue 2 , June 2018 , pp. 218 - 233
Copyright
Copyright © Canadian Association on Gerontology 2018 

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Footnotes

*

We thank the family caregivers who participated in this study and the research assistant, Abdulkarim Alotaibi, who assisted us with the data collection and analysis and early version of the manuscript. Special thanks is also forwarded to Arwa Arab for her recommendations to the scale translation in the target culture (Saudi Arabia), and Fahad AlWahabi and the Saudi Alzheimer’s Disease Association for the help they provided to facilitate the data collection. This study is a part of EH’s doctoral dissertation, and aspects of this study were presented in the poster presentation session of the 44th Annual Scientific and Educational Meeting of the Canadian Association on Gerontology (CAG2015), Calgary, Alberta.

Funding: Eradah O. Hamad is supported by the graduate scholarship program of King Abdulaziz University, Ministry of Education, Saudi Arabia. The funding agency played no role in the development or review of the manuscript.

References

Abdelmoneium, A. O., & Alharahsheh, S. T. (2016). Family home caregivers for old persons in the Arab region: Perceived challenges and policy implications. Open Journal of Social Sciences, 04(01), 151–164.10.4236/jss.2016.41019CrossRefGoogle Scholar
Adelman, R. D., Tmanova, L. L., Delgado, D., Dion, S., & Lachs, M. S. (2014). Caregiver burden: A clinical review. JAMA, 311(10), 1052.10.1001/jama.2014.304CrossRefGoogle ScholarPubMed
Ahern, D., Guberman, N., Levine, C., Maslow, K., Montgomery, A., Reinhard, S., & Zarit, S. (2006). Caregiver assessment: Voices and views from the field. Report from a National Consensus Development Conference (Vol. II). San Francisco, CA. Retrieved from https://www.caregiver.org/sites/caregiver.org/files/pdfs/v2_consensus.pdfGoogle Scholar
Alobaidi, I., & Aldamigh, S. (2001). Dementia in Saudi Arabia: Its spread and related factors. Riyadh, SAU: Sultan bin Abdulaziz Foundation.Google Scholar
Ankri, J., Andrieu, S., Beaufils, B., Grand, A., & Henrard, J. C. (2005). Beyond the global score of the Zarit Burden Interview: Useful dimensions for clinicians. International Journal of Geriatric Psychiatry, 20(3), 254–260.10.1002/gps.1275CrossRefGoogle ScholarPubMed
Chaaya, M., Phung, T. K. T., El Asmar, K., Atweh, S., Ghusn, H., Khoury, R. M., … Waldemar, G. (2016). Validation of the Arabic Rowland Universal Dementia Assessment Scale (A-RUDAS) in elderly with mild and moderate dementia. Aging & Mental Health, 20(8), 880–887.10.1080/13607863.2015.1043620CrossRefGoogle ScholarPubMed
Cheng, S.-T., Lau, R. W. L., Mak, E. P. M., Ng, N. S. S., & Lam, L. C. W. (2014). Benefit-finding intervention for Alzheimer caregivers: Conceptual framework, implementation issues, and preliminary efficacy. The Gerontologist, 54(6), 1049–1058.10.1093/geront/gnu018CrossRefGoogle ScholarPubMed
Cheung, F. M., van de Vijver, F. J. R., & Leong, F. T. L. (2011). Toward a new approach to the study of personality in culture. American Psychologist, 66(7), 593–603.10.1037/a0022389CrossRefGoogle Scholar
Chiu, M.-J., Chen, T.-F., Yip, P.-K., Hua, M.-S., & Tang, L.-Y. (2006). Behavioral and psychologic symptoms in different types of dementia. Journal of the Formosan Medical Association, 105(7), 556–562.10.1016/S0929-6646(09)60150-9CrossRefGoogle ScholarPubMed
Choi, H. (1993). Cultural and noncultural factors as determinants of caregiver burden for the impaired elderly in South Korea. The Gerontologist, 33(1), 8–15.10.1093/geront/33.1.8CrossRefGoogle ScholarPubMed
Chou, K. R., Chu, H., Tseng, C. L., & Lu, R. B. (2003). The measurement of caregiver burden. Journal of Medical Sciences, 23(2), 73–82.Google Scholar
Cohen, C. A., Colantonio, A., & Vernich, L. (2002). Positive aspects of caregiving: Rounding out the caregiver experience. International Journal of Geriatric Psychiatry, 17(2), 184–188.10.1002/gps.561CrossRefGoogle ScholarPubMed
Creswell, J. W., & Plano Clark, V. L. (2011). Designing and conducting mixed methods research (2nd ed.). Thousand Oaks, CA: SAGE.Google Scholar
Dalky, H. F. (2012). Perception and coping with stigma of mental illness: Arab families’ perspectives. Issues in Mental Health Nursing, 33(7), 486–491. doi:10.3109/01612840.2012.676720.CrossRefGoogle ScholarPubMed
del-Pino-Casado, R., Frías-Osuna, A., Palomino-Moral, P. A., & Pancorbo-Hidalgo, P. L. (2011). Coping and subjective burden in caregivers of older relatives: A quantitative systematic review. Journal of Advanced Nursing, 67(11), 2311–2322.10.1111/j.1365-2648.2011.05725.xCrossRefGoogle ScholarPubMed
Dilworth-Anderson, P., Goodwin, P. Y., & Williams, S. W. (2004). Can culture help explain the physical health effects of caregiving over time among African American caregivers? The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 59(3), S138–S145.CrossRefGoogle ScholarPubMed
Donnelly, M. L. (2005). Behavioral and psychological disturbances in Alzheimer disease: Assessment and treatment. British Columbia Medical Journal, 47(9), 487–493.Google Scholar
Drisko, J., & Maschi, T. (2015). Content Analysis. New York, NY: Oxford University Press.10.1093/acprof:oso/9780190215491.001.0001CrossRefGoogle Scholar
Dunkin, J. J., & Anderson-Hanley, C. (1998). Dementia caregiver burden: A review of the literature and guidelines for assessment and intervention. Neurology, 51(1, S1), S53–S60.CrossRefGoogle ScholarPubMed
Etters, L., Goodall, D., & Harrison, B. E. (2008). Caregiver burden among dementia patient caregivers: A review of the literature. Journal of the American Academy of Nurse Practitioners, 20(8), 423–428.CrossRefGoogle ScholarPubMed
Farley, N., Demers, L., & Swaine, B. R. (2008). Development of the French Canadian version of the Montgomery Borgatta Caregiver Burden Scale. Canadian Journal on Aging, 27(2), 181–190. doi:10.3138/cja.27.2.181CrossRefGoogle ScholarPubMed
Feinberg, L. F. (2002). The state of the art: Caregiver assessment in practice settings. San Francisco, CA: Family Caregiver Alliance. Retrieved from http://www.rosalynncarter.org/UserFiles/CaregiverAssessment2002FCA.pdfGoogle Scholar
Floyd, F. J., & Widaman, K. F. (1995). Factor analysis in the development and refinement of clinical assessment instruments. Psychological Assessment, 7(3), 286–299. doi:10.1037/1040-3590.7.3.286CrossRefGoogle Scholar
Fuh, J.-L. (2006). Study of behavioral and psychological symptoms of dementia in Taiwan. Acta Neurologica Taiwanica, 15(3), 154–160.Google ScholarPubMed
Grad, J., & Sainsbury, P. (1963). Mental illness and the family. The Lancet, 281(7280), 544–547. doi:10.1016/S0140-6736(6391339-4)CrossRefGoogle Scholar
Halabi, A. K., & Zafar, J. M. (2010). Care of the elderly in United Arab Emirates. International Journal of Geriatric Psychiatry, 25(9), 925–927.CrossRefGoogle ScholarPubMed
Hamad, E.O., AlHadi, A.N., Lee, C.J., Savundranayagam, M.Y., Holmes, J.D., Kinsella, E.A., & Johnson, A.M. (2017). Assessment of caregiving constructs: Toward a personal, familial, group, and cultural construction of dementia care through the eyes of personal construct psychology. Journal of Cross-Cultural Gerontology, 32(4), 413–431.CrossRefGoogle Scholar
Harrington, D. (2009). Confirmatory Factor Analysis. New York, NY: Oxford University Press.Google Scholar
Harwood, D. G., Barker, W. W., Ownby, R. L., Bravo, M., Aguero, H., & Duara, R. (2000). Predictors of positive and negative appraisal among Cuban American caregivers of Alzheimer’s disease patients. International Journal of Geriatric Psychiatry, 15(6), 481–487.3.0.CO;2-J>CrossRefGoogle ScholarPubMed
Hill, R. A. (1995). Content analysis for creating and depicting aggregated personal construct derived cognitive maps. In Neimeyer, R. A. & Neimeyer, G. J. (Eds.), Advances in personal construct psychology (pp. 101–132). Greenwich, CT: JAI Press.Google Scholar
Hinkle, D. N. (2010). The change of personal constructs from the viewpoint of a theory of construct implications (Doctoral dissertation, Ohio State University, 1965). Personal Construct Theory & Practice, 7(Suppl. no. 1), 1–61.Google Scholar
Jankowicz, D. (2003). The easy guide to repertory grids. West Sussex, ENG: John Wiley & Sons.Google Scholar
Kalaria, R. N., Maestre, G. E., Arizaga, R., Friedland, R. P., Galasko, D., Hall, K., … Antuono, P. (2008). Alzheimer’s disease and vascular dementia in developing countries: Prevalence, management, and risk factors. The Lancet Neurology, 7(9), 812–826. doi:10.1016/S1474-4422(0870169-8)CrossRefGoogle ScholarPubMed
Kar, N. (2009). Behavioral and psychological symptoms of dementia and their management. Indian Journal of Psychiatry, 51(Suppl. 1), S77–S86.Google ScholarPubMed
Kelly, G. A. (1955). The psychology of personal constructs. New York, NY: Norton.Google Scholar
Kim, J.-S., & Lee, E.-H. (2003). Cultural and noncultural predictors of health outcomes in Korean daughter and daughter-in-law caregivers. Public Health Nursing, 20(2), 111–119.CrossRefGoogle ScholarPubMed
Kosberg, J. I. (Eds.). (1992). Family care of the elderly: Social and cultural changes. Newbury Park, CA: SAGEGoogle Scholar
Lai, D. W. L. (2010). Filial piety, caregiving appraisal, and caregiving burden. Research on Aging, 32(2), 200–223.10.1177/0164027509351475CrossRefGoogle Scholar
Lauber, C., & Rössler, W. (2007). Stigma towards people with mental illness in developing countries in Asia. International Review of Psychiatry, 19(2), 157–178.CrossRefGoogle ScholarPubMed
Leggett, A. N., Zarit, S., Taylor, A., & Galvin, J. E. (2011). Stress and burden among caregivers of patients with Lewy body dementia. The Gerontologist, 51(1), 76–85. doi:10.1093/geront/gnq055CrossRefGoogle ScholarPubMed
Matsumoto, N., Ikeda, M., Fukuhara, R., Shinagawa, S., Ishikawa, T., Mori, T., … Tanabe, H. (2007). Caregiver burden associated with behavioral and psychological symptoms of dementia in elderly people in the local community. Dementia and Geriatric Cognitive Disorders, 23(4), 219–224.CrossRefGoogle ScholarPubMed
Montgomery, R. J. V., Borgatta, E. F., & Borgatta, M. L. (2000). Societal and family change in the burden of care. In Liu, W. T. & Kendig, H. (Eds.), Who should care for the elderly? An East-West value divide (pp. 27–54). River Edge, NJ: World Scientific.CrossRefGoogle Scholar
Montgomery, R. J. V., Gonyea, J. G., & Hooyman, N. R. (1985). Caregiving and the experience of subjective and objective burden. Family Relations, 34(1), 19.CrossRefGoogle Scholar
Montgomery, R. J. V., Rowe, J. M., & Kosloski, K. (2007). Family caregiving. In Blackburn, J. A. & Dulmus, C. N. (Eds.), The handbook of gerontology: Evidence-based approaches to theory, practice, and policy (pp. 426–454). Indianapolis, IN: John Wiley & Sons.CrossRefGoogle Scholar
Montgomery, R. V, Stull, D. E., & Borgatta, E. F. (1985). Measurement and the analysis of burden. Research on Aging, 7(1), 137–152.CrossRefGoogle ScholarPubMed
Muangpaisan, W., Hori, H., & Brayne, C. (2009). Systematic review of the prevalence and incidence of Parkinson’s disease in Asia. Journal of Epidemiology, 19(6), 281–293. doi:10.2188/jea.JE20081034CrossRefGoogle ScholarPubMed
Osman, B. A., Shukri, A. S. M., & Othman, N. (2011). Filial piety in Confucianism and Islam: A comparative literary analysis of Qur’an, Hadith, and four Chinese classics. Islam & Civilisational Renewal, 3(1), 133.Google Scholar
Pearlin, L. I., Mullan, J. T., Semple, S. J., & Skaff, M. M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30(5), 583–594.10.1093/geront/30.5.583CrossRefGoogle ScholarPubMed
Rappoport, A., & Lowenstein, A. (2007). A possible innovative association between the concept of inter-generational ambivalence and the emotions of guilt and shame in care-giving. European Journal of Ageing, 4(1), 13–21.CrossRefGoogle ScholarPubMed
Roff, L. L., Burgio, L. D., Gitlin, L., Nichols, L., Chaplin, W., & Hardin, J. M. (2004). Positive aspects of Alzheimer’s caregiving: The role of race. The Journals of Gerontology. Series B, Psychological Sciences and Social Sciences, 59(4), P185–P190.CrossRefGoogle ScholarPubMed
Salama, R. A. A., & Abou El-soud, F. A. (2012). Caregiver burden from caring for impaired elderly: A cross-sectional study in rural Lower Egypt. Italian Journal of Public Health, 9(4), 1–10.Google Scholar
Savundranayagam, M. Y., Montgomery, R. J. V., & Kosloski, K. (2011). A Dimensional analysis of caregiver burden among spouses and adult children. The Gerontologist, 51(3), 321–331.CrossRefGoogle ScholarPubMed
Sibai, A. M., Rizk, A., & Kronfol, K. M. (2014). Ageing in the Arab Region: Trends, implications and policy options. Beirut, LBN: The United Nations Population Fund (UNFPA), Economic and Social Commission of Western Asia (ESCWA), and the Center for Studies on Aging (CSA). Retrieved from http://www.csa.org.lb/cms/assets/csapublications/unfpaescwaregionalageingoverview_full_reduced.pdfGoogle Scholar
Sinunu, M., Yount, K. M., & El Afify, N. A. (2009). Informal and formal long-term care for frail older adults in Cairo, Egypt: Family caregiving decisions in a context of social change. Journal of Cross, 24, 63–76.Google Scholar
Saudi, Stats. (2016, November 20). Infographic illustrates age distribution of Saudi population based on the 2016 demographic population survey [Translated tweet]. Retrieved from https://twitter.com/stats_saudi/status/800400902293164032Google Scholar
Szinovacz, M. E., & Davey, A. (Eds.). (2008). Caregiving contexts: Cultural, familial, and societal implications. New York, NY: Springer.Google Scholar
Walker, A. (2000). Sharing long-term care between the family and the state: A European perspective. In Liu, W. T. & Kending, H. (Eds.), Who should care for the elderly? An East-West value divide (pp. 78–106). SGP: Singapore University Press.CrossRefGoogle Scholar
Ward, W. B., & Younis, M. Z. (2013). Steps toward a planning framework for elder care in the Arab world. Springer briefs in aging. New York, NY: Springer Science and Business Media. doi:10.1007/978-1-4614-5978-1CrossRefGoogle Scholar
Weech-Maldonado, R., Weidmer, B. O., Morales, L. S., & Hays, R. D. (2001). Cross-cultural adaptation of survey instruments: The CAHPS® experience. In Cynamon, M. L. & Kulka, R. A. (Eds.), Seventh Conference of Health Survey Methods (pp. 75–81). Hyattsville, MD: DHHS.Google Scholar
Zarit, S. H. (1985). The hidden victims of Alzheimer’s disease: Families under stress. NY, NY: New York University Press.Google Scholar
Zarit, S. H., & Femia, E. E. (2008). A future for family care and dementia intervention research? Challenges and strategies. Aging & Mental Health, 12(1), 5–13. doi:10.1080/13607860701616317CrossRefGoogle ScholarPubMed
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