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Evaluation of the measurement properties of the Perceived Stress Scale (PSS) in Hispanic caregivers to patients with Alzheimer’s disease and related disorders

Published online by Cambridge University Press:  21 April 2020

Jeanne A. Teresi ,
Katja Ocepek-Welikson ,
Mildred Ramirez ,
Marjorie Kleinman ,
Katherine Ornstein ,
Albert Siu  and
Jose Luchsinger
Jeanne A. Teresi*
Affiliation:
Research Division, Hebrew Home at Riverdale, Riverdale, New York, NY, USA Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA Analytic Core, Columbia University Alzheimer’s Disease Resource Center for Minority Aging Research and Stroud Center, New York State Psychiatric Institute, New York, NY, USA Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, USA
Katja Ocepek-Welikson
Affiliation:
Research Division, Hebrew Home at Riverdale, Riverdale, New York, NY, USA
Mildred Ramirez
Affiliation:
Research Division, Hebrew Home at Riverdale, Riverdale, New York, NY, USA Measurement and Data Management Core, Mount Sinai Pepper Older Americans Independence Center, Mount Sinai Medical Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA Analytic Core, Columbia University Alzheimer’s Disease Resource Center for Minority Aging Research and Stroud Center, New York State Psychiatric Institute, New York, NY, USA Division of Geriatrics and Palliative Medicine, Weill Cornell Medical Center, New York, NY, USA
Marjorie Kleinman
Affiliation:
Analytic Core, Columbia University Alzheimer’s Disease Resource Center for Minority Aging Research and Stroud Center, New York State Psychiatric Institute, New York, NY, USA
Katherine Ornstein
Affiliation:
Department of Geriatrics and Palliative Medicine, Institute for Translational Epidemiology Mount Sinai School of Medicine, New York, NY, USA
Albert Siu
Affiliation:
Department of Geriatrics and Palliative Medicine, General Internal Medicine, Health Evidence and Policy, Mount Sinai Medical Center, New York, NY, USA
Jose Luchsinger
Affiliation:
Department of Medicine, Columbia University, New York, NY, USA
*
Correspondence should be addressed to: Jeanne Teresi, EdD, PhD, Research Division, Hebrew Home at Riverdale, 5901 Palisade Avenue, Riverdale, New York, NY10471, USA. Phone +718 581 1139. Fax: +718 543-2477. Email: teresimeas@aol.com.
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Abstract

Objectives:

The Perceived Stress Scale (PSS) is the most widely used measure of perceived stress; however, minimal psychometric evaluation has been performed among Hispanic respondents, and even less among Hispanic caregivers to persons with Alzheimer’s disease and related disorders (ADRDs).

Design:

Secondary data analysis.

Setting:

New York City, NY, USA.

Participants:

A sample of 453 community dwelling Hispanic caregivers to patients with ADRD.

Measurements:

Latent variable models were used to evaluate the PSS. Exploratory and confirmatory factor analyses were used to examine unidimensionality. Differential item functioning (DIF) was examined for age, education, and language using the graded item response model.

Results:

The factor and bifactor analyses results supported essential unidimensionality of the item set; however, positively worded items were observed using response item theory to be less informative than the negatively worded items. Reliability estimates were high. Salient DIF was not observed for age, education, or language of interview using the primary DIF detection method. Sensitivity analyses using a second DIF detection method identified uniform language-DIF for the item, “In the last month, how often have you felt that you were on top of things?” However, the non-compensatory DIF value was below the threshold considered salient.

Conclusions:

In summary, the 10-item PSS performed well in a sample of English- and Spanish-speaking Hispanic caregivers to patients with ADRD. Very little DIF, and none of high magnitude and impact, was observed. However, the negatively worded items, perhaps because they are more directly reflective of stress, were more informative. In the context of a short-form measure or computerized adaptive test, more informative items are those that would be selected for inclusion.

Keywords

stress measurementdifferential item functioningLatinx caregiversdementia
Type
Original Research Article
Information
International Psychogeriatrics , Volume 32 , Issue 9: Issue Theme: Enhanced Assessment Instruments for Older Adults with Major Neurocognitive Disorders , September 2020 , pp. 1073 - 1084
Copyright
© International Psychogeriatric Association 2020

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