Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T21:59:41.081Z Has data issue: false hasContentIssue false

Validation of family conflict scales for family caregivers of persons with dementia in long-term care facilities and exploration of family conflicts and support

Published online by Cambridge University Press:  08 November 2017

Chie Fukui
Affiliation:
Department of Family Nursing, School of Health Sciences and Nursing, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan
Mariko Sakka
Affiliation:
Department of Family Nursing, School of Health Sciences and Nursing, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan
Rachel Marry Amiya
Affiliation:
Department of Family Nursing, School of Health Sciences and Nursing, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan TechWerks LLC, Silver Spring, Maryland, USA
Iori Sato
Affiliation:
Department of Family Nursing, School of Health Sciences and Nursing, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan
Kiyoko Kamibeppu*
Affiliation:
Department of Family Nursing, School of Health Sciences and Nursing, Graduate school of Medicine, The University of Tokyo, Tokyo, Japan
*
Correspondence should be addressed to: Kiyoko Kamibeppu, Department of Family Nursing, Graduate School of Health Sciences and Nursing, Faculty of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo 113-0033, Japan. Phone/Fax: 03-5841-3399. Email: kkamibeppu-tky@umin.ac.jp.
Get access

Abstract

Background:

The aim of the study was to develop a family conflict scale for family caregivers of persons with dementia in long-term care facilities and to explore the relationship between family conflicts and family support.

Methods:

The scale was developed through forward- and back-translations, interviews with 12 staff members in long-term care facilities, and cognitive interviews with 12 family caregivers who met operational definitions in this study. The test was conducted with 334 family caregivers and a retest was conducted with 318 family caregivers who had indicated willingness to participate further.

Results:

The internal consistency was relatively high for all subscales (Cronbach's α >0.87); sufficient retest reliability was demonstrated for all subscales (intraclass correlation coefficient >0.69). Confirmatory factor analysis supported a three-factor model. Convergent and discriminant validity for each of the family conflict scale subscales, family APGAR, and the Symptom Check List–90 Items–Revised were acceptable. Family caregivers who received no family assistance for caregiving perceived more conflict in their family than those receiving family assistance.

Conclusions:

The Japanese version of the family conflict scale for family caregivers of persons with dementia in long-term care facilities was developed. The reliability and validity of the scale were verified. When providing support to family caregivers in long-term care facilities, it is necessary to consider the family from multiple viewpoints, including family conflicts and support conditions from other family members.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2017 

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

Bloomer, M., Digby, R., Tan, H., Crawford, H. T. K. and Williams, A. (2016). The experience of family carers of people with dementia who are hospitalised. Dementia, 15, 12341245. DOI: 10.1177/1471301214558308CrossRefGoogle ScholarPubMed
Clark, P. C., Shields, C. G. Aycock, D. and Wolf, S. L. (2003). Preliminary reliability and validity of a family caregiver conflict scale for stroke. Progress in Cardiovascular Nursing, 18, 7792. DOI: 10.1111/j.0889-7204.2006.01887.xGoogle Scholar
Derogatis, L. R. (1983). SCL-90-R: Administration, Scoring and Procedures: Manual II. Baltimore, MD: Clinical Psychometric Research.Google Scholar
Fisher, R. P. and Geiselman, R. E. (1992). Memory Enhancing Techniques for Investigative Interviewing: the Cognitive Interview. Springfield, IL: Charles C Thomas Publisher.Google Scholar
Gaugler, J. E., Duval, S., Anderson, K. A. and Kane, R. L. (2007). Predicting nursing home admission in the U.S.: a meta-analysis. BMC Geriatrics, 7, 13. DOI: 10.1186/1471-2318-7-13Google Scholar
Gaugler, J. E., Roth, D. L., Haley, W. E. and Mittelman, M. S. (2008). Can counseling and support reduce burden and depressive symptoms in caregivers of people with Alzheimer's disease during the transition to institutionalization? Results from the New York University caregiver intervention study. Journal of the American Geriatrics Society, 56, 421428. DOI: 10.1111/j.1532-5415.2007.01593.xGoogle Scholar
Gaugler, J. E., Zarit, S. H. and Pearlin, L. I. (1999). Caregiving and institutionalization: perceptions of family conflict and socioemotional support. International Journal of Aging and Human Development, 49, 125. DOI: 10.2190/91A8-XCE1-3NGX-X2M7CrossRefGoogle ScholarPubMed
Kinney, J. M. and Stephens, M. A. P. (1989). Caregiving hassles scale: assessing the daily hassles of caring for a family member with dementia. The Gerontologist, 29, 328332.CrossRefGoogle ScholarPubMed
Kokubo, M. and Kamibeppu, K. (2013). Development of family functioning scale: the Japanese version of Family APGAR. The establishment of the family nursing technique and construction of the medical cooperation system model to realize abuse prevention from the perinatal period (principal researcher: Kamibeppu K). In Working Report of Grant in Aid for Scientific Research in 2009–2011, 34. (in Japanese)Google Scholar
Kramer, B. J., Kavanaugh, M., Trentham-Dietz, A., Walsh, M. and Yonker, J. A. (2010). Predictors of family conflict at the end of life: the experience of spouses and adult children of persons with lung cancer. Gerontologist, 50, 215225. DOI: 10.1093/geront/gnp121CrossRefGoogle ScholarPubMed
Kramer, B. J., Kavanaugh, M., Trentham-Dietz, A., Walsh, M. and Yonker, J. A. (2011). Complicated grief symptoms in caregivers of persons with lung cancer: the role of family conflict, intrapsychic strains, and hospice utilization. OMEGA – Journal of Death and Dying, 62, 201220. DOI: 10.2190/OM.62.3.aGoogle Scholar
Kwak, M., Ingersoll-Dayton, B. and Kim, J. (2012). Family conflict from the perspective of adult child caregivers: the influence of gender. Journal of Social and Personal Relationships, 29, 470487. DOI: 10.1177/0265407511431188Google Scholar
Landis, J. R. and Koch, G. G. (1977). The measurement of observer agreement for categorical data. Biometrics, 3, 159174.CrossRefGoogle Scholar
Lieberman, M. A. and Fisher, L. (1999). The effects of family conflict resolution and decision making on the provision of help for an elder with Alzheimer's disease. Gerontologist, 39, 159166.Google Scholar
Livingston, G. et al. (2010). Making decisions for people with dementia who lack capacity: qualitative study of family carers in UK. BMJ, 341, c4184. DOI: 10.1136/bmj. c4184Google Scholar
Ministry of Health, Labour and Welfare. (2015). Genetic Strategy for the Promotion of Policies for Dementia. Available at: http://www.mhlw.go.jp/file/04-Houdouhappyou-12304500-Roukenkyoku-Ninchishougyakutaiboushitaisakusuishinshitsu/02_1.pdf (in Japanese).Google Scholar
Moos, R. and Moos, B. (1994). Family Environment Scale Manual: Development, Applications, Research. 3rd edn. Palo Alto, CA: Consulting Psychologists Press.Google Scholar
Morris, J. N. et al. (1994). MDS cognitive performance scale. Journal of Gerontology, 49, 174182. DOI: 10.1093/geronj/49.4.M174CrossRefGoogle ScholarPubMed
Parks, S. M. et al. (2011). Family factors in end-of-life decision-making: family conflict and proxy relationship. Journal of Palliative Medicine, 14, 179184. DOI: 10.1089/jpm.2010.0353Google Scholar
Peacock, S. C. (2013). The experience of providing end-of-life care to a relative with advanced dementia: an integrative literature review. Palliative and Supportive Care, 11, 155168. DOI: 10.1017/S1478951512000831Google Scholar
Peisah, C., Brodaty, H. and Quadrio, C. (2006). Family conflict in dementia: prodigal sons and black sheep. International Journal of Geriatric Psychiatry, 21, 485492. DOI: 10.1002/gps.1501Google Scholar
Port, C. L. (2004). Identifying changeable barriers to family involvement in the nursing home for cognitively impaired residents. Gerontologist, 44, 770778. DOI: 10.1093/geront/44.6.770Google Scholar
Schermelleh-Engel, K., Moosbrugger, H. and Müller, H. (2003). Evaluating the fit of structural equation models: tests of significance and descriptive goodness-of-fit measures. Methods of Psychological Research Online, 8, 2374.Google Scholar
Semple, S. J. (1992). Conflict in Alzheimer's caregiving families: its dimensions and consequences. Gerontologist, 32, 648655.Google Scholar
Stephens, M. A. P., Kinney, J. M. and Ogrocki, P. K. (1991). Stressors and well-being among caregivers to older adults with dementia: the in-home versus nursing home experience. The Gerontologist, 31, 217223. DOI: 10.1093/geront/31.2.217CrossRefGoogle ScholarPubMed
Straus, M. A. (1979). Measuring intrafamily conflict and violence: the Conflict Tactics (CT) scales. Journal of Marriage and Family, 41, 7588.Google Scholar
Tokyo Metropolitan Government. (2015). The list of long-term care facilities. Available at:: http://www.fukushihoken.metro.tokyo.jp/kourei/shisetsu/gaiyo/osagashi.html (in Japanese).Google Scholar
Tomioka, M., Shimura, M., Hidaka, M. and Kubo, C. (2008). The reliability and validity of a Japanese version of symptom checklist-90-revised. Biopsychosocial Medicine, 2, 19. DOI: 10.1186/1751-0759-2-19CrossRefGoogle ScholarPubMed
Van Soest-Poortvliet, M. C. et al. (2015). Advance care planning in nursing home patients with dementia: a qualitative interview study among family and professional caregivers. Journal of the American Medical Directors Association, 16, 979989. DOI: 10.1016/j.jamda.2015.06.015Google Scholar
Winter, L. and Parks, S. M. (2008). Family discord and proxy decision makers' end-of-life treatment decisions. Journal of Palliative Medicine, 11, 11091114. DOI: 10.1089/jpm.2008.0039CrossRefGoogle ScholarPubMed
World Health Organization and Alzheimer's Disease International. (2012). Epidemiology of dementia. In Dementia: A Public Health Priority (pp. 12–32). Available at:: http://apps.who.int/iris/bitstream/10665/75263/1/9789241564458_eng.pdf?ua=1.Google Scholar