Developing a scale to measure family dynamics related to long-term care, and testing that scale in a multicenter cross-sectional study

BMC Family Practice

Research Article

Ken Sakushima¹  Takafumi Wakita²  Kotaro Sato³  Yoshinori Matsui³  Tesshu Kusaba³  Takashi Ando³  Satoshi Matsuda³  Shingo Fukuma⁴  Shunichi Fukuhara⁴ 

[1] Department of Neurology, Hokkaido University Graduate School of Medicine, N15W7, Kita-ku, Sapporo, Japan;Faculty of Sociology, Kansai University, 3-3-35, Yamate-cho, Suita-shi, Osaka, Japan;Institute for Health Outcomes and Process Evaluation Research, Akinonocho, Nakagyo Ward, Kyoto, Japan;Hokkaido Center for Family Medicine, 1-18 Kita 41-Jo Higashi 15 Cho-me, Higashi-ku, Sapporo, Japan;Institute for Health Outcomes and Process Evaluation Research, Akinonocho, Nakagyo Ward, Kyoto, Japan;Department of Healthcare Epidemiology, School of Public Health in the Graduate School of Medicine, Kyoto University, Yoshida Konoemachi, Sakyo-ku, 606 8501, Kyoto, Japan;Center for Innovative Research for Communities and Clinical Excellence (CIRC2LE), Fukushima Medical University, 1 Hikariga-oka, Fukushima City, Japan;

关键词: Family dynamics;    Scale;    Family caregivers;    Long-term care;    Care burden;    Family medicine;    Factor analysis;    Criterion-related validity;    Reliability;    Family dynamics index for long-term care;   

DOI  :  10.1186/1471-2296-15-134

 received in 2013-08-27, accepted in 2014-06-24,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundAs Japan’s population ages, more frail elderly people are cared for by members of their family. The dynamics within such families are difficult to study, in part because they are difficult to quantify. We developed a scale for assessing family dynamics related to long-term care. Here we report on the development of that scale, and we present the results of reliability testing and validation testing.MethodsTwo primary-care specialists drafted questions about family dynamics, and discussed them with other primary-care physicians and clinical researchers. The final questionnaire asked about four problems or undesirable situations: disengagement (emotional distance), scapegoating (inappropriate blame), transfer of problems across generations (transfer of unnecessary burden from older to younger generations, trans-generationally displaced revenge), and undesirable behavior (co-dependence). Next, at six general-medicine clinics, doctors evaluated families that had a caregiver and a patient requiring long-term care. The results were analyzed by factor analysis. Cronbach’s α was computed, and criterion-related validation tests were done with three types of criteria: relationship before caregiving, ability to do activities of daily living (ADL), and the duration of care.ResultsResults were obtained from 199 families. Among the caregivers, 79% were women and their mean age was 63 years. Among the patients, 71% were women and their mean age was 84 years. The results of factor analysis indicated that the scale was unidimensional. Cronbach’s α was 0.73. Not having a good relationship before caregiving was associated with significantly worse family dynamics scores, as was greater dependence regarding ADL.ConclusionsWe developed a scale that enables physicians to assess the dynamics of families with a patient and a family caregiver. The scale’s scores are reliable and the results of validation testing were generally good. This scale holds promise as a tool both for research and for primary-care practice.

【 授权许可】

Unknown   
© Kusaba et al.; licensee BioMed Central Ltd. 2014. This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited.