The Competence Scale in Managing Behavioral and Psychological Symptoms of Dementia (CS-MBPSD) for family caregivers: Instrument development and cross-sectional validation study

Abstract

Background: Families' caring competence plays a key role in caring for the elderly with dementia. In particular, the management of the behavioural and psychological symptoms of dementia is different from the management of other symptoms of dementia. However, there is no tool for evaluating family caregiver competence for managing the behavioural and psychological symptoms of dementia.

Objective: This study aimed to develop a competence scale in managing the behavioural and psychological symptoms of dementia for family caregivers and to evaluate its psychometric properties.

Design: An instrument development and cross-sectional validation study was conducted.

Settings: Twenty-one local dementia centres in Seoul, Korea.

Participants: A total of 460 community-dwelling family caregivers of people living with dementia (mean age = 69.82 ± 11.08, female = 78.7%, spouse = 65.7%) participated in the study.

Methods: This study was conducted in two steps: (1) instrument development and (2) psychometric tests (N = 460). After item generation and the evaluation of content validity and face validity, a total of 39 preliminary items were tested. For the psychometric tests, item analysis using the corrected item-to-total correlations and construct validity with exploratory and confirmatory factor analysis were performed. Using measurement tools of the Behaviour Management Skill, a Visual Analogue Scale, and a general question of the scale developed in this study, the concurrent validity was examined by calculating Pearson's correlation coefficient. Reliability was evaluated with Cronbach's α, test reliability with the standard error of measurement, and test-retest reliability with the intraclass correlation coefficient.

Results: The exploratory and confirmatory factor analyses yielded a six-factor solution with 28 items. The six factors were 'person-centred attitude', 'introspection for improvement', 'symptom occurrence analysis', 'application of various strategies', 'awareness of symptoms' and 'caring for one's own mind and body'. The concurrent validity was established. The reliability was demonstrated to be acceptable (Cronbach's α = 0.922, ICC = 0.781).

Conclusions: The competence scale in managing the behavioural and psychological symptoms of dementia for family caregivers was found to be a valid and reliable instrument. The scale is potentially useful for promoting better dementia care in both research and clinical practice settings by enabling the identification of needs to be improved for family caregivers in coping with dementia symptoms.

Keywords: Caregivers; Clinical competence; Dementia; Disease management; Family; Instrumentation; Neurobehavioural manifestations; Validation study.