Givens Jane L, Jones Richard N, Mazor Kathleen M, Prigerson Holly G, Mitchell Susan L
Hebrew SeniorLife Institute for Aging Research, Boston, MA; Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA.
Department of Psychiatry and Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI.
J Am Med Dir Assoc. 2015 Sep 1;16(9):775-80. doi: 10.1016/j.jamda.2015.03.028. Epub 2015 May 1.
The majority of scales to measure family member distress in dementia are designed for community settings and do not capture the unique burdens of the nursing home (NH) environment. We report the psychometric properties of a new Family Distress in Advanced Dementia Scale for use in the NH setting.
DESIGN, SETTING, PARTICIPANTS: Cross-sectional questionnaire of 130 family member health care proxies of NH residents with advanced dementia in 31 Boston-area NHs.
Thirty-one initial items were evaluated, measuring the frequency over the past 3 months of sources of distress. Exploratory factor analysis identified domains of distress; Cronbach's alpha was computed for each domain. Associations between the domains and other measures were evaluated using Pearson correlation coefficients, including measures of depression (PHQ-9), satisfaction with care (Satisfaction with Care at the End-of-Life in Dementia [SWC-EOLD]), and caregiver burden (Zarit Burden Interview short version).
Factor analysis suggested 3 domains: emotional distress (9 items), dementia preparedness (5 items), and NH relations (7 items). Cronbach's alpha coefficients were 0.82, 0.75, and 0.83 respectively. The PHQ-9 correlated most strongly with the emotional distress factor (r = 0.34), the SWC-EOWD correlated most strongly with the NH relations factor (r = 0.35), as did the Zarit Burden Scale (r = 0.50).
The Family Distress in Advanced Dementia Scale encompasses 3 domains of distress. This scale represents a much needed tool to assess distress among family members of NH residents with advanced dementia and provides a metric to evaluate interventions in the population.
大多数用于测量痴呆症患者家庭成员痛苦程度的量表是为社区环境设计的，无法体现养老院环境特有的负担。我们报告一种用于养老院环境的新型晚期痴呆症家庭痛苦量表的心理测量特性。
设计、地点、参与者：对波士顿地区31家养老院中130名晚期痴呆症养老院居民的家庭成员医疗保健代理人进行横断面问卷调查。
对31个初始项目进行评估，测量过去3个月中痛苦来源出现的频率。探索性因素分析确定痛苦领域；计算每个领域的Cronbach's alpha系数。使用Pearson相关系数评估各领域与其他测量指标之间的关联，包括抑郁测量指标（PHQ-9）、护理满意度（痴呆症临终护理满意度[SWC-EOLD]）和照顾者负担（Zarit负担访谈简版）。
因素分析表明有3个领域：情绪困扰（9个项目）、痴呆症准备（5个项目）和养老院关系（7个项目）。Cronbach's alpha系数分别为0.82、0.75和0.83。PHQ-9与情绪困扰因素的相关性最强（r = 0.34），SWC-EOWD与养老院关系因素的相关性最强（r = 0.35），Zarit负担量表也是如此（r = 0.50）。
晚期痴呆症家庭痛苦量表涵盖3个痛苦领域。该量表是评估晚期痴呆症养老院居民家庭成员痛苦程度急需的工具，并为评估该人群的干预措施提供了一个指标。
