Department of Geriatric Psychiatry, Institute of Mental Health, Singapore.
Psychotherapy Service, Institute of Mental Health, Singapore.
Gerontologist. 2020 Jan 24;60(1):e1-e10. doi: 10.1093/geront/gny161.
Caregivers of persons with dementia (PWD) can experience loss and grief long before the death of the person. Although such experience of caregiver grief is measurable, available scales (such as the Marwit-Meuser Caregiver Grief Inventory, MM-CGI) are lengthy and have overlaps with other caregiving constructs. We developed a briefer scale that captures the essence of caregiver grief-with comparable psychometric properties and total score to MM-CGI, as well as less overlap with other caregiving constructs.
Family caregivers of community-dwelling PWD (N = 394) completed questionnaires containing MM-CGI and other caregiving scales. Initially, we split the study samples into two -the derivation sample (n = 179) was used to develop a brief scale that best predicts MM-CGI (using the best-subset approach with tenfold cross-validation), whereas the validation sample (n = 215) verified its actual performance in predicting MM-CGI. Thereafter, we evaluated the derived scale in its reliability and validity, and mapped its scores to MM-CGI using the equipercentile equating method.
We derived a 6-item scale, which explained 84.1% of the variability in MM-CGI and had area under the receiver operating characteristic curve of .96 in discriminating high caregiver grief (95% CI: .94-.99). It had single dimension in confirmatory factor analysis (comparative fit index = .98; Tucker-Lewis index = .97) and maintained good psychometric properties similar to those of MM-CGI, while showing lower correlation with caregiver burden and depression. It also had scores that could be mapped to MM-CGI with reasonable precision.
We developed the first brief scale with less than 10 items that can conveniently and accurately measure caregiver grief, which opens the way for grief-related interventions in clinical care. Notably, this 6-item scale was developed using rigorous methods and demonstrated consistent evidence of capturing the essence of caregiver grief.
痴呆症患者（PWD）的护理人员在患者去世之前很久就可能经历失落和悲伤。尽管这种护理人员悲伤的体验是可以衡量的，但现有的量表（如 Marwit-Meuser 护理人员悲伤量表，MM-CGI）冗长且与其他护理构建重叠。我们开发了一种更简洁的量表，可以捕捉护理人员悲伤的本质，具有与 MM-CGI 相当的心理测量学特性和总分，并且与其他护理构建的重叠较少。
居住在社区的 PWD 的家庭护理人员（N=394）完成了包含 MM-CGI 和其他护理量表的问卷。最初，我们将研究样本分为两组 - 推导样本（n=179）用于开发最佳预测 MM-CGI 的简洁量表（使用十倍交叉验证的最佳子集方法），而验证样本（n=215）验证其在预测 MM-CGI 方面的实际表现。此后，我们评估了衍生量表的可靠性和有效性，并使用等百分位等价方法将其分数映射到 MM-CGI。
我们得出了一个 6 项量表，该量表解释了 MM-CGI 变异的 84.1%，在区分高护理人员悲伤方面的接收者操作特征曲线下面积为.96（95%CI：.94-.99）。它在验证性因素分析中有单一维度（比较拟合指数=.98；塔克-刘易斯指数=.97），并保持与 MM-CGI 相似的良好心理测量学特性，同时与护理人员负担和抑郁的相关性较低。它也有可以用合理精度映射到 MM-CGI 的分数。
我们开发了第一个少于 10 项的简洁量表，可以方便准确地衡量护理人员的悲伤，为临床护理中的悲伤相关干预开辟了道路。值得注意的是，这种 6 项量表是使用严格的方法开发的，并证明了一致的证据，即捕捉护理人员悲伤的本质。
