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American Journal of Alzheimer's Disease and Other Dementias logoLink to American Journal of Alzheimer's Disease and Other Dementias
. 2006 Oct-Nov;21(5):304–311. doi: 10.1177/1533317506292283

Assessing Perceived Change in the Well-being of Family Caregivers: Psychometric Properties of the Perceived Change Index and Response Patterns

Laura N Gitlin 1, Laraine Winter 2, Marie P Dennis 3, Walter W Hauck 4
PMCID: PMC10832633  PMID: 17062548

Abstract

The purpose of this study was to evaluate the psychometric properties of the Perceived Change Index (PCI), a 13-item scale that measures caregiver appraisals of self-improvement or decline in distinct areas of well-being, and to examine demographic differences in responses. The scale was administered to 255 care-givers participating at the Philadelphia site of the National Institute of Aging-funded Resources for Enhancing Alzheimer’s Caregiver Health initiative. Principal axis analysis with one half of the sample was used to evaluate factor structure. Evidence of convergent and divergent validity was examined using the second half of the sample. Differential response patterns by caregiver characteristics were also examined using regression analysis. Using one half of the sample, 3 underlying factors were found (affect, α = .85; somatic, α = .80; management, α = .76), accounting for 63% of the variance. The overall index was internally consistent (Cronbach’s α = .90). Using the second half of the sample, Pearson correlational analyses of the overall index and its subscales revealed that perceived improvement was significantly associated with fewer depressive symptoms, higher scores on perceived positive aspects of caregiving, and more participation in social activities. As expected, it was not associated with the care recipient’s Mini-Mental Status Examination scores or functional status. Perceived improvement scores for specific areas of well-being were associated with being African American, male, and a spouse. The PCI is a brief, easily administered, and valid self-report measure that can serve as an indicator of caregiver appraisal of well-being in research and clinical practice.

Keywords: Alzheimer’s disease, informal caregiving, burden

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Contributor Information

Laura N. Gitlin, Center for Applied Research on Aging and Health, Thomas Jefferson University, Philadelphia, Pennsylvania, laura.gitlin@jefferson.edu .

Laraine Winter, Center for Applied Research on Aging and Health, Thomas Jefferson University, Philadelphia, Pennsylvania.

Marie P. Dennis, Center for Applied Research on Aging and Health, Thomas Jefferson University, Philadelphia, Pennsylvania.

Walter W. Hauck, Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, Philadelphia, Pennsylvania.

References

  1. Vitaliano PP, Young HM, Russo J. Burden: a review of measures used among caregivers of individuals with dementia. Gerontologist. 1991;31: 67-75. [DOI] [PubMed] [Google Scholar]
  2. Bedard M, Molloy DW, Squire L, Dubois S, Lever JA, O’Donnell M. The Zarit burden interview: a new short version and screening version. Gerontologist. 2001;41: 652-657. [DOI] [PubMed] [Google Scholar]
  3. Frijda NH. The laws of emotion. Am Psychol. 1988;43: 349-358. [DOI] [PubMed] [Google Scholar]
  4. Helson H. Adaption-Level Theory. New York, NY: Harper and Row; 1964. [Google Scholar]
  5. Brickman P, Coates D, Janoff-Bulman R. Lottery winners and accident victims: is happiness relative? J Pers Soc Psychol. 1978;36: 917-927. [DOI] [PubMed] [Google Scholar]
  6. Carver CS, Scheier MF. Principles of self-regulation. In: Higgins ET, Sorrentino RM, eds. Handbook of Motivation and Cognition: Foundations of Social Behavior. Vol 2. New York, NY: Guilford; 1990:3-52. [Google Scholar]
  7. Suh E, Diener E, Fujita F. Events and subjective well-being: only recent events matter. J Pers Soc Psychol. 1996;70: 1091-1102. [DOI] [PubMed] [Google Scholar]
  8. Hsee CK, Abelson RP. Velocity relation: satisfaction as a function of the first derivative of outcome over time. J Pers Soc Psychol. 1991;60: 341-347. [Google Scholar]
  9. Winter L, Lawton MP, Langston CA, Ruckdeschel K, Sando R. Symptoms, affects, and self-related health: evidence for a subjective trajectory of health. J Aging Health. In press. [DOI] [PubMed] [Google Scholar]
  10. ShuaHaim JR, ShuaHaim V, Comsti E, Ross JS. Donepezil (AriceptReg.) Treatment of multi infarct dementia: the caregivers and clinical impression. Am J Alzheimer Dis. 2000;15: 201-211. [Google Scholar]
  11. Schneider LS, Olin JT, Doody RS, et al. Validity and reliability of the Alzheimer’s Disease Cooperative Study-clinical global impression of change. The Alzheimer’s Disease Cooperative Study. Alzheimer Dis Assoc Disord. 1997;11(suppl 2): S22-S32. [DOI] [PubMed] [Google Scholar]
  12. Gitlin LN, Lawton MP, WindsorLandsberg LA, Kleban MH. In search of psychological benefits: exercise in healthy older adults. J Aging Health. 1992;4: 174-192. [Google Scholar]
  13. Lawton MP, Cohen J. The generality of housing impact on the well-being of older people. J Gerontol. 1974;29: 194-204. [DOI] [PubMed] [Google Scholar]
  14. Haley WE, Roth DL, Coleton MI, et al. Appraisal, coping, and social support as mediators of well-being in black and white family caregivers of patients with Alzheimer’s disease. J Consult Clin Psychol. 1996;64: 121-129. [DOI] [PubMed] [Google Scholar]
  15. Roth DL, Haley WE, Owen JE, Clay OJ, Goode KT. Latent growth models of the longitudinal effects of dementia caregiving: a comparison of African American and white family caregivers. Psychol Aging. 2001;16: 427-436. [PubMed] [Google Scholar]
  16. Yee JL, Schulz R. Gender differences in psychiatric morbidity among family caregivers: a review and analysis. Gerontologist. 2000;40: 147-164. [DOI] [PubMed] [Google Scholar]
  17. Folstein MF, Folstein SE, McHugh PR. “Mini-Mental State.” A practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res. 1975;12: 189-198. [DOI] [PubMed] [Google Scholar]
  18. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW. Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychology function. JAMA. 1963;185: 914-919. [DOI] [PubMed] [Google Scholar]
  19. Schinfeld S, Kelin S, Winter L, Gitlin LN. A community-academic partnership for recruiting diverse Alzheimer’s caregivers. Paper presented at: Annual Meeting of the Gerontological Society of America; November 2002; Chicago, Ill. [Google Scholar]
  20. Wisniewski S, Belle S, Coon D, et al, and the REACH Group. The Resources for Enhancing Alzheimer’s Caregiver Health (REACH): project design and baseline characteristics. Psychol Aging. 2003;18: 375-384. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Radloff LS. The CES-D scale: a self-report depression scale for research in the general population. Appl Psychol Meas. 1977;1: 385-401. [Google Scholar]
  22. Anastasi A. Validity: basic concepts. In: Anastasi A, ed. Psychological Testing. 6th ed. New York, NY: Macmillian; 1988:139-164. [Google Scholar]
  23. Messick S. Validy. In: Linn R, ed. Educational Measurement. 3rd ed. New York, NY: American Council on Education and Macmillian Publishing Co; 1989:13-103. [Google Scholar]
  24. Weiss D. Further considerations in applications of factor analysis. J Couns Psychol. 1971;18: 85-92. [Google Scholar]
  25. Weiss D. Factor analysis and counseling research. J Couns Psychol. 1970;17: 477-485. [Google Scholar]
  26. Switzer GE, Wisniewski SR, Belle SH, Dew MA, Schultz R. Selecting, developing, and evaluating research instruments. Soc Psychiatry Psychiatr Epidemiol. 1999;34: 399-409. [DOI] [PubMed] [Google Scholar]
  27. Schulz R, Beach SR. Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA. 1999; 282: 2215-2219. [DOI] [PubMed] [Google Scholar]
  28. Bradburn N. The Structure of Psychological Well-being. Chicago, Ill: Aldine; 1969. [Google Scholar]

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