Testing the psychometric properties of a Chinese version of Dementia Management Strategies Scale

Abstract

Wai Tong ChienSchool of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong SAR, People’s Republic of ChinaAbstract: Caregiving stress and burden are universal phenomena among family caregivers of people with dementia. Family caregivers who adopted adaptive management strategies in dementia care could alleviate their own distress and the progression of neuropsychiatric symptoms in people with dementia. An understanding about the management strategies used by these caregivers in caring for their relatives with dementia would be crucial to family services in dementia care. This study aimed to validate a Chinese version of Dementia Management Strategies Scale (DMSS) in family caregivers of Hong Kong Chinese people with dementia. Face and content validity, semantic equivalence, and test–retest reliability of the translated Chinese version of 34-item DMSS were examined. A random sample of 211 family caregivers and their relatives with dementia were then recruited to identify the factor structure of the Chinese version by exploratory factor analysis followed by varimax rotation and assess its internal consistency. Reproductibility and responsiveness of the scale to changes in neuropsychiatric symptoms were also examined over a 6-month interval. Results indicated that the Chinese version of DMSS indicated very satisfactory content validity, semantic equivalence with the original English version, and test–retest reliability. Factor analysis showed that 32 items of the Chinese version had substantial loadings on one of the three identified factors (“Criticism toward older relative”, “Showing encouragement”, and “Active management strategies”), explaining 72.4% of the total variance. The three-factor Chinese version also indicated good internal consistency of its three subscales (Cronbach’s α=0.86–0.90) and satisfactory reproducibility over 6 months (intraclass correlation coefficients =0.85–0.89). Furthermore, the Chinese version demonstrated moderate effect sizes for detecting changes in symptom severity of dementia (Cohen’s d=0.50–0.60). This study provides evidence on the sound psychometric properties of the Chinese version of DMSS to measure the levels of management strategies in family caregivers of people with dementia.Keywords: family caregivers, instrument validation, psychometric properties, responsiveness, reproducibility