Psychometric Properties of the Problem-Solving Inventory in Caregivers of Persons With Memory Loss

2.50
Hdl Handle:
http://hdl.handle.net/10755/622032
Category:
Full-text
Format:
Text-based Document
Type:
Presentation
Level of Evidence:
N/A
Research Approach:
N/A
Title:
Psychometric Properties of the Problem-Solving Inventory in Caregivers of Persons With Memory Loss
Other Titles:
Cognitive Impairment Effects on Clinical Outcomes
Author(s):
Ji, Meihua; Sereika, Susan M.; Rohay, Jeffrey M.; Erlen, Judith A.
Lead Author STTI Affiliation:
Beta Zeta-at-Large
Author Details:
Meihua Ji, MSN, RN, Professional Experience: 2015-present, PhD student, teaching fellow, School of Nursing, University of Pittsburgh, PA 2012-2015, nursing instructor, School of Nursing, Capital Medical University, Beijing, China. Member and Secretory-General, China Medical Informatics Association-Nursing Informatics Committee Research interest focus on: problem solving abilities of persons with chronic disease and their caregivers; use of technology in facilitating care of chronicaly ill Author Summary: Meihua Ji, is currently a PhD student at School of Nursing, University of Pittsburgh, Pennsylvania, USA. Her research focus on the use of information technology in assisting with chronic disease management as well as with other clinical issues, such as assessment of delirium in the intensive care unit using mobile technology. Her current research while earning her doctoral degree is focusing on chronic disease management among patients with type 2 diabetes in China.
Abstract:

Background: Having adequate problem solving skills is important for caregivers of persons with memory loss to adjust to the changing needs and behaviors of the care recipient as their cognitive function declines (Berry et al., 2012; Chiu et al., 2015; Sousa et al., 2016). There is limited evidence evaluating problem solving abilities among caregivers of persons with memory loss using validated instruments.

Purpose: The purpose of this study was to evaluate the psychometric properties (reliability, factor structure and validity) of the Problem Solving Inventory (PSI) among informal caregivers of community-dwelling persons with memory loss.

Methods:  For this secondary analysis, data from the baseline and 2-month post-baseline assessments of a randomized controlled trial designed to improve informal caregivers’ problem solving skills related to medication management of community-dwelling persons with memory loss was used. The 32-item PSI which was originally tested among undergraduate college students with three subscales (problem solving confidence, approach-avoidance style, and personal control) was used to measure caregivers’ level of problem solving, with lower PSI total scores indicative of better problem solving. Reliability of the PSI was examined considering internal consistency using Cronbach’s alpha as well as test-retest reliability over a 2-month period for control group participants. Construct validity of the PSI was explored using principal component analysis for extraction with varimax rotation to explore the factor structure of the PSI. Pearson correlations between the PSI total score and scores on the Beck Depression Inventory II (BDI), Newest Vital Sign (NVS) for health literacy, as well as Self-Efficacy for Managing Chronic Disease (SEM) was tested at baseline for convergent validity. It was hypothesized that there would be at least a moderate positive association between PSI total score and BDI score; a moderate negative association between PSI total score and total scores of NVS as well as SEM.

Results: Participants (n=78 with complete data) were mainly white (87.2%), female (71.8%), and on average ± SD 66.5±12.3 years of age with 14.7±2.8 years of education. Estimates of internal consistency for the PSI using Cronbach’s alpha were 0.92 for the overall total score, and 0.90, 0.82, and 0.84 for the problem solving confidence, approach-avoidance style, and personal control subscales, respectively. Estimates of test-retest reliability over 2 months were 0.562 (p<0.001) for the total score and 0.435 (p=0.006), 0.587(p<0.001), and 0.559 (p<0.001) for the problem solving confidence, approach-avoidance style, and personal control subscales, respectively, for caregivers in the control group (n=39). Exploratory factor analysis using principal component analysis extraction revealed seven factors for the PSI. Two factors were dropped due to less than three items having loaded on those factors, and a total of 4 items were excluded following exclusion of the two factors as well as considering a factor loading threshold of ≥0.40. As a result, five factors were retained with a total of 28 items, where factors one and two were “personal control” (8 items) and “problem solving confidence” (9 items) as originally identified for the PSI. Most of the items for factor three “proactive approach” (3 items), factor four “avoidance style” (4 items) and factor five “decision processing” (4 items) were included in the approach-avoidance style in the original PSI. Pearson correlations showed a moderate positive relationship between PSI total and BDI total scores (r=0.372, p=0.001), and a moderate negative relationship between PSI total and SEM total scores (r=-0.408, p<0.001); however, the association between PSI total and NVS total scores (r=-0.096, p=0.411) was not significant.

Conclusion:  The 32-item PSI was internally consistent and showed temporal stability over 2 months for measuring problem solving abilities in informal caregivers of persons with memory loss. The extracted factors for PSI (five factors with 28 items) within this context revealed a somewhat different factor structure compared to the original scale which was tested among undergraduate college students, with more specific factors of “proactive approach”, “avoidance style” and “decision processing” that could be helpful in explaining problem solving behaviors among caregivers of persons with memory loss. The correlation between PSI total score and total scores of BDI as well as SEM showed convergent validity, but not with the NVS total score.

Implication: The PSI has the potential to help healthcare providers more adequately evaluate problem solving behaviors among informal caregivers of persons with memory loss and ultimately aid in identifying interventions to improve clinical outcomes. Given the limitations of having a small and homogeneous sample in the current study, future research should include a confirmatory factor analysis of the identified structure in current study in a larger sample of informal caregivers, the psychometric assessment of the instrument in caregivers for different patient populations, and the examination of concurrent validity using another problem solving instrument. 

Keywords:
Problem Solving; Psychometric Properties; Caregiver
Repository Posting Date:
21-Jul-2017
Date of Publication:
21-Jul-2017
Other Identifiers:
INRC17M15
Conference Date:
2017
Conference Name:
28th International Nursing Research Congress
Conference Host:
Sigma Theta Tau International
Conference Location:
Dublin, Ireland
Description:
Event Theme: Influencing Global Health Through the Advancement of Nursing Scholarship

Full metadata record

DC FieldValue Language
dc.language.isoen_USen
dc.type.categoryFull-texten
dc.formatText-based Documenten
dc.typePresentationen
dc.evidence.levelN/Aen
dc.research.approachN/Aen
dc.titlePsychometric Properties of the Problem-Solving Inventory in Caregivers of Persons With Memory Lossen_US
dc.title.alternativeCognitive Impairment Effects on Clinical Outcomesen
dc.contributor.authorJi, Meihuaen
dc.contributor.authorSereika, Susan M.en
dc.contributor.authorRohay, Jeffrey M.en
dc.contributor.authorErlen, Judith A.en
dc.contributor.departmentBeta Zeta-at-Largeen
dc.author.detailsMeihua Ji, MSN, RN, Professional Experience: 2015-present, PhD student, teaching fellow, School of Nursing, University of Pittsburgh, PA 2012-2015, nursing instructor, School of Nursing, Capital Medical University, Beijing, China. Member and Secretory-General, China Medical Informatics Association-Nursing Informatics Committee Research interest focus on: problem solving abilities of persons with chronic disease and their caregivers; use of technology in facilitating care of chronicaly ill Author Summary: Meihua Ji, is currently a PhD student at School of Nursing, University of Pittsburgh, Pennsylvania, USA. Her research focus on the use of information technology in assisting with chronic disease management as well as with other clinical issues, such as assessment of delirium in the intensive care unit using mobile technology. Her current research while earning her doctoral degree is focusing on chronic disease management among patients with type 2 diabetes in China.en
dc.identifier.urihttp://hdl.handle.net/10755/622032-
dc.description.abstract<p><span>Background: Having adequate problem solving skills is important for caregivers of persons with memory loss to adjust to the changing needs and behaviors of the care recipient as their cognitive function declines (Berry et al., 2012; Chiu et al., 2015; Sousa et al., 2016). There is limited evidence evaluating problem solving abilities among caregivers of persons with memory loss using validated instruments.</span></p> <p><strong>Purpose: </strong>The purpose of this study was to evaluate the psychometric properties (reliability, factor structure and validity) of the Problem Solving Inventory (PSI) among informal caregivers of community-dwelling persons with memory loss.</p> <p><strong>Methods: </strong> For this secondary analysis, data from the baseline and 2-month post-baseline assessments of a randomized controlled trial designed to improve informal caregivers’ problem solving skills related to medication management of community-dwelling persons with memory loss was used. The 32-item PSI which was originally tested among undergraduate college students with three subscales (problem solving confidence, approach-avoidance style, and personal control) was used to measure caregivers’ level of problem solving, with lower PSI total scores indicative of better problem solving. Reliability of the PSI was examined considering internal consistency using Cronbach’s alpha as well as test-retest reliability over a 2-month period for control group participants. Construct validity of the PSI was explored using principal component analysis for extraction with varimax rotation to explore the factor structure of the PSI. Pearson correlations between the PSI total score and scores on the Beck Depression Inventory II (BDI), Newest Vital Sign (NVS) for health literacy, as well as Self-Efficacy for Managing Chronic Disease (SEM) was tested at baseline for convergent validity. It was hypothesized that there would be at least a moderate positive association between PSI total score and BDI score; a moderate negative association between PSI total score and total scores of NVS as well as SEM.</p> <p><strong>Results: </strong>Participants (n=78 with complete data) were mainly white (87.2%), female (71.8%), and on average ± SD 66.5±12.3 years of age with 14.7±2.8 years of education. Estimates of internal consistency for the PSI using Cronbach’s alpha were 0.92 for the overall total score, and 0.90, 0.82, and 0.84 for the problem solving confidence, approach-avoidance style, and personal control subscales, respectively. Estimates of test-retest reliability over 2 months were 0.562 (p<0.001) for the total score and 0.435 (p=0.006), 0.587(p<0.001), and 0.559 (p<0.001) for the problem solving confidence, approach-avoidance style, and personal control subscales, respectively, for caregivers in the control group (n=39). Exploratory factor analysis using principal component analysis extraction revealed seven factors for the PSI. Two factors were dropped due to less than three items having loaded on those factors, and a total of 4 items were excluded following exclusion of the two factors as well as considering a factor loading threshold of ≥0.40. As a result, five factors were retained with a total of 28 items, where factors one and two were “personal control” (8 items) and “problem solving confidence” (9 items) as originally identified for the PSI. Most of the items for factor three “proactive approach” (3 items), factor four “avoidance style” (4 items) and factor five “decision processing” (4 items) were included in the approach-avoidance style in the original PSI. Pearson correlations showed a moderate positive relationship between PSI total and BDI total scores (r=0.372, p=0.001), and a moderate negative relationship between PSI total and SEM total scores (r=-0.408, p<0.001); however, the association between PSI total and NVS total scores (r=-0.096, p=0.411) was not significant.</p> <p><strong>Conclusion: </strong> The 32-item PSI was internally consistent and showed temporal stability over 2 months for measuring problem solving abilities in informal caregivers of persons with memory loss. The extracted factors for PSI (five factors with 28 items) within this context revealed a somewhat different factor structure compared to the original scale which was tested among undergraduate college students, with more specific factors of “proactive approach”, “avoidance style” and “decision processing” that could be helpful in explaining problem solving behaviors among caregivers of persons with memory loss. The correlation between PSI total score and total scores of BDI as well as SEM showed convergent validity, but not with the NVS total score.</p> <p>Implication: The PSI has the potential to help healthcare providers more adequately evaluate problem solving behaviors among informal caregivers of persons with memory loss and ultimately aid in identifying interventions to improve clinical outcomes. Given the limitations of having a small and homogeneous sample in the current study, future research should include a confirmatory factor analysis of the identified structure in current study in a larger sample of informal caregivers, the psychometric assessment of the instrument in caregivers for different patient populations, and the examination of concurrent validity using another problem solving instrument. </p>en
dc.subjectProblem Solvingen
dc.subjectPsychometric Propertiesen
dc.subjectCaregiveren
dc.date.available2017-07-21T20:24:25Z-
dc.date.issued2017-07-21-
dc.date.accessioned2017-07-21T20:24:25Z-
dc.conference.date2017en
dc.conference.name28th International Nursing Research Congressen
dc.conference.hostSigma Theta Tau Internationalen
dc.conference.locationDublin, Irelanden
dc.descriptionEvent Theme: Influencing Global Health Through the Advancement of Nursing Scholarshipen
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