Factor structure and construct validity of the Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer)

Background: The ASCOT-Carer is a self-report instrument designed to measure social care-related quality of life (SCRQoL). This article presents the psychometric testing and validation of the ASCOT-Carer four response-level interview (INT4) in a sample of unpaid carers of adults who receive publicly-funded social care services in England. Methods: Unpaid carers were identified through a survey of users of publicly-funded social care services in England. 387 carers completed a face-to-face or telephone interview. Data on variables hypothesised to be related to SCRQoL (for example, characteristics of the carer, cared-for person and care situation) and measures of carer experience, strain, health-related quality of life and overall QoL were collected. Relationships between these variables and overall SCRQoL score were evaluated through correlation, ANOVA and regression analysis to test the construct validity of the scale. Internal reliability was assessed using Cronbach’s alpha and feasibility by the number of missing responses. Results: The construct validity was supported by statistically significant relationships between SCRQoL and scores on instruments of related constructs, as well as with characteristics of the carer and care recipient in univariate and multivariate analyses. A Cronbach’s alpha of 0.87 (7 items) indicates that the internal reliability of the instrument is satisfactory and a low number of missing responses (<1%) indicates a high level of acceptance. Conclusions: The results provide evidence to support the construct validity, factor structure, internal reliability and feasibility of the ASCOT-Carer INT4 as an instrument for measuring social care-related quality of life of unpaid carers who care for adults with a variety of long-term conditions, disability or problems related to old age

Effects of a brief worksite stress management program on coping skills, psychological distress and physical complaints : a controlled trial

Objectives: To examine the effects of single-session, small-group stress management program on knowledge about stress, coping skills, and psychological and physical distress. Methods: A total of 300 employees from a company in western Japan were invited to participate in the study. Those who consented to enter the study were assigned to an intervention (n=149) or waiting list control group (n=151). Participants in the intervention group received a small-group stress management program. The program was primarily aimed at increasing knowledge about stress and improving coping skills. To investigate the intervention effect, change scores in outcome variables were calculated by subtracting the scores at pre-intervention from those at post-intervention (8 weeks after the pre-intervention survey). Next, the difference in the scores between groups was examined using analyses of covariance (ANCOVA) with the pre-intervention score as the covariate. Results: Favorable intervention effects were found on knowledge about stress and on coping skills (P < 0.001 and P=0.012, respectively) and adverse effects on psychological distress (P=0.022). However, this adverse effect on psychological distress did not exist among those who initially perceived higher levels of job control. Conclusion: The single-session stress management program was effective on improving knowledge about stress, and coping skills, where job control moderated the effect of the program on psychological distress

Long-term effects of a group support program and an individual support program for informal caregivers of stroke patients: which caregivers benefit the most?

In this article, we report the long-term outcomes of an intervention for informal caregivers who are the main provider of stroke survivors' emotional and physical support. Based on the stress-coping theory of Lazarus and Folkman two intervention designs were developed: a group support program and individual home visits. Both designs aimed at an increase in caregivers' active coping and knowledge, reducing caregivers' strain and improving well-being and social support. Caregivers were interviewed before entering the program, and I and 6 months after completion of the program. After 6 months, 100 participants remained in the group program, 49 in the home visit program, and 38 in the control group. Multiple stepwise regression analysis was used to determine the effects of the interventions. In the long-term, the interventions (group program and home visits together) contributed to a small to medium increase in confidence in knowledge and the use of an active coping strategy. The amount of social support remained stable in the intervention groups, whereas it decreased in the control group. The same results were found when only the group program was compared with the control group. However, no significant differences between the home visit group and the participants in the group support program were found. Younger female caregivers benefit the most from the interventions. They show greater gains in confidence in knowledge about patient-care and the amount of social support received compared with other caregivers. (C) 2002 Elsevier Science Ireland Ltd. All rights reserved

Short-term effects of a group support program and an individual support program for caregivers of stroke patients

Caregivers of stroke patients who live at home experience many problems. There is evidence from the literature that caregivers' situations can be improved by teaching them active coping strategies and by offering them information about the disease. This study investigated the short-term effects of two different interventions both with the same contents, and both aimed at enhancing caregivers' confidence in knowledge, active coping strategies, mental well-being, vitality, social support, assertiveness, and at reducing strain. In addition, we investigated which type of support, i.e. a group program or home visits, had the most positive effects. Caregivers of stroke patients from four regions of the Netherlands were assigned in blocks to a control group or one of the intervention programs. To the group program 130 caregivers were assigned, to the home visits 78 caregivers, and to the control group 49 caregivers. Caregivers were interviewed before entering the program and after completion of the program. Multiple stepwise regression analysis was used to determine the effects of the interventions. In the short-term, both interventions (group program and home visits together) contributed significantly to an increase in confidence in knowledge about patient care, and the use of the active coping strategies 'confronting' and 'seeking social support'. The group program achieved a small increase in seeking social support. When only taking into account those caregivers that followed a substantial part of the program (per protocol group) also a medium effect was found from both interventions on perceived self efficacy. When comparing the group program and the home visits, no significant differences in effects were found. The results of the program are considered encouraging. We recommend implementation of more intervention programs that focus on coping and providing information. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved

Short-term effects of a group support program and an individual support program for caregivers of stroke patients

Caregivers of stroke patients who live at home experience many problems. There is evidence from the literature that caregivers' situations can be improved by teaching them active coping strategies and by offering them information about the disease. This study investigated the short-term effects of two different interventions both with the same contents, and both aimed at enhancing caregivers' confidence in knowledge, active coping strategies, mental well-being, vitality, social support, assertiveness, and at reducing strain. In addition, we investigated which type of support, i.e. a group program or home visits, had the most positive effects. Caregivers of stroke patients from four regions of the Netherlands were assigned in blocks to a control group or one of the intervention programs. To the group program 130 caregivers were assigned, to the home visits 78 caregivers, and to the control group 49 caregivers. Caregivers were interviewed before entering the program and after completion of the program. Multiple stepwise regression analysis was used to determine the effects of the interventions. In the short-term, both interventions (group program and home visits together) contributed significantly to an increase in confidence in knowledge about patient care, and the use of the active coping strategies 'confronting' and 'seeking social support'. The group program achieved a small increase in seeking social support. When only taking into account those caregivers that followed a substantial part of the program (per protocol group) also a medium effect was found from both interventions on perceived self efficacy. When comparing the group program and the home visits, no significant differences in effects were found. The results of the program are considered encouraging. We recommend implementation of more intervention programs that focus on coping and providing information. (C) 2000 Elsevier Science Ireland Ltd. All rights reserved