Measuring the Person-Centeredness of Caregivers Working With Nursing Home Residents With Dementia

Abstract

There is increasing interest in promoting person-centered caregiving within gerontology. However, few observational instruments have been developed to measure person-centered caregiving behaviors. In the present study, two innovative coding instruments—the Person-Centered Behavior Inventory (PCBI) and the Global Behavior Scale (GBS)—were used to test the hypothesis that caregivers’ person-centeredness would be negatively correlated with residents’ resistiveness to care. The study hypothesis was based on the need-driven dementia-compromised theory of behavior. It was expected that person-centered caregiving would better meet residents’ needs and be associated with less resistiveness to care. This hypothesis was tested by coding 70 videotaped interactions between 54 caregivers and 20 residents diagnosed with dementia. Resistiveness to care was measured by behaviorally coding residents’ resistive behaviors based on the Resistiveness to Care scale. The study hypothesis was supported when the GBS was used to measure person-centeredness, but not when the PCBI was used. The findings provide preliminary support for the predictive and construct validity of the GBS and the PCBI.

Caregiver person-centeredness and behavioral symptoms during mealtime interactions: Development and feasibility of a coding scheme

“…Past research using these instruments has not reported on observers’ perceptions of the ease of use video-coding using these items. 16,26 Fewer categories to describe caregiver actions may also enhance the practical application of research findings using this coding scheme, as they would be more readily translated to direct care staff.…”

“…In addition, future research should identify meaningful composites of similar and frequently overlapping caregiver codes as this will improve the ease of use of the scheme as well as its clinical applicability. Composites may also inform the refinement of the Person-Centered Behavior Inventory, Task-Centered Behavior Inventory 16 and other similar measures such as the Dementia Competent (DSI) and Culturally Competent (CSI) Interaction measures. 32,33 The construct validity of composite caregiver codes can be evaluated in future work by comparing items to measure person-centeredness from the DSI, PCBI and the Dementia Care Mapping tool and by review of refined items with experts in person-centered caregiving.…”

“…Composites may also inform the refinement of the Person-Centered Behavior Inventory, Task-Centered Behavior Inventory 16 and other similar measures such as the Dementia Competent (DSI) and Culturally Competent (CSI) Interaction measures. 32,33 The construct validity of composite caregiver codes can be evaluated in future work by comparing items to measure person-centeredness from the DSI, PCBI and the Dementia Care Mapping tool and by review of refined items with experts in person-centered caregiving. In addition, in order to facilitate a comprehensive evaluation of mealtime interactions, measures of resident engagement or affect should be integrated into the coding scheme.…”

“…Both scales have demonstrated inter-observer reliabilities averaging.82 (Coleman & Medvene, 2012; Hannah Lann-Wolcott et al, 2011) Outpacing was added using definitions provided in the Dementia Care Mapping tool, which has demonstrated test-retest reliability ratings >0.8. (D. J. Brooker & Surr, 2006; Fossey, Lee, & Ballard, 2002)…”

“…11,16,17 In order to describe and quantify complex interactions that occur during mealtimes and identify their temporal relationship to changes in behavior, the development of procedures for collecting, coding and analyzing sequential data in the context of mealtimes are needed.…”