Psychometric Properties of Instruments Measuring Dyadic Communication and Environment in Dementia Care: A Systematic Review

Abstract

Background and Objectives A valid and reliable assessment of dementia dyadic communication and environment is essential to understand and facilitate social interaction and quality care. This review described the characteristics and evaluated psychometric properties of instruments that assess dyadic communication and environment between persons living with dementia and their caregivers. Research Design and Methods A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Guideline. Literature published until June 30 th, 2021, was searched. Ten psychometric properties and the ratio of sample size to the number of items were evaluated using the Psychometric Assessment for Self-report and Observational Tool. Results A total of 3,708 scholarly records was identified, and 24 eligible instruments from 48 scholarly records were evaluated. Twenty-two instruments assessed dyadic communication, and two assessed both dyadic communication and environment. Eighteen instruments were developed to assess task-related communication and fifteen for paid (professional) caregivers. All instruments were scored as low psychometric quality (score range = 0 - 7). Behavioral Observation Scoring System was scored the highest (total score = 7), followed by Dyadic Dementia Coding System, Grid for observation of physical and verbal behaviors of caregiver and resident, and Trouble-Indicating Behaviors and Repair (total score = 6, respectively). These instruments had low psychometric evidence for internal consistency, content validity, and structural validity. Discussion and Implications Existing instruments are in the early stages of development and validation in dementia population. Further testing is needed in diverse communication types in paid and unpaid dementia caregiver populations.

Chewing and Swallowing Abilities of Persons Living With Dementia: A Systematic Review of Psychometric Properties of Instruments

“…In this review, we used the PAT to evaluate the psychometric quality of the included instruments. The PAT was used in our prior systematic reviews of instruments and showed evidence of feasibility and ease of use ( Kim & Liu, 2021 ; Kim et al, 2022 ; Liu & Kim, 2021 ; Liu et al, 2021 ). Overall, included instruments were evaluated as having low psychometric quality except for RSST, SRS, and DSS, which assess swallowing ability and were scored as having moderate psychometric quality.…”

Communication Patterns and Characteristics of Family Caregivers and Persons Living With Dementia: Secondary Analysis of Video Observation

“…The item definitions and the coding rationale of the DCODE were developed from existing instruments and the literature describing communication behaviors in dementia populations. 8 , 9 The pool of items was initially developed through a comprehensive literature review. The items were reviewed by 6 experts specialized in nursing, communication, dementia, and family caregiving to evaluate item relevancy, clarity, specificity, and feasibility to establish face and content validity.…”

“…Other dyadic instruments found in the literature were developed without a conceptual framework and without consideration of type of communication. 9 Moreover, the DCODE assesses 3 categories of communication, including positive, negative, and neutral communication. Communication is a dynamic process with specific context-dependent behaviors (ie, neutral communication).…”