The Development and Psychometric Validation of a Comprehensive Measure Assessing Fear of Incompetence among Adults Who Have a Family Member with Dementia

Abstract

Because the interpersonal skills of individuals with dementia often decline, family members may question their own ability to interact meaningfully. These family members may experience fear of incompetence (i.e., fear of being unable to relate in a meaningful way or take care of a close family member with dementia). Thus, the goal of this research was to develop, refine, and psychometrically validate a scale (Fear of Incompetence—Dementia Scale; FOI-D) assessing fear of incompetence in the context of relationships with a close family member diagnosed with dementia. Three online studies were conducted to accomplish the primary objective. In Study One, the factor structure of the FOI-D was assessed by conducting an exploratory factor analysis using data from 710 adults who indicated having a close living family member who had been diagnosed with dementia. In Study Two, the factor structure was validated via a confirmatory factor analysis and the psychometric properties were established using data from 636 adults who had a family member with dementia. Finally, Study Three determined the temporal consistency of the scale by retesting 58 participants from Study Two. The results from Study One indicated that the FOI-D Scale accounted for 51.75% of the variance and was comprised of three subscales: the Interaction Concerns subscale, the Caregiving Concerns subscale, and the Knowledge Concerns subscale. In Study Two, the three-factor structure was supported, resulting in a 58-item scale. Investigation of the psychometric properties demonstrated the FOI-D to be reliable and valid. In Study Three, the FOI-D Scale demonstrated excellent temporal consistency. This research provides future investigators, educators, and practitioners with an adaptable comprehensive tool assessing fear of incompetence in a variety of settings.

Fear of Incompetence in Family Caregivers and Dementia Care Transitions

“…The scale has excellent construct validity and reliability (Cronbach's αs higher than 0.90) (Thompson et al, 2020). In this study, Cronbach's α is 0.97.…”

“…Fear of incompetence is an affective-motivational response to interactional difficulties that arise within the unique relationship with a close family member with dementia. It was found to be conceptually different from social anxiety or negative caregiver selfefficacy (i.e., a cognitive self-assessment as an incompetent relational and caregiving partner) (Thompson et al, 2020). As Thompson et al (2020) noted, people experiencing greater fear of incompetence do not lack social interactional skills, but rather these skills are put to the test in the context of interacting with a close other who has experienced extensive changes due to dementia.…”

“…One aspect of interpersonal interaction dynamics in relationships of persons with dementia and their caregivers centers around caregivers' feelings about their competencies as interaction partners (i.e., fear of incompetence, Miron et al, 2019a;Thompson et al, 2020). Wicklund (2005) defined fear of incompetence as the fear of interacting with certain others due to lacking the necessary interaction skills and knowledge about those others.…”

“…In interpersonal interactions with a family member with dementia, fear of incompetence is conceptualized as the fear of being unable to interact or communicate in a meaningful way or take care of a close family member with dementia. Fear of incompetence has three components: being afraid about lacking the skills for interacting meaningfully with the person with dementia, being afraid about lacking dementia knowledge, and being afraid about lacking caregiving skills (Thompson et al, 2020). Fear of incompetence is an affective-motivational response to interactional difficulties that arise within the unique relationship with a close family member with dementia.…”

“…This 58-item scale (FOI-D; Thompson et al, 2020) assessed participants' concerns about not knowing how to interact and communicate (e.g., "I will not know how to talk with him/her when he/she does not recognize me anymore"), how to take care of their family member with dementia (e.g., "I will be unable to assist when he/she is in psychological pain"), and about lacking knowledge about dementia (e.g., "I will not know why he/she behaves the way he/she does"). All items were assessed on 5-point scales ranging from 1 = Not at all concerned to 5 = Extremely concerned.…”