Academic journal article Journal of Nursing Measurement

Refinement of the Shared Care Instrument-Revised: A Measure of a Family Care Interaction

Academic journal article Journal of Nursing Measurement

Refinement of the Shared Care Instrument-Revised: A Measure of a Family Care Interaction

Article excerpt

This study's purpose was to evaluate the psychometric properties of the Shared Care Instrument-Revised (SCI-R) in a sample of family care dyads. The SCI-R was developed to measure the construct of shared care, which is a system of three constructs (communication, decision making, reciprocity) used in family care to exchange support. An important aspect of evaluating the SCI-R was to create a measure that is statistically sound and meaningful for patient and caregivers. Surveys were mailed to randomly selected home health dyads, which included 223 patients and 220 caregivers . Reliability and confirmatory factor analysis, and concurrent validity were examined. Internal consistency reliability of the patient subscales ranged from 0.74 to 0.76, and from 0.72 to 0.78 for caregiver subscales. Factor analysis supported the underlying theoretical basis of the SCI-R. Construct validity also was supported using the hypothesis-testing approach. One major challenge in family care research is to develop methods and tools to study the dynamic characteristics of close relationships. The findings from this study support further use of SCI-R to study how shared care facilitates the exchange of support and the influence shared care has on outcomes for both patients and caregivers.

Keywords: dyadic interactions; chronic illness; depressive symptoms; home care; family care; nursing

A tremendous amount of health care is provided by family and friends (Donelan et al., 2002). Family care refers to unpaid assistance to a patient by family and friends in their place of residence (Archbold et al., 2001). Family care involves complex interactions that can impact the quality of the dyadic relationship and health outcomes for both patients and caregivers (Beach et al., 2005; Liang, Krause, & Bennett, 2001; Lyons, Zarit, Sayer, & Whitlatch, 2002). Patients and family cannot provide care alone, and they need guidance, support, and skills to manage often complex care. Family care is an important clinical issue because of the effects of social relationships on health, and family involvement in care is necessary to achieve optimal outcomes from nursing interventions (Grady et al., 2000).

Family care by its nature involves at least two people in a close relationship. Reis and Collins (2000) suggested that close relationships are the context for the provision and receipt of social support. Yet not all close relationships are supportive. Reis and Collins (2000) suggested that more research efforts are needed to understand the relationship processes that foster or inhibit the expression and reception of support. Cohen, Gottlieb, and Underwood (2000) cited a need for more careful measurement of the functions and sources of perceived and received support.

This study begins to address this gap in our understanding of how relationships foster and inhibit the expression of social support, in that it evaluated an instrument developed to measure a supportive family care interaction called shared care . In previous work, shared care was identified as a construct of interest in a theoretical model of family care interactions. Shared care was defined as an interpersonal process used by home care patients and family caregivers to exchange support and manage a chronic illness (Sebern, 1996, 2005b). Although there are many components of family care interactions, the three components of shared care identified in the naturalistic inquiry were communication, decision making, and reciprocity (see Figure 1). Shared care interactions require cognitive ability to communicate, make decisions, and engage in reciprocal actions. The Shared Care Instrument- Revised (SCI-R) was developed and tested to measure the construct (Sebern, 2005a).


This study was designed to evaluate the psychometric properties of the SCI-R in a new sample of home health family care dyads. An important aspect of the SCI-R's development was to create a measure that was statistically sound and meaningful for both patients and caregivers, which could be used to assess shared care interactions. …

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