Sense of competence questionnaire among informal caregivers of older adults with dementia symptoms: A psychometric evaluation

BACKGROUND The Sense of Competence Questionnaire (SCQ) was originally developed for informal caregivers of patients with diagnosed dementia. In order to study the validity and usefulness of the SCQ when applied to informal caregivers of older adults with dementia symptoms (i.e. cognitive impairment, pre-diagnostic dementia or dementia in its early stages), we investigated the construct validity, feasibility, subscales, homogeneity, and floor and ceiling effects in this new target population. METHODS A psychometric evaluation was performed among 99 informal caregivers. To investigate construct validity, hypotheses were tested, concerning the association between sense of competence and burden, mental quality of life, depressive symptoms, and mastery. To investigate feasibility, response rate and the proportion of missing data were explored for each item. An exploratory principal component analysis was used to investigate whether the SCQ comprises the three subscales established in previous studies. Homogeneity was assessed for each subscale with Cronbach's alpha and item-total correlations. Floor and ceiling effects were explored. RESULTS Most hypotheses on construct validity were rejected. Only the subscale 'consequences of involvement in care' was found to be partly valid. Feasibility: 93 out of 99 persons completed the SCQ. The proportion of unanswered items per item ranged from 0-3%. Subscales: the SCQ comprises the three expected subscales. Homogeneity: Cronbach's alpha and item-total correlations of the three subscales were satisfactory. A ceiling effect occurred on the subscale 'satisfaction with the care recipient'. CONCLUSION The three subscales of the SCQ showed good homogeneity and feasibility, but their validity is insufficient: only the subscale 'consequences of involvement' was found to be partly valid. The two other subscales might not be relevant yet for the new target population, since many of the items on these scales refer to problem behaviour and problematic interactions. Our message to clinicians is not to use these subscales.