David Pollio
George Warren Brown School of Social Work, Campus Box 1196
Washington University
One Brookings Drive
St. Louis MO 63130-4899
U.S.A
Phone: 314-935-7516
FAX: 314-935-8511
Email: depollio@gwbmail.wustl.edu
Purpose: Families coping with serious mental illness (SMI) are confronted with multiple demands. Instruments that assess caregivers’ experiences can provide crucial information for understanding the everyday struggles of these families. This study uses Confirmatory Factor Analysis to tests the underlying factorial structure of Lawton and colleagues (1989) Caregiving Appraisal Scale (CAS) with a sample of caregivers of adults with SMI.
Methods: A convenience sample of 159 caretakers was recruited through community-based family workshops sponsored by the Alliance for the Mentally Ill from a large Midwestern city. Structured interviews were used to assess caretakers’ experiences. The CAS is a multidimensional measure that captures caregiving’s positive and negative aspects. It consists of 28-items divided into four subscales: burden, impact, satisfaction, and mastery. A nested model approach was used to compare the fitness of a four versus a three factor model, which combined the burden and impact scales into a single latent construct.
Results: All four subscales had good internal consistency (ranging from cronbach alpha = 0.71 to alpha = 0.86). Goodness of fit indices (CFI and AGFI) showed that both models fitted the data well. The significant Chi-square difference (x2 (3) = 26.96, p < 0.01) between the four factor model and the three factor model indicated superior fit for the four factor structure, affirming that the burden and impact subscales capture different dimension of caregiving experiences.
Implications: Findings indicate that caring for a family member with SMI is composed of four key dimensions: caretaking burdens and impacts as well as caregiver’s satisfaction and mastery of the tasks involved in taking care of an ill family member. Reliable and valid instruments that accurately measure positive and negative experiences of caregiving can help researchers and practitioners incorporate families’ experiences into interventions in order to improve the quality of their lives.