Page 132 - GHES-2-1

Global Health Econ Sustain Elderly people with dementia

2. Methods 2.3. Analytical procedures

2.1. Research design 2.3.1. Questionnaire analysis
This study employed a cross-sectional design, chosen due The questionnaires were reviewed and published in
to its setting in the period immediately preceding the English, Chinese, and Japanese. The Cultural Justifications
COVID-19 pandemic, which spanned from May 2016 for Caregiving Scale (CJCS) was translated into Japanese
to March 2019. The study involved family caregivers and Chinese, with its English translation verified by four
of elderly patients with dementia (with cognitive bilingual translators.
symptoms) living at home in Hong Kong, Singapore,
or Japan. Family caregivers with dementia symptoms Family caregivers themselves were presented with 118
themselves were excluded from the study population. items to respond to, of which 65 items described the status
Recruitment of family caregivers as research subjects was of the elderly patient with dementia. When considering all
conducted through referrals from physicians and heads subject attributes and the items of the rating scale together,
of departments in hospitals and facilities that cooperated the total number of questionnaire items amounted to 183.
in the study. The study facilities were primarily hospitals The rationale behind the extensive number of questions
specializing in dementia care or hospitals equipped with was explained in advance, consent was obtained, and
both outpatient and inpatient facilities for dementia at least, one of the researchers was present during the
management. answering process to address any queries raised.
Current caregiving and demographic variables were
2.2. Data collection
collected, including age, gender, ethnicity, education
In accordance with ethical protocols, hospitals and facilities level, economic status, marital status, number of siblings,
cooperating in the survey were requested to nominate and current caregiving status. In addition, information
participants. Researchers, then, visited these institutions regarding the age, sex, and education level of patients with
and invited family caregivers to complete the appropriate dementia under the care of family caregivers was recorded.
survey forms and answer the questionnaire.
The Revised Memory and Behavior Problems Checklist
In Hong Kong and Singapore, the questionnaires (RMBPC) (Teri et al., 1992), consisting of 24 items, was
were available in Chinese and English. In Japan, the used to assess the frequency of memory and behavioral
questionnaires were translated and administered in problems experienced by elderly dementia patients,
Japanese. To ascertain dementia symptoms, data from the as well as caregivers’ responses to these problems. The
Mini-mental state examination (MMSE) and the presence reliability alpha was 0.90 for the frequency scale and 0.94
or absence of a physician’s diagnosis were included in the for the response scale. Based on responses to these scales,
questionnaire. In addition, a self-rating questionnaire respondents were recoded as “1 = yes” or “0 = no” regarding
was administered to assess the physical, social, and engagement in specific behavior. Higher scores indicated
psychological health status of the family caregivers, along greater levels of caregiver burden. This scale was chosen
with their coping strategies. They were also queried about for its excellent rating in assessing problem behaviors and
the behavioral and memory problems observed in the evaluation.
dementia patients under their care.
Next, self-perceived support was measured using
Family caregivers displaying any signs of mental illness the Perceived Support Received Scale (PSS) (Krause &
or dementia-like symptoms were excluded from the study Markides, 1990). This 11-item scale measures the perceived
cohort. tangible, emotional, and informational support received

On average, it took about 30 min to complete the survey. from others on a 4-point Likert scale ranging from “1”
Evaluations were conducted by the researchers and their (indicating “never”) to “4” (indicating “very often”). The
research assistants, adhering to the protocols established reliability alpha of the scale in this study was 0.86. This
for each scale. scale was selected due to its reliability and credibility in
measuring perceived support.
In each country, data management was performed
using personal computers that were not connected to the To measure participants’ mental health, the 12-item
Internet for data aggregation and analysis. Furthermore, General Health Questionnaire (GHQ-12) (Goldberg,
data were anonymized and stored in locked shelves to 1972; Goldberg & Williams, 1988) was used. This scale,
prevent linkage to individual participants. Ethical approval a shortened version of the original 60-item questionnaire
was obtained in accordance with the laws and systems of (Goldberg & Blackwell, 1970), measures respondents’
each respective country. mental health on a 4-point Likert scale. Higher scores

Volume 2 Issue 1 (2024) 3 https://doi.org/10.36922/ghes.1954