Detection of maltreatment of people with dementia in Spain: usefulness of the Caregiver Abuse Screen (CASE)
The objective of our study is to validate the Caregiver Abuse Screen (CASE) as an instrument for detecting the maltreatment of people with dementia in Spain. In total, 326 informal caregivers of people with different types of dementia were interviewed in several cities in northwest Spain. The caregivers were selected from outpatient neurology clinics and associations of relatives of people with Alzheimer’s disease and other dementias. A comprehensive sociodemographic questionnaire was administered to all participants, and several standardized scales were used to assess burden, anxiety, depression, social support and resilience. The “Psychological Aggression” and “Physical Assault” dimensions of the Revised Conflicts Tactics Scale were used as risk factors of caregivers’ maltreatment for the construct validation. To establish the probability of maltreatment, a latent class analysis was carried out according to the item responses obtained from the CASE. The internal consistency (Cronbach’s alpha) of the CASE was 0.71. The construct validity was explored through factorial analysis, and we found that two dimensions of CASE—i.e., interpersonal abuse and neglect/dependency—explained 62.5% of the variability. According to the latent class probabilities, 20.4% of participants were categorized as possible abusers and 21.4% as non-abusers. The optimal maltreatment cutoff point was six points on the CASE. The validation of the CASE provides us a brief and easy instrument for detecting possible cases of maltreatment of Spanish people with dementia.
KeywordsDementia Psychosocial assessment Detection Maltreatment Informal caregiving
We received support from two public grants: “Detección de la violencia familiar ejercida sobre el anciano con demencia” (ref: CSO2010-20721) and “Trayectorias laborales y reproductivas de la población inmigrante en tiempo de crisis. España y el contexto interno” (ref: CSO2013-41828-R). We would like to express our sincere thanks to the associations of relatives of persons with Alzheimer’s disease and other dementias from Valladolid, Zamora, Burgos, Aranda del Duero, the Merindades area and Árevalo for their collaboration in the study. We would like to extend our gratitude to all caregivers who participated in this research. We are also grateful to the neurology departments of the Hospital Divino Vallés (Burgos) and University Hospital Río Hortega (Valladolid) for facilitating access to informal caregivers of people with dementia. Finally, we thank Elizabeth Nestor, Peter Grelak and Caolán O’Crualaoich for their linguistic assistance and their useful suggestions for this manuscript.
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