Development and validation of caregiver stress and support scale for caregivers of individuals with disabilities in Singapore

Abstract

Purpose Few available measures include culturally salient stressors and support systems for caregivers of offspring with disabilities in Asia. The purpose of this study was to develop and validate a self-report measure that included relevant stressors and sources of support for caregivers of offspring with disabilities. Materials and methods Open-ended interviews with eight caregivers in Singapore, along with existing measures were used to develop items. The original 34 items were administered to caregivers of offspring with disabilities in Singapore (n = 234, 85% mothers). Based on an examination of factor loadings, internal consistency, and feedback from professionals, the scale was revised and administered to 370 caregivers (78% mothers), along with other measures of stress, support, depression, and well-being. Results Exploratory factor analysis of the original 34-item scale yielded two factors, Sources of Stress and Sources of Support. After scale revision, confirmatory factor analysis showed that a two-factor structure demonstrated a fair fit. The subscales showed adequate internal consistency and test-retest reliability, and significant associations in expected directions with other measures of stress and support, as well as with depressive symptoms and well-being. Conclusions The measure has adequate reliability and validity, with implications for use by local service providers. Implications for rehabilitation Caregivers face unique challenges, such as stressors associated with caregiving, with varying support systems available to reduce the stress. A psychometrically-sound measure can be used to assess sources of stress and support, monitor services, and address service gaps for caregivers. The Sources of Caregiver Stress and Support Scale is a contextually-sensitive self-report measure for caregivers of people with disabilities in Singapore.