Abstract
BackgroundInformal caregivers of persons with dementia (PWD) are often associated with negative health outcomes. Self-efficacy in dementia caregiving has been reported to have protective effects on caregiver’s health. This study aims to examine the factors associated with the domains of caregiving self-efficacy among informal caregivers in Singapore, a country with a rapidly aging population and a 10% prevalence of dementia among older adults.MethodsTwo hundred eighty-two informal caregivers were recruited and data including participant’s caregiving self-efficacy, sociodemographic information, perceived social support, positive aspects of caregiving, knowledge of dementia, as well as behavioral and memory problems of care recipients were collected. A confirmatory factor analysis (CFA) was performed for the 3-factor model of the Revised Scale for Caregiving Self-Efficacy (RSCSE), and multiple linear regressions were conducted using the RSCSE subscales as dependent variables.ResultsOur CFA found that the RSCSE 3-factor model proposed by the original scale developer was an acceptable fit among informal caregivers in Singapore. Having established that the 3-factor model of the RSCSE was compatible among our sample, a series of multiple regressions were conducted using each of the factors as a dependent variable. Regressions revealed several factors that were significantly associated with caregiving self-efficacy. Importantly, outlook on life was positively associated to all 3 domains of the RSCSE, while social support was positively associated with self-efficacy in obtaining respite and controlling upsetting thoughts.ConclusionThe 3-factor model of the RSCSE was found to be an appropriate fit for our sample. Findings from this study elucidated important novel insights into the factors that influences caregiving self-efficacy amongst informal caregivers in Singapore. Crucially, caregivers’ outlook on life and social support should be improved in order to enhance their caregiving self-efficacy.
Highlights
Informal caregivers of persons with dementia (PWD) are often associated with negative health outcomes
This study aims to investigate the dementia caregiving self-efficacy among a sample of informal caregivers in Singapore using the multi-dimensional Revised Scale for Caregiving Self-Efficacy (RSCSE), which is a validated scale that has been used in many studies across various countries [25]
Our confirmatory factor analysis (CFA) of the RSCSE showed that the original proposed factor structure by the developer of the scale showed acceptable fit for our sample (i.e. The comparative fit index (CFI) = 0.946, Tucker-Lewis index (TLI) = 0.935, and Root mean square error of approximation (RMSEA) = 0.086, slightly above 0.08 but still demonstrating mediocre fit [41]), and the standardized factor loading for all items varied from 0.570 to 0.959
Summary
Informal caregivers of persons with dementia (PWD) are often associated with negative health outcomes. Self-efficacy in dementia caregiving has been reported to have protective effects on caregiver’s health. The majority of persons with dementia (PWD) are being taken care of by family members or informal caregivers. These caregivers are often referred to as the invisible second patients [1], due to the negative physical and mental health consequences associated with being a caregiver to a PWD. Caregivers of PWD are more likely to be smokers and obese [8], and susceptible to experiencing high burden and burnout [9, 10] In this regard, it is worth highlighting that self-efficacy has been reported to have a protective effect on caregiver’s health. Caregiving selfefficacy has been reported to be inversely related to depressive symptoms [15], and to confer a protective effect against risks of cardiovascular disease [16]
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