Introduction and Psychometric Validation of the Resilience and Strain Questionnaire (ResQ-Care)- A Scale on the Ratio of Informal Caregivers' Resilience and Stress Factors.

Alexandra Wuttke-Linnemann,Svenja Palm,Katharina Geschke,Andreas Fellgiebel,Lea Scholz

doi:10.3389/fpsyt.2021.778633

Abstract

Background: Informal caregivers are a particularly vulnerable population at risk for adverse health outcomes. Likewise, there are many scales available assessing individual caregiver burden and stress. Recently, resilience in caregivers gained increasing interest and scales started to assess resilience factors as well. Drawing on a homeostatic model, we developed a scale assessing both caregivers' stress and resilience factors. We propose four scales, two covering stress and two covering resilience factors, in addition to a sociodemographic basic scale. Based on the stress:resilience ratio, the individual risk of adverse health outcomes and suggestions for interventions can be derived.Methods: A total of 291 informal caregivers filled in the ResQ-Care as part of a survey study conducted during the second wave of the COVID-19 pandemic in Germany. Exploratory factor analysis was performed. Validity analyses were examined by correlations with the Brief Resilience Scale (BRS), the Perceived Stress Scale (PSS-4) and the Geriatric Depression Scale (GDS-15).Results: The data fitted our proposed four-factor solution well, explaining 43.3% of the variance. Reliability of each scale was at least acceptable with Cronbach's α ≥0.67 and MacDonald's ω ≥0.68 for all scales. The two strain scales weighed more than the resilience scales and explained 65.6% of the variance. Convergent and discriminant validity was confirmed for the BRS and PSS-4, whereas the GDS-15 correlation pattern was counterintuitive.Conclusion: The factor structure of the ResQ-Care scale was confirmed, with good indications of reliability and validity. Inconsistent correlations of the scales with the GDS-15 might be due to a reduced validity of GDS-15 assessment during the COVID-19 lockdown.

Highlights

IntroductionIntroduction and Psychometric Validation of theResilience and Strain Questionnaire (ResQ-Care)— A Scale on the Ratio of Informal Caregivers’ Resilience and Stress FactorsAlexandra Wuttke-Linnemann 1*, Svenja Palm 1, Lea Scholz 1, Katharina Geschke 1,2 and Andreas Fellgiebel 1,2,3Edited by: Serena Sabatini, University of Exeter, United KingdomReviewed by: Zachary Kunicki, Brown University, United StatesManuela Altieri, University of Campania ’LuigiVanvitelli, ItalySpecialty section: This article was submitted toAging Psychiatry, a section of the journal Frontiers in PsychiatryReceived: 17 September 2021 Accepted: 25 October 2021Published: 24 November 2021
We designed the ResQ-Care scale to cover five items per scale. This allocation of items has practical reasons as the visualization of the results leads to a scale representing the weight of resilience factors relative to the weight of stress factors
With each scale having the same weight in this visualization, the interpretation of the stress:resilience ratio has high face validity and is intuitive for the user

Summary

Introduction

Introduction and Psychometric Validation of theResilience and Strain Questionnaire (ResQ-Care)— A Scale on the Ratio of Informal Caregivers’ Resilience and Stress FactorsAlexandra Wuttke-Linnemann 1*, Svenja Palm 1, Lea Scholz 1, Katharina Geschke 1,2 and Andreas Fellgiebel 1,2,3Edited by: Serena Sabatini, University of Exeter, United KingdomReviewed by: Zachary Kunicki, Brown University, United StatesManuela Altieri, University of Campania ’LuigiVanvitelli, ItalySpecialty section: This article was submitted toAging Psychiatry, a section of the journal Frontiers in PsychiatryReceived: 17 September 2021 Accepted: 25 October 2021Published: 24 November 2021. Informal caregivers are a vulnerable population often referred to as invisible, secondary patients [1]. They provide the majority of care for home-dwelling care-dependent people [2]. As the caregiving experience can lead to chronic stress, caregivers are at increased risk for the development of physical and mental health impairments. Acute stress is adaptive, chronic stress directly translates into negative health consequences [4] In this regard, allostatic load and homeostasis are central concepts that may help understand how stress endangers health. Informal caregivers are a vulnerable population at risk for adverse health outcomes. Based on the stress:resilience ratio, the individual risk of adverse health outcomes and suggestions for interventions can be derived

Methods

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Discussion

Conclusion