Psychometric Properties of Instruments Measuring Dyadic Communication and Environment in Dementia Care: A Systematic Review

Abstract

Abstract Background and Objectives A valid and reliable assessment of dementia dyadic communication and environment is essential to understand and facilitate social interaction and quality care. This review described the characteristics and evaluated psychometric properties of instruments that assess dyadic communication and environment between persons living with dementia and their caregivers. Research Design and Methods A systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guideline. Literature published until June 30, 2021, was searched. Ten psychometric properties and the ratio of sample size to the number of items were evaluated using the Psychometric Assessment for Self-report and Observational Tool. Results A total of 3,708 scholarly records was identified, and 24 eligible instruments from 48 scholarly records were evaluated. Twenty-two instruments assessed dyadic communication, and 2 assessed both dyadic communication and environment. Eighteen instruments were developed to assess task-related communication and 15 for paid (professional) caregivers. All instruments were scored as low psychometric quality (score range = 0–7). Behavioral Observation Scoring System was scored the highest (total score = 7), followed by Dyadic Dementia Coding System, Grid for observation of physical and verbal behaviors of caregiver and resident, and Trouble-Indicating Behaviors and Repair (total score = 6). These instruments had low psychometric evidence for internal consistency, content validity, and structural validity. Discussion and Implications Existing instruments are in the early stages of development and validation in dementia population. Further testing is needed in diverse communication types in paid and unpaid dementia caregiver populations.