Validity testing of the Benjamin Rose Unmet Need Instrument: a comprehensive measure for dementia caregiving

Few psychometrically tested, comprehensive measures exist for assessing dementia caregivers' unmet needs. This has limited unmet need from being used as a key outcome in efficacy and/or effectiveness testing of programs supporting family/friend caregivers. This investigation tested the psychometric properties of the Benjamin Rose Unmet Need Instrument; a comprehensive measure designed for use in research with dementia caregivers.

The Instrument was examined for 3 types of validity (structural, concurrent, discriminant) and internal consistency reliability using secondary baseline data from a large-scale translation study of 192 community-dwelling family/friend dementia caregivers living in the U.S.

Exploratory factor analysis confirmed structural validity of a 45-item Total Unmet Need Scale (loadings = 0.31-0.66) and 8 multi-item and 1 single-item subscales (loadings = 0.34-0.81). Total Unmet Need and all subscales demonstrated high internal consistency reliability (α = 0.70-0.95). Concurrent validity was demonstrated for Total Unmet Need and seven subscales by significant relationships with measures of depressive symptoms (β = 0.16-0.32) and care-related strains (β = 0.15-0.42). Discriminant validity was partially confirmed through principal component analysis for Total Unmet Need (loading = 0.92) and 9 subscales (loadings = 0.90-0.95).

Results suggest the Benjamin Rose Unmet Need Instrument is a valid and reliable measure to understand dementia caregivers' expressed need for help across a variety of medical and nonmedical domains. It also can be used as a research outcome in studies of programs and services for caregivers. Additional research is needed to further test the Instrument's validity with caregivers of people with mild dementia and those living in facilities.