Modified Decisional Conflict Scale for Primary Caregivers in Long-Term Care Facilities: Psychometric Validation Using...

Area of Science:

• Gerontology
• Healthcare Decision Making
• Psychometrics

Background:

• Family caregivers of long-term care (LTC) residents frequently experience decisional conflict regarding unplanned hospitalizations.
• This conflict impacts caregiver well-being and decision quality during critical care transitions.

Purpose of the Study:

• To adapt and psychometrically validate a modified Decisional Conflict Scale (DCS) tailored for primary family caregivers in LTC settings.
• To assess the reliability and validity of the modified DCS for measuring caregiver decisional conflict.

Main Methods:

• A cross-sectional survey involving 205 caregivers from 20 LTC facilities.
• Exploratory and confirmatory factor analyses (EFA/CFA) and structural equation modeling (SEM) were employed.
• Bollen-Stine bootstrap procedures were used for robust statistical estimation.

Main Results:

• The modified DCS exhibited excellent internal consistency (α = 0.98) and a robust single-factor structure.
• SEM revealed significant associations between Decision Antecedents, Decision-Making Process, and Decisional Conflict (R² = 0.68).
• Decision-Making Process partially mediated the link between Decision Antecedents and Decisional Conflict.

Conclusions:

• The adapted DCS is a reliable and valid tool for assessing decisional conflict in LTC caregivers.
• Caregiver readiness, support, and effective communication are crucial for mitigating decisional conflict.
• Future research should validate findings in diverse samples and explore shorter scale versions.