Most common refusals of personal care in advanced dementia: psychometric properties of the RoCIS

Backhouse, Tamara, Khondoker, Mizanur, Killett, Anne and Mioshi, Eneida (2022) Most common refusals of personal care in advanced dementia: psychometric properties of the RoCIS. The Gerontologist. ISSN 0016-9013 (In Press)

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Background and Objectives: Refusals of care in dementia can be a source of distress for people with dementia and their caregivers. Informant-based measures to examine refusals of care are limited and often measure other behaviours such as agitation. We aimed to assess the validity and reliability of the newly developed, 14-item, Refusals of Care Informant Scale (RoCIS) and then use the scale to verify the most common refusal behaviours. Research Design and Methods: Data from 129 dyads were analysed. Dyad was defined as a person with advanced dementia either living in a care home or supported in their own home and their caregiver. Data about the person with dementia were gathered using informant-based questionnaires. The psychometric properties of the RoCIS were investigated using Rasch analysis to determine validity and reliability. Results: Following Rasch analysis, the item ‘upset’ was removed from the RoCIS. The reduced 13-item RoCIS is unidimensional and achieved a reliability index of 0.85 (Cronbach’s alpha 0.88). 68% of people with dementia had refused care in the last month, with ‘verbally refused’ the most common type of refusal behaviour. People in the ‘very severe/profound’ stage of dementia showed more refusal behaviours than those in the ‘severe’ stage. Discussion and Implications: Results provide initial evidence that the RoCIS is a valid and reliable informant-based scale measuring refusals of care in advanced dementia. Results indicate a need to develop new approaches and techniques to make assistance with personal care more acceptable to people with dementia.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > School of Health Sciences
Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: LivePure Connector
Date Deposited: 28 Apr 2022 09:30
Last Modified: 24 May 2022 14:55

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