Cited by 214Dementia and Cognitive Impairment ResearchNursing care and researchFamily Caregiving in Mental Illness

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Measurement and correlates of family caregiver self-efficacy for managing dementia

Fortinsky, R. H., Kercher, K., Burant, C. J.·2002·Aging & Mental Health

DOI 10.1080/13607860220126763

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Abstract

Researchers in the aging field are paying increasing attention to the importance of perceived self-efficacy in understanding experiences and health-related outcomes of family caregivers. This paper details the strategy we used to measure family caregiver self-efficacy for managing dementia, and reports on observed associations between the resulting self-efficacy measures, caregiver depressive symptoms, and caregiver physical health symptoms. Family caregivers (n = 197) were interviewed after calling a local Alzheimer's Association chapter in the mid-western USA. Nine items inquiring about caregivers' certainty that they could carry out specific behaviors related to dementia care clustered into two distinct self-efficacy factors: symptom management self-efficacy (4 items) and community support service use self-efficacy (5 items). Internal consistency reliability for both factors was high (Cronbach's alpha = 0.77 and 0.78, respectively). Symptom management self-efficacy demonstrated a much stronger correlation with a published global caregiver competence measure than did service use self-efficacy (r = 0.49 and 0.27, respectively). In a multivariate regression model predicting caregiver depression symptoms, higher symptom management self-efficacy scores were associated with fewer depressive symptoms (beta = -0.17, p < 0.05). In a separate model, higher service use self-efficacy scores (beta = -0.20, p < 0.01) and higher symptom management self-efficacy scores (beta = -0.16, p < 0.05) were associated with fewer physical health symptoms. These new measures of dementia management self-efficacy hold promise for use in future studies.

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“Higher caregiving self-efficacy has been directly linked to decreased depressive symptoms (Cheng et al., 2013; Fortinsky et al., 2002; Khan et al., 2021; B. T. Mausbach et al., 2011; Rabinowitz et al., 2006), lower vulnerability to depression and anxiety (Khan et al., 2021; Steffen et al., 2002),…”
Psychometric evaluation of the Caregiver Self-Efficacy Scale with Korean Americans
Hong, M., Kim, K., & Casado, B. L. (2016) · Social Work in Health Care · doi:10.1080/00981389.2016.1231154 · Cited by 4
“As family members play a major role in providing care for their loved ones, it is important for family caregivers to effectively manage their care recipients’ symptoms and know how to locate and use community services for their care recipients (Fortinsky et al., 2002).”
BackgroundMethodInfluential
Caregiver Burden
Given, B. A., Given, C. W., & Sherwood, P. R. (2012) · Elsevier eBooks · doi:10.1016/b978-1-4377-1398-5.10026-8 · Cited by 4
Resource Utilization in Dementia a Question of Collaboration
Jedenius, E. (2010) · Figshare · Cited by 4
‘There’s no straight line…’ a consumer-informed intervention for FTD family care partners: the STELLA-FTD pilot study
Lindauer, A., Smith, S., Gothard, S., Mattek, N., Tran, L., & Mooney, A. R. (2023) · Aging & Mental Health · doi:10.1080/13607863.2023.2250741 · Cited by 3
Education, Training, and Support Programs for Caregivers of Individuals with Alzheimer’s Disease
Siskowski, C., & Gwyther, L. P. (2012) · Caregiving · doi:10.1007/978-1-4614-5335-2_3 · Cited by 3
Living With Dementia: Care Partner Needs and Outcomes of a Dementia Support Program in Primary Care
Schara, H., Johnson, T., Brungardt, A., Marcus, A. M., Cassidy, J., Shanbhag, P., Plys, E., & Lum, H. D. (2022) · Gerontology and Geriatric Medicine · doi:10.1177/23337214221129466 · Cited by 3
“The scale was created for ease of administration over the telephone and compiled from other existing measures that have been correlated with care partner dementia symptom management, ability to access help, and care partner mental and physical health scores (Fortinsky et al., 2002; Jennings et al., 2015; Steffen et al…”
Method
Care partner support
Prizer, L. P., & Hudson, P. (2023) · Handbook of clinical neurology · doi:10.1016/b978-0-12-824535-4.00014-8 · Cited by 3
Case management for people with acquired brain injury: feasibility and effectiveness of a two-year pragmatic randomized controlled trial
Stiekema, A. P. M., Rauwenhoff, J. C. C., Bierlaagh, D., Donkervoort, M., Jansen, N., Jurrius, K. H. M., Zadoks, J. M., & Heugten, C. M. V. (2024) · Brain Injury · doi:10.1080/02699052.2024.2399070 · Cited by 3
“A total of 10 items were scored on a 10-point scale from ‘not at all certain’ to ‘very certain;’ higher scores on the CSES indicate higher levels of self-efficacy.”
Effectiveness of Adult Day Care Programs on Health Outcomes of Thai Family Caregivers of Persons with Dementia
Noimuenwai, P. (2012) · KU ScholarWorks (The University of Kansas) · Cited by 3
Empowering Dementia Care Partners: How Self-Efficacy Influences Anxiety and Depression
Wilks, S. E., Lemieux, C. M., Ainsworth, L., Kim, Y. K., Bardales, R., & Thompson, A. R. (2025) · Illness Crisis & Loss · doi:10.1177/10541373251351393 · Cited by 2
Vokaltraktbeschwerden und Gesundheitserleben von Pflegenden in Senioreneinrichtungen in der Pandemie
Schuster, M. E., Deitmerg, U., & Gantner, S. (2022) · Laryngo-Rhino-Otologie · doi:10.1055/a-1727-6012 · Cited by 2
“Grundsätzlich ist bekannt, dass Pflegende auf erhöhte Anforderungen mit depressiven Symptomen reagieren können [6].”
Background
Self-efficacy for controlling upsetting thoughts and positive appraisals of stressors relate to caregiving competence in female family carers
Bergstrom, K. A., Gerstein, E. D., & Steffen, A. M. (2023) · International Journal of Care and Caring · doi:10.1332/23978821y2023d000000012 · Cited by 2
Conducting Assessments of Community-Based Programs for Individuals With Dementia and Their Family Caregivers
Heid, A. R., & Zarit, S. H. (2024) · The Gerontologist · doi:10.1093/geront/gnae145 · Cited by 2
Factors Affecting On Caregiving Self-efficacy among Dementia Caregivers
Choi, E. S., & Kim, K. S. (2010) · Research in Community and Public Health Nursing · doi:10.12799/jkachn.2010.21.2.210 · Cited by 2
Building Resilience in Persons with Early-Stage Dementia and Their Care Partners
Matchar, B. G., Gwyther, L. P., Galik, E. M., & Resnick, B. M. (2018) · Springer eBooks · doi:10.1007/978-3-030-04555-5_14 · Cited by 2
Impact of self-efficacy on resilience of caregivers attending to Alzheimer’s patients
Hemalatha, M., Banu, N., & Sreedevi, P. (2018) · The Pharma Innovation · doi:10.22271/tpi.2018.v7.i10a.06 · Cited by 2
“The scale comprises of 25 items, each rated on a 5point scale: Not at all true (1), rarely true (2), sometimes true (3), often true (4), very much true (5) with higher scores reflecting greater resilience.”
Background
Self-efficacy v kontextu zátěže neformálních pečovatelů
Ostravská univerzita, C. R., Hanyášová, H., & Kuzníková, I. (2022) · Ceskoslovenska psychologie · doi:10.51561/cspsych.66.5.514 · Cited by 1
“The Caregiver Inventory - CGI (Merluzzi et al., 2011) – Self-efficacy for managing dementia (Fortinsky et al., 2002), – Turecká modifikace Self-Efficacy Scale (Sherer et al., 1982) – General Self-efficacy scale - GSE (Schwazer a Jerusalem, 1979) a její modifiko- vané verze – Communication…”
Method
Instrumentos de avaliação da autoeficácia do cuidador informal na assistência domiciliar: revisão integrativa
dos Santos, F. G. T., Correia, E. T., Cardoso, L. C. B., Martins, M. A., Zulin, A., & Radovanovic, C. A. T. (2023) · Revista de Enfermagem da UFSM · doi:10.5902/2179769270100 · Cited by 1
Evaluating the web-based ‘Partner in Balance’ program for informal caregivers of people with Huntington's disease: A pilot study
Daemen, M., Boots, L. M. M., Oosterloo, M., de Vugt, M. E., & Duits, A. (2024) · Internet Interventions · doi:10.1016/j.invent.2024.100782 · Cited by 1
Enhancing ethical self-efficacy among dementia caregiver staff: A mixed-methods feasibility study of the care programme
Lauridsen, S., Skov, S. S., Ferm, L.-M. T., Berg, M.-E., Folker, A. P., Simonsen, P., & Schou‐Juul, F. (2025) · International Journal of Nursing Studies Advances · doi:10.1016/j.ijnsa.2025.100294 · Cited by 1
“While the concept of self-efficacy has been used as an outcome measure in studies within the other domains of dementia care (Tonga et al., 2020; Fortinsky et al., 2002), it has not been specifically applied to ethical decision-making in dementia care.”
Case Management for People with Acquired Brain Injury with Complex Problems (Part 1): Outcomes of a One-group Trial
Stiekema, A. P. M., Winkens, B., Bierlaagh, D., Donkervoort, M., Jansen, N., Jurrius, K. H. M., Zadoks, J. M., & Heugten, C. M. V. (2025) · International Journal of Integrated Care · doi:10.5334/ijic.8649 · Cited by 1
“S elf-efficacy regarding care management and service use was assessed using the Carer Self-Efficacy Scale (CSES; [36]).”
Exploring self-efficacy as perceived by men and women unpaid caregivers of older adults: A secondary analysis of focus group data
Pizzol, F. L. F. D., Duggleby, W., Baxter, P. E., Peacock, S., Thompson, G. N., Swindle, J., & O’Rourke, H. M. (2025) · Geriatric Nursing · doi:10.1016/j.gerinurse.2025.103662 · Cited by 1
A videoconferencing group-based psychoeducation for family caregivers of people living with dementia: a feasibility study
Chan, H. M., Ho, K. H. M., & Chan, H. Y. L. (2026) · BMC Geriatrics · doi:10.1186/s12877-026-07010-y · Cited by 2
“…to moderate stage and required assistance in physical activities of daily living (ADL) (i.e., score ≥ 2 on the Activity of Daily Living scale [2, 30]; (iv) providing at least 5 h of caregiving per week in the past month [31]; and (v) had low caregiving self-efficacy (i.e., score ≤ 3 on the…”
The physical and mental health of spouse caregivers in dementia: Finding meaning as a mediator of burden
McLennon, S. M. (2008) · Cited by 1
Spaced Retrieval Memory Training System for Elderly
Fang, Y., Chen, C., & Hoe, Z.-Y. (2019) · International Conference on Information and Education Technology (ICIET) · doi:10.1145/3323771.3323793 · Cited by 1
“The most serious problems faced by families is memory disturbance [10].”
Background
Demens og etik
Lauridsen, S., Schou‐Juul, F., Folker, A. P., Pihl, M. L., Simonsen, P., & Skov, S. S. (2024) · Klinisk Sygepleje · doi:10.18261/ks.38.1.5 · Cited by 1
Using Clustering Methods to Map the Experience Profiles of Dementia Caregivers
Ashida, S., Lynn, F. B., Thompson, L., Koehly, L. M., Williams, K. N., & Donohoe, M. (2024) · Innovation in Aging · doi:10.1093/geroni/igae046 · Cited by 1
“…is the mean of 12 items (alpha = 0.89) and measures the extent to which caregivers feel prepared for the caregiver role (8 items), such as meeting the physical and emotional needs and successfully finding organizations (33), and self-efficacy to use relevant support services (4 items) (34).”
BackgroundInfluential
Quality and Global Satisfaction with Physicians' Dementia Care as Reported by Family Caregivers
Zlateva, I. (2006) · OpenCommons - UConn (University of Connecticut)
450 Depressive Symptomatology in Care-Givers of Patients with Alzheimer Diseases
Khan, A. M., & Taj, R. (2011) · Asian Journal of Psychiatry · doi:10.1016/s1876-2018(11)60166-4
The Influence of Readiness to Change on the Effects of an Intervention for Dementia Caregivers
Yarry, S. J. (2010) · OhioLink ETD Center (Ohio Library and Information Network)
Supporting carers of older people with dementia: a case study of intervention programmes
Callaby, P. (2012) · ePrints Soton (University of Southampton)
Prevalence and Correlates of Anxiety and Depression among Family Carers of Cancer
Katende, G., & Nakimera, L. (2016) · World Academy of Science, Engineering and Technology, International Journal of Nursing and Health Sciences
Balanced and prepared
Boots, L. M. M. (2016) · doi:10.26481/dis.20160701lb · Cited by 5
The effect of Risperidone, Sertraline as monotherapy and in combination with Cholinesterase inhibitors on cognitive functioning due to Alzheimer’s Disease: A randomized clinical trial
Melissari-Tzanakaki, M., Benioudakis, E. S., Botonaki, G., Seliniotaki, T., Spyridaki, E. C., Tsoukareli, A. K., Kyriakoulaki, E., Darakis, E., Melissari, A.-I., & Steiri, A. (2017) · Alzheimer s Dementia & Cognitive Neurology · doi:10.15761/adcn.1000114
“Furthermore, behavioral disturbances burden the caregivers more, which can increase the incidence of depressive disorders among them [28,29].”
Background
Stress, coping and self-efficacy : designing an intervention to support informal caregivers of people with dementia
Douglas, L. (2017)
Improving the lived experience of dementia transitions
Drummond, N., Garcia, L., & McCleary, L. (2020) · Elsevier eBooks · doi:10.1016/b978-0-12-817566-8.00001-2
EVALUATING THE COPING STRATEGIES OF CAREGIVERS AMONG PATIENTS OF DEMENTIA
Singh, T., & Mathur, K. (2020)
Current Awareness in Geriatric Psychiatry
(2002) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.581
Current Awareness in Geriatric Psychiatry
(2002) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.582
Family caregivers of persons with young-onset dementia
Bruinsma, J. (2022) · doi:10.26481/dis.20220420jb
The effectiveness and health-economic evaluation of “Partner in Balance,” a blended self-management program for early-stage dementia caregivers: study protocol for a cluster-randomized controlled trial
Osstyn, S. L., Handels, R. L. H., Boots, L. M. M., Balvert, S. C. E., Evers, S., & de Vugt, M. E. (2023) · Trials · doi:10.1186/s13063-023-07423-9
“The sample size calculation was based on an earlier short-term effectiveness study of PiB [21] that targeted a similar population and used the CSES as a primary effectiveness outcome measure.”
MethodInfluential
ผลของโปรแกรมเสรมสรางทกษะการเผชญความเครยดตอภาวะกดดนดานจตใจของผดแลผปวยจตเภท
ยะมะโน, ศ., & อุปเสน, ร. (2018) · doi:10.58837/chula.the.2018.1007

Authors: Fortinsky, R. H., Kercher, K., & Burant, C. J.
Affiliations: UConn Health (US)
Case Western Reserve University (US)
ORCID: Fortinsky, R. H.
Burant, C. J.
Venue: Aging & Mental Health
Publisher: Informa UK Limited
Published: 2002-05
Volume: 6
Issue: 2
Pages: 153-160
ISSN: 1360-7863 (ISSN-L)
1364-6915
DOI: 10.1080/13607860220126763
OpenAlex: W2049155331
Cited by: 214
References: 23
Citations by year: 2026: 9 · 2025: 9 · 2024: 9 · 2023: 13 · 2022: 13 · 2021: 11 · 2020: 14 · 2019: 10 · 2018: 17 · 2017: 9 · 2016: 9 · 2015: 7 · 2014: 8 · 2013: 7 · 2012: 14
FWCI: 2.52
Type: journal article
Language: en
Open access: closed
Locations: Aging & Mental Health (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
Health Sciences › Nursing › Research and Theory › Nursing care and research
Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords: family caregivers, self-efficacy, dementia care, caregiver depression, caregiver physical health, caregiver competence, scale development, Alzheimer's disease
MeSH terms: Aged, Aging, Dementia, Depression, Female, Health Status, Humans, Male, Middle Aged, Psychometrics, Quality of Life, Regression Analysis, Social Support, Caregivers, Self Efficacy

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Measurement and correlates of family caregiver self-efficacy for managing dementia

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