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Negative Impact and Positive Value in Caregiving: Validation of the COPE Index in a Six-Country Sample of Carers

Cristian Balducci, MSc¹, Eva Mnich, MA², Kevin J. McKee, PhD³, Giovanni Lamura, PhD⁴, Anke Beckmann, MSc², Barbro Krevers, PhD⁵, Z. Beata Wojszel, PhD⁶, Mike Nolan, PhD³, Constantinos Prouskas, PhD⁷, Barbara Bie, PhD⁶ and Birgitta Öberg, PhD⁵

Correspondence: Address correspondence to Kevin J. McKee, Sheffield Institute for Studies on Ageing, University of Sheffield, Community Sciences Centre, Northern General Hospital, Sheffield S5 7AU, United Kingdom. E-mail: k.j.mckee{at}sheffield.ac.uk

Purpose: The present study attempts to further validate the COPE Index on a large sample of carers drawn from six European countries. Design and Methods: We used a cross-sectional survey, with approximately 1,000 carers recruited in each of six countries by means of a common standard evaluation protocol. Our saturation recruitment of a designated quota of carers occurred by means of several channels, in identified geographical zones within countries. Interviews were carried out with primary informal carers by use of a common assessment tool. We subjected items of the COPE Index to principal component analysis and we assessed emergent components through the use of Cronbach's alpha reliability procedures. We examined factor components as summative scales for confirmatory correlations with caregiving and psychological variables.  Results: Three components emerged, which we identified as the negative impact of caregiving, the positive value of caregiving, and the quality of support for caregiving. Internal consistency was good for negative impact and satisfactory for positive value and quality of support. Negative value was most consistently and strongly correlated with caregiving and psychological variables, although we did find diverse associations between these variables and the COPE Index subscales. Implications: The COPE Index is a brief, first-stage assessment of some sophistication that can enable health and social care professionals to develop appropriately targeted interventions to enhance the positive aspects of the caregiving experience and quality of support, as well as reduce the negative impacts of caregiving.

Key Words: Assessment • Burden • Caregiving • Intervention