Abstract
BACKGROUND: Psychometrically sound resilience outcome measures are essential to establish how health and care services or interventions can enhance the resilience of people living with dementia. In response to a lack of resilience outcome measures designed specifically with, and for, people living with dementia, this research builds on several stages of measurement development and evaluates the psychometric properties of a new outcome measure of resilience for people living with dementia. METHODS: We aimed to recruit 185 people aged 18 + living with dementia. An online survey containing demographic questions, the draft 37-item resilience measure, the 7-item Generalised Anxiety Disorder Assessment (GAD- 7) and the 5-item Canterbury Wellbeing Scale was widely shared in the UK. Three people living with dementia piloted the survey before recruitment commenced and gave suggestions for improvement. Exploratory factor analysis was applied to the draft resilience measure and the construct validity and internal consistency ascertained. Convergent validity with other measures was tested. RESULTS: Minor changes were made to the survey following piloting to help people with dementia. The survey was completed by 193 participants, aged 47-93 (M = 69.9; SD = 9.5), 58% male, and living with a range of dementia diagnoses. The exploratory factor analysis led to a final 19-item measure (Chronbach's Alpha = 0.85) with 5-factors underlying resilience: 'Outlook', 'Adaptation', 'Acceptance', 'community and peer support' and 'family and friends'. The new resilience measure demonstrated convergent validity with well-being (r = 0.49, p < 0.001) and anxiety (r = - 0.28, p < 0.001). CONCLUSIONS: This study presents preliminary field-testing and validation of the Bangor Dementia Resilience Scale, a new psychometrically sound resilience measure for people living with mild to moderate dementia. The scale may be a valuable tool for practitioners to provide strengths-based and person-centred support to maintain and enhance the resilience of people living with dementia, and evaluating the extent to which health and social care services may improve resilience. Given the global policy focus to support people with dementia to live as well as possible, the new scale has international significance for translation and cultural adaptation by other countries.