The Birmingham Relationship Continuity Measure: the development and evaluation of a measure of the perceived continuity of spousal relationships in dementia: the development and evaluation of a measure of the perceived continuity of spousal relationships in dementia

Research output: Contribution to journalArticlepeer-review


  • Gemma Fisher
  • Barbara F. Hagger
  • Amy Elliott
  • Hannah Le Serve
  • Jan R. Oyebode

Colleges, School and Institutes

External organisations

  • University of Birmingham


Background: Qualitative research has suggested that spousal carers of someone with dementia differ in terms
of whether they perceive their relationship with that person as continuous with the premorbid relationship or
as radically different, and that a perception of continuity may be associated with more person-centered care
and the experience of fewer of the negative emotions associated with caring. The aim of the study was to
develop and evaluate a quantitative measure of the extent to which spousal carers perceive the relationship to
be continuous.
Methods: An initial pool of 42 questionnaire items was generated on the basis of the qualitative research about
relationship continuity. These were completed by 51 spousal carers and item analysis was used to reduce the
pool to 23 items. The retained items, comprising five subscales, were then administered to a second sample
of 84 spousal carers, and the questionnaire’s reliability, discriminative power, and validity were evaluated.
Results: The questionnaire showed good reliability: Cronbach’s α for the full scale was 0.947, and test–retest
reliability was 0.932. Ferguson’s δ was 0.987, indicating good discriminative power. Evidence of construct
validity was provided by predicted patterns of subscale correlations with the Closeness and Conflict Scale and
the Marwit–Meuser Caregiver Grief Inventory.
Conclusion: Initial psychometric evaluation of the measure was encouraging. The measure provides a
quantitative means of investigating ideas from qualitative research about the role of relationship continuity in
influencing how spousal carers provide care and how they react emotionally to their caring role.


Original languageEnglish
Pages (from-to)263-274
Number of pages12
JournalInternational Psychogeriatrics
Issue number2
Publication statusPublished - Feb 2013


  • Affective Symptoms, Aged, Caregivers, Cost of Illness, Dementia, Emotional Intelligence, Female, Humans, Interpersonal Relations, Male, Psychometrics, Qualitative Research, Questionnaires, Reproducibility of Results, Social Perception, Spouses