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Empirical instruments for assessment of care partners, in response to Bennett, P. N., Wang, W., Moore, M., & Nagle, C. (2017). Care partner: A concept analysis. Nursing Outlook, 65(2), 184-194

      To the Editor:
      We were pleased to read the concept analysis written by Bennett, P. N., Wang, W., Moore, M., & Nagle, C. (2017). Care partner: A concept analysis. Nursing Outlook, 65(2), 184-194. Thank you.
      The authors carefully analyzed the literature to render a more complete understanding of the concept care partners. They carefully synthesized a working definition, and their work contributes to the concept's interpretation for use in research, practice, and education. For example, the authors recognized that a person with a chronic health condition is a partner in their own care and not a passive recipient of care. Furthermore, the authors stated that a shared care model best represents the working partnership between the persons with a chronic illness and the individual assisting with care. The authors' development of the concept for care partners supports and informs our own research (
      • Sebern M.
      • Brown R.
      • Flatley-Brennan P.
      Shared care contributions to self-care and quality of life in chronic cardiac patients.
      ,
      • Sebern M.
      • Whitlatch C.J.
      Dyadic relationship scale: A measure of the impact of the provision and receipt of family care.
      ), and we are grateful for their contribution.
      However, we were surprised with the authors' conclusion that there are no care partner models or empirical referents: “We have not discovered an available empirical instrument to evaluate the presence or effect of care partner or care partner relationships … no care partner model has been developed” (p. 191).
      We now discuss a care partner model, instruments that measure attributes of care partners, and a resource for additional care partner instruments. The self- and family management of chronic conditions model (
      • Grey M.
      • Knafl K.
      • McCorkle R.
      A framework for the study of self- and family management of chronic conditions.
      ,
      • Grey M.
      • Schulman-Green D.
      • Knafl K.
      • Reynolds N.R.
      A revised self- and family management framework.
      ) clearly describes how both individuals and families or care partners participate in the management of chronic conditions. Although this model does not use the term care partner, it clearly addressed the phenomenon of care partners managing chronic conditions.
      In addition, we are aware of several empirical instruments that can be used to assess care partners. In our research, we have used four unique instruments to assess attributes of care partner relationships. The first instrument is the Mutuality scale (
      • Archbold P.G.
      • Stewart B.J.
      • Greenlick M.R.
      • Harvath T.A.
      Mutuality and preparedness as predictors of caregiver role strain.
      ,
      • Archbold P.G.
      • Stewart B.J.
      • Greenlick M.R.
      • Harvath T.A.
      The clinical assessment of mutuality and preparedness in family caregivers to frail older people.
      ,
      • Sebern M.
      Psychometric evaluation of the shared care instrument in a sample of home health care family dyads.
      ). The Mutuality Scale measures shared values, love, shared activities, and reciprocity within care partner relationships. The second is the Dyadic Relationship Scale (DRS) (
      • Sebern M.
      • Whitlatch C.J.
      Dyadic relationship scale: A measure of the impact of the provision and receipt of family care.
      ). The DRS measures positive and negative aspects of the caregiving and receiving relationship from the perspective of both care partners. The third instrument is the self-care confidence in heart failure (HF) index (
      • Lyons K.S.
      • Vellone E.
      • Lee C.S.
      • Cocchieri A.
      • Bidwell J.T.
      • D'Agostino F.
      • Riegel B.
      A dyadic approach to managing heart failure with confidence.
      ). This scale measures individual and dyadic self-management and self-care confidence in partners managing HF. Finally, the Share Care Instrument-3 (
      • Sebern M.
      Psychometric evaluation of the shared care instrument in a sample of home health care family dyads.
      ,
      • Sebern M.
      Refinement of the shared care instrument—Revised: A measure of a family care interaction.
      ,
      • Sebern M.
      • Riegel B.
      Contributions of supportive relationships to heart failure self-care.
      ) measures the processes of communication, decision making, and reciprocity in care partner relationships.
      Another source for descriptions of care partner measures is “Selected caregiver assessment measures: A resource inventory for practitioners,” published by the

      Family Caregiver Alliance. (2012). Selected caregiver assessment measures: A resource inventory for practitioners. Second. Retrieved from https://www.caregiver.org/sites/caregiver.org/files/pdfs/SelCGAssmtMeas_ResInv_FINAL_12.10.12.pdf

      . This resource inventory details a select group of caregiver assessment measures that can be used by practitioners who work with family and informal caregivers of older persons and adults with disabilities. The inventory includes practice-oriented measures that reflect the multidimensional aspects of the caregiving experience. Although the inventory is not an exhaustive collection, it includes measures that characterize the broadest possible range of the caregiving experience. Moreover, the inventory also describes measures that have been used with care recipients, have a care recipient version, and/or are designed to assess constructs from the perspective of both care partners such as values for care and preferences for care tasks (
      • Whitlatch C.J.
      Assessing the personal preferences of persons with dementia.
      ).
      Again, we thank the authors for their work to develop the concept of care partners. We hope that they will also consider the existing empirical indicators and care partner models as they continue their work.

      References

        • Archbold P.G.
        • Stewart B.J.
        • Greenlick M.R.
        • Harvath T.A.
        The clinical assessment of mutuality and preparedness in family caregivers to frail older people.
        in: Funk S.G. Tornquist E.M. Champagne M.T. Copp L.A. Key aspects of elder care. Springer, New York, NY1992: 328-339
        • Archbold P.G.
        • Stewart B.J.
        • Greenlick M.R.
        • Harvath T.A.
        Mutuality and preparedness as predictors of caregiver role strain.
        Research in Nursing & Health. 1990; 13: 375-384
      1. Family Caregiver Alliance. (2012). Selected caregiver assessment measures: A resource inventory for practitioners. Second. Retrieved from https://www.caregiver.org/sites/caregiver.org/files/pdfs/SelCGAssmtMeas_ResInv_FINAL_12.10.12.pdf

        • Grey M.
        • Knafl K.
        • McCorkle R.
        A framework for the study of self- and family management of chronic conditions.
        Nursing Outlook. 2006; 54: 278-286
        • Grey M.
        • Schulman-Green D.
        • Knafl K.
        • Reynolds N.R.
        A revised self- and family management framework.
        Nursing Outlook. 2015; 63: 162-170
        • Lyons K.S.
        • Vellone E.
        • Lee C.S.
        • Cocchieri A.
        • Bidwell J.T.
        • D'Agostino F.
        • Riegel B.
        A dyadic approach to managing heart failure with confidence.
        Journal of Cardiovascular Nursing. 2015; 30: S64-S71
        • Sebern M.
        Refinement of the shared care instrument—Revised: A measure of a family care interaction.
        Journal of Nursing Measurement. 2008; 16: 43-60
        • Sebern M.
        Psychometric evaluation of the shared care instrument in a sample of home health care family dyads.
        Journal of Nursing Measurement. 2005; 13: 175-191
        • Sebern M.
        • Brown R.
        • Flatley-Brennan P.
        Shared care contributions to self-care and quality of life in chronic cardiac patients.
        Western Journal of Nursing Research. 2016; 38: 837-857
        • Sebern M.
        • Riegel B.
        Contributions of supportive relationships to heart failure self-care.
        European Journal of Cardiovascular Nursing. 2009; 8: 97-104
        • Sebern M.
        • Whitlatch C.J.
        Dyadic relationship scale: A measure of the impact of the provision and receipt of family care.
        The Gerontologist. 2007; 47: 741-751
        • Whitlatch C.J.
        Assessing the personal preferences of persons with dementia.
        in: Lichtenberg P.A. Handbook of assessment in clinical gerontology. 2nd ed. Elsevier, New York, NY2010: 557-578