title: Adapting the structural family systems rating to assess the patterns of interaction in families of dementia caregivers.
abstract: OBJECTIVE
  This study adapted the Structural Family Systems Ratings (SFSR), an observational measure of family interactions, for dementia caregivers. This article presents the development of the SFSR-Dementia Caregiver adaptation (SFSR-DC) and examines relationships between specific family-interaction patterns and caregiver distress.
  
  
  METHODS
  The families of 177 Cuban American and White non-Hispanic American caregivers of dementia patients were assessed at baseline, 6, 12, and 18 months. Structural family theory and clinical experience were used to identify family interaction patterns believed to be related to caregiver emotional functioning. Factor analysis was used to refine subscales and develop a multiscale measure.
  
  
  RESULTS
  Six reliable subscales were related to caregiver distress and included in the SFSR-DC. There were two second-order factors. The SFSR-DC was provisionally cross-validated and showed invariance across the two ethnic groups.
  
  
  CONCLUSIONS
  The SFSR-DC provides a method for examining specific and multiple interaction patterns in caregiver families and thus can advance knowledge regarding the role of the family in the stress processes of caregiving. These findings support the relevance of family interactions in caregiver distress and suggest that a treatment approach aimed at supporting family closeness and conflict resolution and reducing negativity might enhance caregiver well-being.
authors.affiliation: Center for Family Studies, Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, 1425 N.W. 10th Avenue, Miami, FL 33136, USA. vmitrani@med.miami.edu
authors.forename: Victoria B
authors.initials: VB
authors.lastname: Mitrani
authors.forename: Daniel J
authors.initials: DJ
authors.lastname: Feaster
authors.forename: Brian E
authors.initials: BE
authors.lastname: McCabe
authors.forename: Sara J
authors.initials: SJ
authors.lastname: Czaja
authors.forename: Jose
authors.initials: J
authors.lastname: Szapocznik
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D003462:Cuba / Q000208:ethnology; D003704:Dementia / Q000451:nursing*; D005163:Factor Analysis, Statistical; D005195:Family Relations; D005260:Female; D006801:Humans; D008297:Male; D015203:Reproducibility of Results; D013315:Stress, Psychological / Q000175:diagnosis* / Q000523:psychology; D011795:Surveys and Questionnaires; D014481:United States; D044465:White People