title: The relative stress scale, a useful instrument to identify various aspects of carer burden in dementia?
abstract: OBJECTIVE
  To identify carer and patient characteristics associated with various aspects of burden of care.
  
  
  METHODS
  The burden on 196 carers, each caring for one patient with dementia, was rated by means of the Relative Stress Scale (RSS). Patients were assessed with the Mini Mental State Examination (MMSE), the Disability Assessment for Dementia (DAD) and the Neuropsychiatric Inventory (NPI).
  
  
  RESULTS
  Factor analysis of the RSS resulted in three subgroups: 'emotional distress', 'social distress' and 'negative feelings'. The total NPI score contributed to the explanation of the RSS total score and the three RSS subgroup scores with an explanatory power of 37% for total RSS, 34% for emotional distress, 27% for social distress and 20% for negative feelings. In multiple regression analysis, total NPI, DAD%, the carer being a wife and the hours spent caring per week, contributed to the explanation of total RSS with an explanatory power of 48%. Total NPI, the carer being a female and the hours spent caring, explained 38% of the variance in 'emotional distress'. Total NPI, the DAD%-score, contact with the patient on a daily basis and the hours spent caring, explained 'social distress' (49%). 'Negative feelings' were associated with total NPI, younger patients and the carer being a wife (27%).
  
  
  CONCLUSIONS
  The RSS offers an opportunity to differentiate between different patterns of distress. This facilitates the creation of tailored intervention to reduce the strain of caring.
authors.affiliation: Norwegian Centre for Dementia Research, Department of Geriatric Medicine, Ullevaal University Hospital, Oslo, Norway. ingun.ulstein@nordemens.no
authors.forename: Ingun
authors.initials: I
authors.lastname: Ulstein
authors.forename: Torgeir
authors.initials: T
authors.lastname: Bruun Wyller
authors.forename: Knut
authors.initials: K
authors.lastname: Engedal
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003704:Dementia / Q000451:nursing*; D004644:Emotions; D005163:Factor Analysis, Statistical; D005192:Family Health; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008297:Male; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D013315:Stress, Psychological / Q000175:diagnosis*