Stroke is a leading cause of adult disability because of its physical and cognitive consequences. Cognitive changes are important contributors to family caregivers' experiences of emotional distress. To date, measures to assess cognition treat it as a global construct, but it is more likely that unique domains differentially affect family caregivers. The research objectives in this study were to: (1) identify the different domains of cognitive changes in the form of behavioral and psychological symptoms after stroke, and (2) establish the reliability of the Brain Impairment Behavior Scale (BIBS) in measuring cognitive domains. Family caregivers of stroke survivors (N = 300) completed the BIBS as part of cross-sectional and longitudinal studies. A subsample of caregivers completed the BIBS twice, 2 weeks apart, to examine the scale's test-retest reliability. We used exploratory factor analysis to identify four domains of behavioral and psychological symptoms in the BIBS: apathy, depression/emotional distress, comprehension/memory problems, and irritability. Internal consistency for the subscales representing each identified domain ranged from .78 to .91, and the 2-week intra-class correlation coefficients ranged from .75 to .88. Future research and clinical use of this measure will increase our understanding of how specific domains of stroke survivors' behavioral and psychological symptoms affect the well-being of family caregivers.
Questions or comments about this article may be directed to Jill I. Cameron, PhD, atJill.Cameron@utoronto.ca. She is an assistant professor in the Department of Occupational Science and Occupational Therapy at the University of Toronto, Toronto, Ontario, Canada.
Angela M. Cheung, MD PhD FRCPC, is the director of the University Health Network (UHN)/Mount Sinai Hospital Osteoporosis Program, associate director of the UHN Women's Health Program, and associate professor at the University of Toronto, Toronto, Ontario, Canada.
David L. Streiner, PhD, is a professor in the Department of Psychiatry at the University of Toronto, and assistant vice president and research director of the Kunin-Lunenfeld Applied Research Unit Baycrest Centre, Toronto, Ontario, Canada.
Peter C. Coyte, PhD, is a professor in the Department of Health Policy Management and Evaluation at the University of Toronto, Toronto, Ontario, Canada.
Mina D. Singh, PhD RN, is an assistant professor in the School of Nursing at York University, Toronto, Ontario, Canada.
Donna E. Stewart, MD FRCPC, is a professor at the University of Toronto and chair of the Women's Health Program at Toronto General Hospital, Toronto, Ontario, Canada.