Date of Award

2003

Degree Type

Thesis

Degree Name

Doctor of Philosophy

School

School of Psychology

Faculty

Faculty of Community Services, Education and Social Sciences

First Advisor

Associate Professor Edward Helmes

Second Advisor

Dr Craig Speelman

Abstract

Increasing dependency in older age is conceptualised differently by various disciplines. Psychologists have contributed to the understanding of dependency in older age by describing and explaining the functionality of dependency across the life-span. Psychological research has also examined variables (such as the responses of carers to-the dependent behayiours of older people) that exacerbate dependent feelings and behaviours (Baltes, 1996), but it has not included an individual difference measure of interpersonal dependency. According to Rosowsky~ Dougherty, Johnson and Gurian (1997), an understanding of the ways that personality style affects older adults' engagement and reception of health services would assist providers in planning treatments and services that are more cost effective and attuned to individuals' needs. A review of the literature found that no scale for the measurement of interpersonal dependency of older adults had been developed. This research, therefore, developed a measure of interpersonal dependency for use with older adults and evaluated it in a home-care service setting. The following questions were addressed in the process: 1) Are older people who access home-care services higher in their levels of interpersonal dependency than older people who do not access home-care services? 2) What is the relationship among interpersonal dependency, depression and physical dependency in an older home-care population? The scale was developed in four stages: 1) an item development stage that included the facilitation of focus groups followed by a scale pilot study; 2) an item reduction stage; 3) a stage that examined and summarised the components of the scale; and 4) a scale validation stage. The 15 participants for item• selection focus group sessions and the scale pilot study included 14 women and 1 man aged over 65 years from Perth metropolitan day centres and also three allied health professionals. Participants for scale reliability and validity studies included 703 older adults (aged over 65 years). Two hundred and fifty-two were Silver Chain Nursing Association clients, 358 were Positive Ageing Foundation members and 93 were members of the Council on the Ageing. A reliable and valid 20-item interpersonal dependency measure for use with older adults resulted from the development process. In addition a comparative study utilising the new measure found that older adults in the home-care service population scored higher on the measure of interpersonal dependency than older adults sampled from the other populations. A hierarchical regression analysis found that both interpersonal dependency and depression were significant positive predictors of mobility in older adults. These findings have important intervention and financial implications for service providers. Screening for interpersonal dependency in older adults could assist in designing interventions that are more attuned to individuals' needs and thus reduce reliance on services.

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