Indicatoren van emotioneel welbevinden in de psychogeriatrische praktijk

Responses of 1,442 consecutive participants in psychogeriatric day care (mean age 78.8; SD 6.5) to 15 items of a mood questionnaire were analyzed by Mokken scale analysis which is based on nonparametric item response theory models. As from 2002, 825 participants also answered eight self-esteem questions. For the purpose of an exploratory and confirmatory study the sample was split into random halves. The sample represented a broad range of cognitive impairment, from moderately severe to mild dementia. An automated item selection procedure available in the R package mokken revealed a scale for emotional well-being consisting of nine items fitting the monotone homogeneity model of unidimensionality and adequate person separation (Loevingers H = 0.37; SE = 0.02; Cronbach’s coefficient alpha = 0.79; SE = 0.02). A confirmatory analysis in the second random half of the sample confirmed these results. The scale for emotional well-being consists of the items feeling ‘contented’, ‘healthy’, ‘tired’, ‘lonely’, ‘down’, ‘in good spirits’, ‘helpless’, ‘weak’ and ‘having faith in the future’. Mokken scale analysis of the eight self-worth items confirmed the unidimensionality and discriminatory power of the self-esteem scale (H = 0.41; SE = 0.03; Cronbach’s alpha = 0.80; SE = 0.02). Emotional well-being was positively associated with self-worth (Spearman correlation = 0.56; 95%-confidence interval [0.49;0.62]). The two scales allow the objective ordering of persons on the latent variables of emotional well-being and self-worth by their test scores. Three case vignettes illustrate application of the indicators in clinical psychogeriatric practice.