Electronic Thesis and Dissertation Repository


Doctor of Philosophy


Health and Rehabilitation Sciences


Dr.Andrew Johnson

2nd Supervisor

Dr. Jeffrey Holmes

Joint Supervisor


As observed globally, family (informal and in-home) caregiving of older adults with Alzheimer’s disease or other forms of dementia has become a critical issue in the Arab region, including Saudi Arabia. This doctoral research psychometrically and conceptually evaluates an Arabic version of the Montgomery Borgatta Caregiver Burden Scale for use as a measurement tool to assess family caregivers of older adults living at home with dementia in Saudi Arabia. Currently, there is no published literature that addresses family caregiving for individuals with dementia in Saudi Arabia. Through further examination of family caregiving narratives, this research maps the personal and social construing of the family caregiver role of older adults with dementia in Saudi Arabia.

This doctoral research is guided by the theoretical framework and philosophical understanding of personal construct theory and employs an integrated mixed methods approach to data collection, analysis, and interpretation of findings from 20 Saudi Arabian family caregivers. The research is presented in five chapters, including three individual manuscripts and introduction and conclusion chapters. The first manuscript introduces personal construct theory with its underlying philosophy, fundamental concepts, and methods of assessment as a potential constructivist research approach to examine the personal, familial, group, and cultural construct systems that shape the context of dementia care within and across cultures. The defined gap in the first manuscript led to a mixed methods study to examine the construction of Western-based existing measure of “caregiver burden.” The second manuscript, therefore, examines the items of the Montgomery Borgatta Caregiver Burden Scale and the construct of caregiver burden using the repertory grid technique and laddering procedure—the two constructivist methods derived from personal construct theory—to identify culturally sensitive items of the scale in the target cultural context of Saudi Arabia. Alongside the conceptual and psychometric evaluation of scale items, the third manuscript further examines family caregivers’ daily narratives and personal and cultural constructs that shape their caregiver role.

This research contributes to the international literature of family gerontology and research on caregiver assessment. It elaborates the assessment methods of personal construct theory to expand alternatives for research methodologies of measurement evaluation and validation. The research also promotes the therapeutic approaches of personal construct theory and other practical implications for the development of support programs for family caregivers and recommends an integrated system for health and social services and a national strategy for dementia care in Saudi Arabia.

Included in

Gerontology Commons