Attitude Toward the Provision of Long-Term Care (ATPLTC)

Abstract

The Attitude Toward the Provision of Long-Term Care (ATPLTC) is a specialized psychological scale designed to measure the beliefs, values, and dispositions of individuals, typically family members or potential caregivers, regarding the obligation and feasibility of providing ongoing care for dependent relatives. Developed by Waldo C. Klein in 1992, the scale assesses attitudes across various dimensions of long-term care, including the perceived fairness of the burden, the appropriateness of institutionalization, and the moral imperative of familial responsibility. It is a crucial instrument for researchers and clinicians interested in understanding the factors that influence family decisions about long-term care provision.

Keywords

Attitude measurement, caregiver burden, family responsibility, institutionalization, elderly care, disability care, long-term care, psychological assessment.

Authors

Waldo C. Klein

Purpose

The primary purpose of the ATPLTC scale is to quantify an individual’s attitude toward the provision of long-term care within a familial context. This measurement is essential for predicting the likelihood of family members accepting or rejecting caregiving roles, and for understanding the underlying ideological conflicts between individual sacrifice and societal support.

By capturing the spectrum of attitudes—from strong endorsement of familial duty to belief in institutional or governmental responsibility—the scale provides valuable data for social workers, policymakers, and healthcare providers. It helps in identifying caregivers at risk of burnout or those who may benefit most from external support services.

Construct

The ATPLTC measures a multidimensional construct rooted in the social psychology of responsibility and obligation. It primarily focuses on the tension between the traditional expectation of family caregiving and the challenges posed by modern life, increasing longevity, and complex disabilities. The construct encompasses several latent dimensions, including:

• Familial Obligation: The degree to which an individual believes that care for disabled or elderly relatives is an inherent family duty, regardless of personal cost.
• Perceived Burden: The perception of the physical, emotional, and financial strain associated with caregiving.
• Acceptance of Institutionalization: The belief that professional settings (nursing homes, institutions) are superior or more appropriate alternatives for severe dependency.

Validity

The validity of the ATPLTC was established during its initial development, primarily through content and construct validity assessments. Content validity was ensured by deriving items from extensive literature review and clinical observations concerning caregiver decision-making processes. Subsequent research, such as that conducted by Klein (1992), supported the scale’s ability to measure the intended construct.

Studies employing the ATPLTC have demonstrated its utility in differentiating between individuals with varying levels of acceptance regarding long-term care responsibilities, thereby supporting its construct validity. Further validation efforts often involve correlating ATPLTC scores with behavioral outcomes, such as actual care provision status or expressed willingness to utilize formal support services.

Reliability

Reliability of the ATPLTC scale is typically assessed using measures of internal consistency. While specific reliability coefficients were established in the original 1992 publication, subsequent research utilizing the scale often reports high internal consistency. For example, researchers frequently report Cronbach’s alpha values indicating strong reliability for the overall scale score, suggesting that the 26 items consistently measure the same underlying attitude toward caregiving responsibility.

The consistent results across diverse populations, as seen in the application of the ATPLTC to different cultural and demographic groups, further support its stability and reliability as a measure of caregiver attitude.

Factor Analysis

Initial factor analysis performed by the scale’s author, Waldo C. Klein, aimed to confirm the hypothesized structure of attitudes toward long-term care. While the scale is often used as a single, unitary measure of overall attitude, exploratory factor analysis (EFA) has frequently suggested the presence of multiple, distinct factors that align with the dimensions of familial obligation, burden perception, and institutional preference. Researchers often analyze these factors separately to gain nuanced insights into the complexity of caregiver beliefs.

Instrument

Test Type: Self-report psychological scale

Format: 26 items scored on a 5-point Likert scale.

Language Available: English (Original), translations may exist in published literature (e.g., Persian, as suggested by the Bastani et al. reference).

Population Group: Family members, potential caregivers, and general adult population.

Age Group: Adults (typically 18 years and older).

Population Details: The scale is designed for use with individuals who are currently providing care, are anticipating providing care, or are generally reflecting on the social responsibility surrounding care for disabled or elderly dependents.

Test Methodology: Respondents rate their agreement with each statement using a 5-point continuum: 1= Strongly agree, 2= Moderately agree, 3= Neither agree nor disagree, 4= Moderately disagree, 5= Strongly disagree. Specific items are reverse-scored to mitigate response bias.

Keywords

Familial duty, social service research, psychometrics, caregiver attitude, institutional care, burden, scale development, health psychology.

Authors

Author ORCID Identifier: Not publicly provided for Waldo C. Klein based on available source information.

Affiliation Email addresses: Not publicly provided based on available source information.

Correspondence Address: Not publicly provided based on available source information.

Permissions & Fee and Test Year

The Attitude Toward the Provision of Long-Term Care (ATPLTC) was first published in 1992 by Waldo C. Klein. The instrument is generally considered available for academic research use, particularly as it has been widely cited and reproduced in sourcebooks like Fischer and Corcoran’s Measures for Clinical Practice and Research. Users should consult the original publication or the sourcebook for formal permission requirements, although standard academic use typically requires appropriate citation.

The original PDF detailing research related to this instrument can be downloaded here: https://scholarspace.manoa.hawaii.edu/bitstream/handle/10125/3031/uhm_phd_4261_r.pdf?sequence=2

Reference’s

Bastani, F. and Ramezani, A. and Lolati, H.A. and Haghani, H. (2017). Family caregivers’ attitude toward long-term care of elderly with psychiatric disorders and associated factors. Iranian Journal of Psychiatry and Behavioral Sciences, 11 (1).

Fischer, Joel. and Corcoran, Kevin J. (2007). Measures for Clinical Practice and research: A sourcebook. (4th ed.). NY. Oxford University Pr. Vol. 1, Pages: 207-209.

Klein, Waldo C. (1992). Measuring Caregiver Attitude Toward the Provision of Long-Term Care. Journal of Social Service Research, 16(3-4), 147-162.

Klein, W. (1992). Attitude Toward the Provision of Long-Term Care (ATPLTC). IN Fischer, Joel. and Corcoran, Kevin J. (2007). Measures for Clinical Practice and research: A sourcebook. (4th ed.). NY. Oxford University Pr. Vol. 1, Pages: 207-209.

Items of the Attitude Toward the Provision of Long-Term Care (ATPLTC)

IMPORTANT: The following scale items must be preserved in their original language and must not be changed in any way.

1. It is not fair that adult children should have to give up so much to care for frail elderly parents.*
2. Families should not place severely retarded children in institutions.
3. A parent should look after his/her child even if that child is severely disabled.
4. Families that really want to provide care for a disabled relative will find a way to do so.
5. Nursing homes or institutions can provide better care for disabled relatives than families.*
6. The physical demands of providing care to a disabled family member are manageable.
7. It is the responsibility of families to care for their disabled members.
8. This society will collapse if family members do not provide care for their disabled members.
9. Family members who cannot bathe or dress themselves are better off in nursing homes or institutions.*
10. Providing care for a disabled family member is one of the basic responsibilities of a family.
11. It is not fair that young parents should have to give up so much to care for retarded children.*
12. Any right-thinking person would have second thoughts about providing care to a disabled family member.*
13. People should be willing to quit their jobs in order to provide care to impaired family members.
14. Providing ongoing care for a disabled relative would be one of the most meaningful things a person could do.
15. Providing care to a disabled family member is a basic human responsibility.
16. Families should plan for the possibility of providing care for an elderly disabled family member.
17. Families should rearrange their schedules in order to provide care to disabled family members.
18. Providing care for disabled family members at home is useless since most of them will end up in institutions or nursing homes anyway.*
19. Although medical advances have increased the need for extended care, family members should continue to provide this care to dependent family members.
20. Disabled children over the age of six years who cannot bathe or dress themselves are an unfair burden to their parents.*
21. When people can no longer care for themselves, it would be better for them to die than to be dependent on family to provide care.*
22. Providing care for a disabled family member is mentally exhausting.*
23. it should be the responsibility of government programs rather than families to provide care for disabled people.*
24. Families are just as good at providing care to dependent family members as organizations that specialize in providing those kind of services.
25. Older family members who cannot bathe or dress themselves are an unfair burden to their children.*
26. Humankind is benefited by families that care for their disabled members.

* Reverse scoring

Response Scale:

1= Strongly agree, 2= Moderately agree, 3= Neither agree nor disagree, 4= Moderately disagree, 5= Strongly disagree