A psychometric study of the Flourishing Scale for people living with dementia

Clarke, Chris; Baird, Kalpita; Moniz-Cook, Esme; Mountain, Gail; Wolverson, Emma; Lee, Ellen; Hewitt, Catherine

Abstract

INTRODUCTION
There are few validated strengths-based outcome measures for evaluations of psychosocial interventions in dementia and measurement of the concept of flourishing has not been directly explored. This study therefore examined the psychometric properties of the Flourishing Scale (FS)—an eight-item generic self-report measure of social-psychological well-being—and how it might be adapted for people with dementia.

METHOD
A secondary data analysis of baseline data from the Journeying Through Dementia study, a randomized controlled trial of a self-management intervention for older adults with dementia living in the community in the United Kingdom (n = 480). Confirmatory Factor Analysis (CFA), Item Response Theory (IRT) analyses, and convergent/discriminatory analyses were undertaken.

RESULTS
Moderate negative skew in total FS scores was noted and adjusted for. A good level of internal consistency reliability was evident (alpha = 0.83). Both CFA and IRT analyses verified the unidimensionality of the scale and there was evidence of item discrimination. Measurement precision appeared greater for lower to moderate levels of well-being, with some item-level variation. Total FS scores were significantly associated with quality of life, self-efficacy, and mood, supporting convergent validity. FS total scores were not associated with cognitive ability or time since diagnosis in this sample but were associated with living alone / with others.

DISCUSSION
These findings offer new avenues for strengths-based research and practice of psychosocial interventions for people with dementia in relation to the measurement social-psychological well-being. The FS shows promise as a valid and reliable self-report instrument for people with early-stage dementia but further validation research is needed to confirm optimum item content and responsiveness. The measurement of well-being of people living with moderate to severe cognitive impairments requires further research.

Citation

Clarke, C., Baird, K., Moniz-Cook, E., Mountain, G., Wolverson, E., Lee, E., & Hewitt, C. (2025). A psychometric study of the Flourishing Scale for people living with dementia. Alzheimer's and Dementia: Translational Research and Clinical Interventions, 11(2), Article e70097. https://doi.org/10.1002/trc2.70097

• Journal Article Type: Article
• Acceptance Date: Apr 15, 2025
• Online Publication Date: May 24, 2025
• Publication Date: 2025-06
• Deposit Date: Apr 23, 2025
• Publicly Available Date: May 29, 2025
• Electronic ISSN: 2352-8737
• Publisher: Wiley Open Access
• Peer Reviewed: Peer Reviewed
• Volume: 11
• Issue: 2
• Article Number: e70097
• DOI: https://doi.org/10.1002/trc2.70097
• Public URL: https://hull-repository.worktribe.com/output/5132615