Sekentei and family caregiving of elders among Japanese : development and evaluation of the Sekentei Scale

Abstract

This study describes the development of a measure for assessing sekentei. The concept of sekentei is peculiar to the culture of Japan. Translated, sekentei is defined as social appearance that causes an individual to worry about others' observations and evaluations of his or her behavior. It is believed that sekentei prevents Japanese family caregivers of elders from utilizing needed social services. Although sekentei may be a major factor influencing caregiving burden and stress resulting from avoidance of social services among Japanese family caregivers, little attention has been given to empirically studying the construct of sekentei. Due to the importance of this construct in understanding underutilization of social services among Japanese family caregivers, the purpose of this study was to develop a measure of sekentei and to evaluate the psychometric properties of this new measure. There were five phases in this study. Phase 1 consisted of item generation based on a thorough review of the Japanese literature on sekentei. Phase 2 consisted of item selection and refinement using seven America-educated Japanese cultural experts. Phase 3 consisted of item translation using back translation procedures to achieve linguistic equivalence of the Japanese and English versions of the Sekentei Scale. Phase 4 consisted of a pilot study in which five Japanese national and three Caucasian American caregivers completed the Sekentei Scale and provided suggestions for correcting ambiguity or lack of clarity in item-wording. Phase 5 consisted of a psychometric evaluation of the Sekentei Scale. Internal consistency reliability was estimated by Cronbach's alpha and by examining item-total correlations. Validity was evaluated by examining (a) the extent to which sekentei varies between Japanese nationals and Caucasian Americans, and (b) the relationship between sekentei and shame. Participants were 150 Japanese national and 116 Caucasian American family caregivers. The results of this study provide strong support for the reliability and validity of the Sekentei Scale. The findings also provide strong support for the measure's use in future research on the effects of sekentei on caregiving among Japanese families.