# Development and content evaluation of a multidimensional coping model-based health education manual for dementia care support

## TL;DR

This study created a practical health education manual for dementia caregivers based on a multidimensional coping model and tested its validity.

## Contribution

The novel contribution is a multidimensional coping model-based manual for dementia care with high content validity.

## Key findings

- The manual was structured around three coping strategies: problem-focused, emotion-focused, and meaning-focused.
- Expert evaluation showed high content validity (CVI = 0.81–1.00).
- The manual includes accessible content and multimedia resources for caregivers.

## Abstract

This study aimed to develop an evidence- and theory-based health education manual for dementia care and to test its validity and reliability.

A multi-phase study design was employed to develop a health education manual for caregivers of persons with dementia (PWD). A systematic review of randomized controlled trials identified effective interventions, while parallel semi-structured interviews with caregivers explored practical needs. Then, the initial content framework of the manual was developed based on the previously established Dementia Caregiver Stress Process Model (DeCare-SPM), which informed the organization of content around three core coping strategies: problem-focused, emotion-focused, and meaning-focused coping. Based on this framework, a multidisciplinary team refined and translated the material into accessible, practice-oriented guidance through scientific adaptation and collaborative design. The manual was finalized through expert validation using the Delphi method.

A total of 31 studies were included in the systematic review, with psychosocial and psychoeducational approaches identified as the most common across seven intervention categories. Family caregivers of PWD faced social support barriers and needed dementia knowledge, skills, and emotional stress management. A content system for the education manual was established, comprising three domains (i.e., problem-focused, emotion-focused, and meaning-focused coping), nine secondary indicators, and thirty-one tertiary indicators. The problem-focused domain covered disease knowledge, daily care, and symptom management; the emotion-focused domain included stress adaptation, mindfulness training, and behavioral activation, and the meaning-focused domain focused on self-management and psychological adjustment. The manual incorporated scientifically designed illustrations and multimedia resources (QR codes), and expert evaluation demonstrated high content validity (CVI = 0.81–1.00).

This study developed a health education manual for caregivers of PWD, grounded in caregivers’ needs and evidence-based practices, structured around a multidimensional coping model, and delivered in both paper and digital formats with identical content. Expert validation demonstrated strong content validity, indicating its value as a practical resource for PWD and their care services.