Development of Chinese Version of Quality of Life and Burden Instruments of Cancer Caregivers
|School||Fourth Military Medical University|
|Keywords||cancer caregivers QOL burden cross-culture translation reliability validity CQOLC CSI+|
ObjectiveTo test the reliability and validity of the Chinese version of CQOLC(CQOLC-C) and CSI+with the samples in Chinese mainland. Analyse thefeasibility of these two scales and provide proper instruments for future QOL andburden assessment of Chinese cancer caregivers.Methods1. The35-items traditional Chinese version of CQOLC was transformed intosimplified Chinese following the steps of culture adjustment, back-translation andpretest. Evaluate the reliability of CQOLC-C by Cronbach’s alpha and test-retestcoefficient. Use principal component analysis with varimax rotation to explainthe structure of the scale and count Pearson’s correlation for convergent validity.Finally, assess the QOL of cancer caregivers of Xi’an hospitals with this newscale. 2. The18-items English version of CSI+(include5positive items) was translatedinto Chinese following the steps of culture translation, back-translation andpretest. Evaluate the reliability of CSI+by Cronbach’s alpha and test-retestcoefficient. Use principal component analysis and varimax rotation to explain thestructure of the scale and Pearson’s correlation for convergent validity. Finally,assess the burden of cancer caregivers of Xi’an hospitals with this new scaleResults1. Development, evaluation and application of CQOLC-C1) Development of CQOLC-C During cross-culture translation,6items havebeen changed the way of expression according to the original meaning of thescale. Some items, such as item12, have been questioned by experts of theunderstanding of “spiritulity” for Chinese people. Afte4rounds of pilot study, theform and options have adjusted for more convenient answering. Some items, suchas item22, should be thought again wheather it could improve the QOL ofcaregivers.2) Evaluation of CQOLC-C CQOLC-C’s overall Cronbach’s alpha was0.884,and0.88,0.86,0.82,0.81,0.68,0.66for1~6latent factors of EFA. The half-halfcoefficient is0.793and test-retest coefficient is0.821. Four factors of CFA wererotated by varimax, accounting for45.307%of total variance, and59.693%of8factors of EFA, which is higher than other versions. The correlations between theCQOLC-C and the subscale scores of the SF-36and CED-S were high.3). Application of CQOLC-C A total of361cancer caregivers were recruitedin this part of study. The average score of QOL is68.53±14.48, with the highestof112and lowest of29. People in marriage have high QOL than single ones,while children have better QOL than spouses of patients. The main factor whichaffects caregivers’ QOL is economic burden. Caregivers of malignant hematological diseases patients have the worst QOL, followed by caregiver oflung cancer, Osteosarcoma, digestive system cancer and reproductive systemcancer patients.2. Development, evaluation and application of CSI+1) Development of CSI+There is no significant change during thecross-culture translation. Afte4rounds of pilot study, the form and options haveadjusted for more convenient answering.2) Evaluation of CSI+The overall Cronbach’s alpha was0.802and theCronbach’s alpha of1~4latent factors of EFA are0.71,0.68,0.65, and0.49,respectively. The half-half coefficient is0.687and test-retest coefficient is0.768.Five factors of EFA include physical founction, social condition, mental burden,disturbance of daily life, and positive adaptability. The score of CSI+werenegative related to the subscale scores of CQOLC-C and positive related to ZBI.3) Application of CSI+A total of210cancer caregivers were recruited in thispart of study. The average score of burden is10.01±3.56, with the highest of18and lowest of0. Parents and spouses have higher burden than children of patients.The main factor which affects caregivers’burden is disturbance of daily life. Loweducation background, low income level and bad occupation are importantfactors to lead high burden.ConclusionThe result shows that CQOLC-C and CSI+have a very good reliability,validity, and feasibility. It is suitable for cancer caregiver of Chinese mainland. Itwill be more efficient if use them together in future assessment.