Validity and reliability of Chinese version of Adult Carer Quality of Life questionnaire (AC-QoL) in family caregivers of stroke survivors
November
Validity and reliability of Chinese version of Adult Carer Quality of Life questionnaire (AC- QoL) in family caregivers of stroke survivors
Yongxia Mei 0 1 2
Beilei Lin 1 2
Yingshuang Li 1 2
Chunge Ding 1 2
Zhenxiang Zhang 1 2
0 School of Nursing, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, Unites States of America , USA
1 School of Nursing, Zhengzhou University , Zhengzhou, Henan Province , People's Republic of China, 2 First Affiliated Hospital of Zhengzhou University , Zhengzhou, Henan Province , People's Republic of China
2 Editor: Chaojie Liu, La Trobe University , AUSTRALIA
The Adult Carer Quality of Life questionnaire (AC-QoL) is a reliable and valid instrument used to assess the quality of life (QoL) of adult family caregivers. We explored the psychometric properties and tested the reliability and validity of a Chinese version of the AC-QoL with reliability and validity testing in 409 Chinese stroke caregivers. We used item-total correlation and extreme group comparison to do item analysis. To evaluate its reliability, we used a test-retest reliability approach, intraclass correlation coefficient (ICC), together with Cronbach's alpha and model-based internal consistency index; to evaluate its validity, we used scale content validity, confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) via principal component analysis with varimax rotation. We found that the CFA did not in fact confirm the original factor model and our EFA yielded a 31-item measure with a five-factor model. In conclusions, although some items performed differently in our analysis of the original English language version and our Chinese language version, our translated AC-QoL is a reliable and valid tool which can be used to assess the quality of life of stroke caregivers in mainland China. Chinese version AC-QoL is a comprehensive and good measurement to understand caregivers and has the potential to be a screening tool to assess QoL of caregiver.
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Data Availability Statement: All relevant data are
within the paper and its Supporting Information
files.
Funding: This study was funded by China
Scholarship Council (grant number
201707040006) and Science and Technology
Department of Henan Province, China (grant
number 134200510018 and 132102310108) and
no author is the sponsor. The funders had no role
in study design, data collection and analysis,
Introduction
According to the American Heart Association, on average, a stroke occurs every 40 seconds
and a stroke fatality occurs every 4 minutes [
1
]. In the United Kingdom (UK), stroke is a
major cause of morbidity, the third-most-common cause of death for women in England and
Wales, and the fourth-most-common cause of death in men [
2
]. In China, stroke is the most
frequent cause of death and the annual incidence rate of stroke is 8.7 per 1000, resulting in
costs in excess of more than $100 billion [
3,4
]. About 75% of Chinese stroke survivors have at
least some form of disability and experience difficulty in completing day-to-day chores [5].
decision to publish, or preparation of the
manuscript.
More than 80% of disabled stroke patients need long-term care from family caregivers [
6
].
Caring for patients with stroke results in burden and emotional distress, as well as hope and
positive outcomes [7±9], all of which affect the QoL of their caregivers [
10,11
]. QoL is regarded
as an established marker of biopsychosocial health and an increasingly-used measure of
caregivers' health [
11,12
]. Reports from the literature indicate that the QoL of caregivers can affect
the physical outcomes and QoL of patients [
13,14
]. QoL of Chinese caregivers has been found
to be poor in both community and hospital setting (in the short term as well as the long term
care contexts), suggesting that these caregivers need support from health providers [15±18].
Consequently, promoting the health of stroke patients may require acknowledging and
ensuring the QoL of their caregivers.
The World Health Organization (WHO) defines QoL as a broad multidimensional concept
which includes subjective evaluations of both the positive and the negative aspects of life [19].
We focus here on health related QoL, which, according to the National Center for Chronic
Disease Prevention and Health Promotion, includes perceptions of both physical and mental
health, and their correlates on the individual level [20]. Researchers have used QoL (in the
stress-coping framework of Lazarus and Folkman) as the outcome of the process of coping
with stressor for caregivers when using the the stress-coping framework of Lazarus and
Folkman to explain [21, 22]. White et al. [23] developed a model to evaluate the QoL of family
caregivers of stroke survivors in the context of the caregiving situation, the caregiver's
characteristics, and characteristics of the environment, including the balance of positive and negative
effects of caregiving. Reports from the lit (...truncated)