Abstract
There is no disease-specific instrument to measure the quality of life of significant others of cancer patients in Germany. In this study, we evaluated the reliability and construct validity of a German version of the Caregiver Quality of Life Index-Cancer (CQOLC) in a sample of 212 caregivers of breast and gynaecologic cancer patients. The CQOLC was administered along with the World Health Organization Quality of Life short version (WHOQOL-BREF) to caregivers of patients taking part in a randomized-controlled intervention study. Data of 212 caregivers were gained at the baseline of the study. Internal consistency was determined by Cronbach’s α. Construct validity was examined by conducting a confirmatory factor analysis (CFA) and hypothesis testing. Correlations between change scores with patients’ global health-related quality of life (HRQoL) were calculated for three time points to evaluate the responsiveness. The three subscales “burden”, “disruptiveness”, and “financial concerns” indicate to a good reliability of the instrument (Cronbach’s α ranged between 0.754 and 0.832), while the subscale “positive adaptation” demonstrated low reliability (α = 0.579). A CFA based on data from the whole set of CQOLC items resulted in CFI levels < .90, and a CFA without problematic items resulted in CFI levels also < .90.The construct validity of the CQOLC could be approved by a moderate to high convergence with close variables as the global HRQoL. Mean differences between caregivers of curatively or palliatively treated patients were nonsignificant (p = 0.959) at T1. Correlations for responsiveness were low with correlation coefficients ranging from 0.030 to 0.326. These data indicate that additional research is needed to further verify the validity of the instrument. The German scale of the CQOLC might be appropriate for clinical and research use, if the wording of some items is refined and if content validity is also assessed by caregivers themselves. The assessment of cancer patients’ caregiver’s quality of life can contribute to a better understanding of the effects of patient-oriented interventions including also closely involved next of kin’s around the cancer patients.
Highlights
In Germany, the incidence of cancer has almost doubled since the 1970s
We decided to apply this instrument, as another evaluation study of Weitzner, Jacobsen, et al (1999) demonstrated that the Caregiver Quality of Life Index-Cancer (CQOLC) measures substantially different aspects than general health-related quality of life (HRQoL) instruments, and values of convergent and divergent validity have been satisfactory as demonstrated with the Medical Outcomes Study Short Form 36 (MOS SF-36) and the Caregiver Burden Scale. We considered another advantage of applying the CQOLC, as this instrument is able to differentiate between caregivers of curatively and palliatively treated cancer patients (Weitzner, McMillan, & Jacobsen, 1999)
In the validation study of the questionnaire, a total of 212 caregivers (71.4%) who completed the questionnaires at the baseline (CQOLC, WHOQOL-BREF, sociodemographic questionnaire) were included
Summary
In Germany, the incidence of cancer has almost doubled since the 1970s. In addition, the number of patients surviving the disease has increased even more up to four million cases with subsequent implications for patients requiring follow-up care within the German healthcare system (Barnes et al, 2016). Negative effects resulting from the diagnosis and treatment of cancer are experienced by patients, and by their family members closely involved in patients’ daily activities interrupted by the cancer diagnosis and its treatment (Lewis, 1990; Nijboer, Tempelaar, Sanderman, Triemstra, & Spruijt, 1998). Close persons around the cancer patients experience burden such as increased psychological distress, physical symptoms, and changes in daily routines (Lewis, 1990) leading to a decline in their quality of life (Nijboer et al, 1998). It is crucial that the needs of cancer patients’ family members are addressed within supportive and follow-up healthcare programmes, and that their disease-specific quality of life is measured ; a specific assessment is highly needed. According to the World Health Organization (1997), HRQoL is a broad and complex concept influenced by individual physical health, psychological condition, social relationships, and personal beliefs as well as environmental factors
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