Measuring the impact of caregiving on informal carers: a construct validation study of the CarerQol instrument
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RESEARCH
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Measuring the impact of caregiving on informal carers: a construct validation study of the CarerQol instrument Renske J Hoefman*, Job van Exel and Werner BF Brouwer
Abstract Background: Informal caregivers provide a significant part of the total care needed by ill or disabled persons. Although informal care is often the preferred option of those who provide and those who receive informal care, caring can nevertheless be very straining. This study investigates construct validation of an instrument of the impact of caregiving, the CarerQol. Methods: Data was collected among adult caregivers (n = 1,244) selected from the general population using an online questionnaire in October 2010, in the Netherlands. The CarerQol measures and values the impact of informal care. The CarerQol measures subjective burden (CarerQol-7D) and well-being (CarerQol-VAS). Construct validation comprised clinical, convergent and discriminative validity tests. Results: Clinical validity was supported by statistically significant associations of CarerQol-VAS and caregivers’ health, income and employment status, care recipients’ health, and the relationship between caregiver and care recipient. Convergent validity was supported by positive associations of CarerQol-VAS with the two positive CarerQol-7D dimensions (fulfillment and support) and negative associations with the five negative CarerQol-7D dimensions (relational problems, mental health problems, problems combining daily activities, financial problems and physical health problems). Moreover, CarerQol-VAS was negatively associated with other instruments measuring caregiving burden. Conclusions: Construct validity tests in a large, heterogeneous sample of caregivers show that the CarerQol validly measures the impact of caregiving. The CarerQol can be used in informal care research and economic evaluations of health care interventions. Hence, its use can facilitate informed decision making in health care. Keywords: Informal care, CarerQol instrument, Impact of caregiving, Construct validation, Economic evaluations
Background The attention for informal care appears to be increasing, given the inherent and increasingly noticed scarcity of formal health care resources in many Western countries [1]. Informal care is an important part of total care, especially in the context of chronic illness and frailty due to ageing, and is often provided voluntarily by family, friends or acquaintances. Informal care may reduce the pressure on the capacity and budget of formal health care [2-4]. Moreover, it may be preferred by both patient and informal caregiver over formal care [5]. Notwithstanding the fact that providing informal care can be rewarding [5,6], caring can have considerable * Correspondence: [email protected] Erasmus University Rotterdam, Institute of Health Policy and Management, P.O. Box 1738, 3000 DR Rotterdam, The Netherlands
negative effects on the health and general well-being of informal caregivers [7-13]. Therefore, the impact of providing informal care on car
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