Psychometric properties of the Chinese version of quality of life in life-threatening illness-family carer version

Background

The Quality of Life (QOL) in Life-threatening Illness-Family Carer Version (QOLLTI-F) has been proven to be a brief, reliable, and valid instrument for measuring the caregivers' QOL in western cultures. However, whether it is suitable to be used in Chinese culture is unclear. This study aimed to test the reliability and validity of the Chinese version of (QOLLTI-F-CV).

Materials and methods

A total of 202 family caregivers (FCs) of advanced cancer patients from Fujian Provincial hospice care center were investigated using the Chinese version of QOLLTI-F-CV from September 2019 to August 2020. The questionnaire was evaluated using an exploratory structural equation model. Its psychometric properties were examined in terms of factor structure, convergent validity, discriminant validity, internal consistency, and test-retest reliability.

Results

Differently from the seven-domain original QOLLTI-F, its Chinese version had only three domains including caregiver's self-feelings, caregiver's stress, and caregiver's outlooks. The total variance explanation rate for the domains was 55.4%. The Chinese version fitted well with the structure model (χ2 = 153.932, df = 75, P < 0.001); its comparative fit index (CFI) was 0.971; Tucker-Lewis index was 0.954; and the root mean square error of approximation (RMSEA) was 0.072. The success rate of its convergent and discriminant validity calibration test was 100%. Its Cronbach's alpha coefficient of the whole questionnaire and three domains was from 0.650 to 0.874, and test-retest reliability was 0.836.

Conclusion

The 3-domain QOLLTI-F-CV is a valid and reliable instrument for identifying QOL concerns of FCs of advanced cancer patients in China. The refactoring structure optimally matches Chinese culture and value system well.

Psychometric Properties of the "Quality of Life in Life-Threatening Illness-Family Carer Version" (QOLLTI-F) in Persian-Speaking Carers of COVID-19 Patients

Background

Measuring family caregivers' quality of life plays a significant role in improving the quality, efficiency, development, and provision of efficient services for patients with COVID-19. As a result, evaluating the quality of life requires the use of valid and reliable measures that are culturally appropriate. This study was conducted to determine the psychometric properties of the Persian version of the Quality of Life in Life-Threatening Illness-Family Carer Version (QOLLTI - F) in patients with COVID-19.

Methods

This methodological study was carried out in 2021 at Baqiyatallah Hospital in Tehran. After gaining approval from the tool creator, the translation was carried out utilizing the forward-backward approach. Cognitive interviews with 10 family caregivers of COVID-19 patients were used to demonstrate face validity. Moreover, construct validity was identified by performing exploratory factor analysis (EFA) (n = 251), confirmatory factor analysis (CFA) (n = 200), and convergent validation using Zarit Burden Interview (ZBI) questionnaire. For scale reliability, internal consistency and stability were performed using Cronbach's Alpha Coefficient and test-retest, respectively.

Results

451 family caregivers of patients with COVID-19 were enrolled in this study. Three factors with a cumulative variance of 51.85% were extracted during EFA: (1) Caregiver's physical-emotional status, (2) Satisfaction with the situation, and (3) Caregiver's concerns. CFA showed that the model enjoyed a moderate to a good fit of information (RMSEA: 0.087; NFI: 0.98; CFI: 0.91; IFI: 0.91; GFI 0.89; standardized RMR: 0.070). A significant correlation was found between the Persian version of the ZBI and participants' total scores of QOLLTI - F v3 (r = -0.196, P = 0.000). Cronbach's Alpha Coefficient = 0.719 and ICC stability reliability = 0.71 of the questionnaire were confirmed.

Conclusion

The Persian version of the QOLLTI - F v3 is a valid and reliable scale that can measure family caregivers' quality of life during a Life-Threatening illness in patients with COVID-19. This instrument may be utilized in clinical trials and research to enhance the quality of life for family carers in Iranian society.

Validation of the Latin American-Spanish version of the scale 'Quality of Life in Life-Threatening Illness-Family Caregiver Version' (QOLLTI-F)

Measuring the quality of life in family caregivers of people in palliative care is essential to document the impact of care on the caregiver. This study aimed to adapt and validate a Latin American-Spanish version of the QOLLTI-F scale in family caregivers of palliative care patients. This study was conducted between May and November 2019 in Medellin, Colombia. We develop three phases: translation and semantic adaptation (n = 17), face and content validity (n = 21), construct validity, internal consistency (n = 208) and test-retest reliability (n = 35). Main family caregivers of stage-IV cancer patients receiving palliative treatment, participated. In the translation and semantic adaptation, some items were adjusted following the caregivers' recommendations. In face validity, Fleiss' Kappa was over 0.65 for family caregivers. In content validity, Fleiss' Kappa ranged from 0.54 to 1 for experts. In construct validity, the original version seven-factor structure did not show appropriate model fit indices. The data revealed instead a new 3-factor structure related to (1) impact of care-giving, (2) social and healthcare interactions and (3) meaning of life. Cronbach's alpha was 0.83 for the overall scale. Test-retest reliability was 0.87 between measurements 1 and 2. This study found that The Latin American-Spanish version of the QOLLTI-F scale is an understandable, useful, and relevant tool for family caregivers of people with cancer receiving palliative care. Future research is needed to confirm the factor structure identified in this study.

Quality of life of family caregivers of people with cancer in palliative care

OBJECTIVE

To describe quality of life and related factors in a sample of Colombian caregivers of people with cancer in palliative care.

METHOD

A correlational, descriptive and cross-sectional study conducted with 208 family caregivers of people with cancer in outpatient palliative care in Medellín, Colombia. The Quality of Life in Life-Threatening Illness - Family Caregiver Version (QOLLTI-F) instrument was used.

RESULTS

Quality of life obtained scores between 116.36 and 122.35 (95%CI). The dimensions with the lowest scores were Patient condition (2.4-3.2, 95%CI), Caregiver's own state (36.2-39.9, 95% CI) and Environment (14.4-15.7, 95%CI). The patient's and caregiver's ages and the Karnofsky index presented a positive correlation, from weak to moderate and significant with the caregiver's quality of life. The daily hours devoted to care presented a weak correlation, negative and significant, with the overall quality of life and with the Caregiver's own state dimension.

CONCLUSION

It is necessary to develop interventions to improve quality of life in caregivers of people with advanced cancer in the palliative phase, considering the importance of relief actions and the management of the patient's functional dependence.

Applying User-Centered Design Methods to the Development of an mHealth Application for Use in the Hospital Setting by Patients and Care Partners

INTRODUCTION

Developing an optimized and user-friendly mHealth application for patients and family members in the hospital environment presents unique challenges given the diverse patient population and patients' various states of well-being.

OBJECTIVE

This article describes user-centered design methods and results for developing the patient and family facing user interface and functionality of MySafeCare, a safety reporting tool for hospitalized patients and their family members.

METHODS

Individual and group usability sessions were conducted with specific testing scenarios for participants to follow to test the usability and functionality of the tool. Participants included patients, family members, and Patient and Family Advisory Council (PFAC) members. Engagement rounds were also conducted on study units and lessons learned provided additional information to the usability work. Usability results were aligned with Nielsen's Usability Heuristics.

RESULTS

Eleven patients and family members and 25 PFAC members participated in usability testing and over 250 patients and family members were engaged during research team rounding. Specific themes resulting from the usability testing sessions influenced the changes made to the user interface design, workflow functionality, and terminology.

CONCLUSION

User-centered design should focus on workflow functionality, terminology, and user interface issues for mHealth applications. These themes illustrated issues aligned with four of Nielsen's Usability Heuristics: match between system and the real world, consistency and standards, flexibility and efficiency of use, and aesthetic and minimalist design. We identified workflow and terminology issues that may be specific to the use of an mHealth application focused on safety and used by hospitalized patients and their families.

Predictors of Change in Quality of Life in Patients With End-Stage Disease During Hospitalization

BACKGROUND

Currently, there are no studies aimed at evaluating the quality of life (QoL) of patients with end-stage disease during hospitalization and the factors that influence it.

AIM

The aim of the research was to identify predictors of change in the QoL of patients hospitalized due to advanced stage of disease.

METHODS

The sample consisted of 140 patients with end-stage disease who were hospitalized on this account. For evaluation of QoL, the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) was used. The Hospital Anxiety and Depression Scale and Karnofsky Performance Status questionnaires were used for the assessment of mental and functional status. For the evaluation of predictors of negative change in QoL, a logistic regression analysis was used.

RESULTS

During hospitalization, there was a significant deterioration in the scores given for all domains of the functional QLQ-C30 scale, but not the symptomatic scale. Predictors of change in overall QoL detected were marital status, improved functional status, and depression detected on admission to hospital. Gender and age were found to be protective factors against deterioration in overall QoL.

CONCLUSION

Sociodemographic characteristics and mental and functional status may be associated with change in QoL of patients with end-stage disease during hospitalization.