Reliability and validity of the QASCI questionnaire to assess caregiving burden in COPD
Bibliographic record
Abstract
Introduction Chronic obstructive pulmonary disease (COPD) often leads to an increased dependence on the informal carer, which can result in higher levels of distress, anxiety or depression associated with the burden of caregiving and, consequently, reduced quality of life [1 Figueiredo D, Gabriel R, Jácome C, et al. Caring for people with early and advanced chronic obstructive pulmonary disease: how do family carers cope? J Clin Nurs. 2014;23(1–2):211–220.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]]. Several instruments have been used to assess carer burden in COPD; however, their measurement properties have been poorly assessed in this population [2 Cruz J, Marques A, Machado A, et al. Informal caregiving in COPD: a systematic review of instruments and their measurement properties. Respir Med. 2017;128:13–27.[Crossref], [PubMed], [Web of Science ®] , [Google Scholar]]. The Questionário de Avaliação de Sobrecarga do Cuidador Informal (QASCI) is a Portuguese questionnaire, originally created for carers of patients with stroke [3 Martins T, Garrett C, Pais-Ribeiro J. Estudo de Validação do Questionário de Avaliação da Sobrecarga para Cuidadores Informais. Psicologia Saúde Doenças. 2003;4(1):131–148. [Google Scholar]] and later validated in a sample with various chronic diseases, including respiratory diseases [4 Martins T, Garrett C, Pais-Ribeiro J. Questionário de Avaliação da Sobrecarga do Cuidador Informal (QASCI) – Reavaliação das Propriedades Psicométricas. Referência: Revista de Enfermagem. 2004;11(1):17–31 [Google Scholar]]. However, its reliability and validity in informal carers of patients with COPD have yet to be established. Therefore, this study aimed to assess the reliability and validity of the QASCI questionnaire for informal carers of patients with COPD.Materials and methods The Portuguese questionnaire QASCI evaluates the distress associated with burden of caregiving (scores range from 0 to 100, with higher scores indicating higher levels of burden). It has 32 items divided in 7 subscales (emotional burden; personal life implications; financial burden; reactions to demands; mechanism of efficacy and control; familiar support; and satisfaction with the role). Each item is scored with a 5-point Likert scale. Reliability included internal consistency assessment using the Cronbach’s alpha. Construct validity was assessed using the following questionnaires: Zarit Burden Interview (ZBI) for concurrent validity; the Hospital Anxiety and Depression Scale (HADS) (anxiety and depression) and WHOQOL-Bref (quality of life) for convergent validity. Pearson’s (r) or Spearman’s (ρ) correlation coefficients were used according to the distribution of each variable. QASCI was expected to present a stronger (positive) correlation with ZBI than with HADS (r ≥ 0.5) and a negative correlation with WHOQOL-Bref (r≤–0.4) [3 Martins T, Garrett C, Pais-Ribeiro J. Estudo de Validação do Questionário de Avaliação da Sobrecarga para Cuidadores Informais. Psicologia Saúde Doenças. 2003;4(1):131–148. [Google Scholar],4 Martins T, Garrett C, Pais-Ribeiro J. Questionário de Avaliação da Sobrecarga do Cuidador Informal (QASCI) – Reavaliação das Propriedades Psicométricas. Referência: Revista de Enfermagem. 2004;11(1):17–31 [Google Scholar]].Results Forty-one carers (62.4 ± 10.1 years, 90.2% female; patients’ FEV1=43.7 ± 19.7%pred) completed the questionnaires. Cronbach’s alpha of the full QASCI scale was 0.767 and the subscales presented values between .633 and .929. QASCI and ZBI had a very strong positive correlation (r = 0.914; p=.01). QASCI had a strong positive correlation with HADS anxiety (r = 0.608; p=.01) and depression (ρ = 0.617; p=.01) subscales and moderate to strong negative correlations with all the WHOQOL-Bref subscales (–0.418 to 0.723, p=.01).Discussion and conclusions QASCI presented good internal consistency and construct validity results. QASCI seems to be a promising measure to evaluate distress levels associated with burden of caregiving in informal carers of patients with COPD.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.030 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".