Browsing by Author "Martins, Sara"
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- Construct validity and reliability of the Informal Caregiver Burden Assessment Questionnaire (QASCI) in caregivers of patients with COPDPublication . Hipólito, Nádia; Martins, Sara; Ruivo, Adriana; Flora, Sofia; Silva, Cândida G.; Marques, Alda; Brooks, Dina; Cruz, JoanaIntroduction: COPD often leads to loss of independence in daily activities which may increase the dependency on the informal caregiver, resulting in caregiving burden. Several instruments have been used to assess caregiving burden in COPD; however, their measurement properties have been poorly investigated in this population. This study assessed the construct validity and reliability of the Informal Caregiver Burden Assessment Questionnaire (QASCI) in informal caregivers of patients with COPD. Methods: Participants completed the QASCI (higher scores indicate higher burden) and the following questionnaires to assess construct validity: Zarit Burden Interview (ZBI), Hospital Anxiety and Depression Scale (HADS) and World Health Organization Quality of Life Instrument – Short Form (WHOQOL-Bref). QASCI was completed again one week later to assess test-retest reliability. Statistical analyses included: Pearson’s (r) or Spearman’s (ρ) correlations (construct validity); Cronbach’s α (internal consistency); Intraclass Correlation Coefficient (ICC2,1, test-retest reliability) and Standard Error of Measurement (SEM), Minimal Detectable Change (MDC95) and Bland and Altman 95% Limits of Agreement (LoA). Results: Fifty caregivers (62.7 ± 9.8 years, 88% female; patients’ FEV1 = 45.2 ± 21.3%predicted) participated. QASCI mean score was 28.5 ± 19.8 (moderate burden). QASCI was positively correlated with ZBI (r = 0.908; p < 0.01), HADS anxiety (r = 0.613; p < 0.01) and depression (ρ = 0.634; <0.01) and negatively correlated with WHOQOL-Bref ( 0.476 to 0.739) (all p < 0.01). Cronbach’s α was 0.793 for the QASCI total score (subscales: 0.747–0.932). The ICC2,1 was 0.924, SEM 2.8 and MDC95 7.8, and the LoA were 18.3 to 11.1. Conclusions: The QASCI seems to be a promising measure to assess burden levels associated with informal caregiving in COPD.
- Relação entre a atividade física e o distress associado à sobrecarga em cuidadores informais de indivíduos com DPOCPublication . Ruivo, Adriana; Hipólito, Nádia; Martins, Sara; Marques, Alda; Brooks, Dina; Silva, Cândida G.; Cruz, JoanaIntrodução: A doença pulmonar obstrutiva crónica (DPOC) é uma condição que pode levar ao aumento da dependência do doente em relação ao cuidador informal e, consequentemente, promover um aumento do distress associado à sobrecarga deste.1 De acordo com a literatura, na população geral, maiores níveis de atividade física (AF) contribuem para menores níveis de distress2. O objetivo principal deste estudo foi verificar se esta relação se confirma em cuidadores informais de pessoas com DPOC. Metodologia: Foi desenvolvido um estudo observacional transversal, tendo-se realizado a caracterização sociodemográfica da amostra, a recolha de informação sobre o contexto de prestação de cuidados e a aplicação dos questionários: Questionário de Avaliação de Sobrecarga do Cuidador Informal (QASCI), para avaliar o nível de distress associado à sobrecarga, e Habitual Physical Activity Questionnaire (HPAQ), para avaliar o nível de AF. Para a análise de dados foram utilizadas medidas de estatística descritiva, os coeficientes de correlação Pearson e Spearman e regressões lineares (simples e múltiplas). Resultados: Foram incluídos 26 cuidadores (63,1 ± 9,7 anos; 84,6% feminino e 15,4% masculino). A média do QASCI foi de 31,3 ± 22 e a do HPAQ foi de 5,5 ± 1,8. A correlação entre estas variáveis foi moderada negativa (r=-0,535, p=0.01). A variável AF teve a capacidade de predizer o valor do QASCI em 28,7%. Ao adicionar a variável duração de cuidados em anos, foi possível aumentar para 54,6% a capacidade de a equação predizer o valor do QASCI. Conclusões: Os resultados sugerem que existe uma relação entre o aumento do nível da AF e a diminuição do nível de distress nesta população. Estes achados suportam a importância da promoção da prática de AF nos cuidadores informais de indivíduos com DPOC. Estudos longitudinais futuros deverão ser considerados.
- Relationship between Distress Related to Caregiver Burden and Physical Activity in Informal Caregivers of Patients with COPDPublication . Hipólito, Nádia; Ruivo, Adriana; Martins, Sara; Dinis, Beatriz; Flora, Sofia; Marques, Alda; Brooks, Dina; Silva, Cândida G.; Januário, Filipa; Silva, Sónia; Cruz, JoanaChronic obstructive pulmonary disease (COPD) can lead to increased dependence on the informal caregiver and, consequently, to distress associated with caregiving burden. In the general population, higher levels of physical activity (PA) are related to lower distress levels; however, this relationship has been scarcely studied in COPD. This study aimed to explore the relationship between distress and PA in informal caregivers of patients with COPD, and the influence of caregivers’ (age, sex) and patients’ (age, sex, lung function) characteristics and caregiving duration on this relationship. A cross-sectional study was conducted with 50 caregivers (62.7 ± 9.8 years, 88% female; 78% caring for a spouse/partner; 38% caring >40 h/week; patients’ FEV1=45.2 ± 21.3% predicted). Data collection comprised questions related to the caregiving context, distress related to caregiving burden assessed with the Informal Caregiver Burden Assessment Questionnaire (QASCI; total score, 7 subscales), and self-reported PA with the Habitual Physical Activity Questionnaire (HPAQ). Spearman’s correlation coefficient and linear regressions were used. Significant, negative and moderate correlations were found between the QASCI (28.5 ± 19.8) and the HPAQ (5.2 ± 1.3) (ρ=-0.46; p = 0.01); and between the HPAQ and some QASCI subscales (emotional burden ρ=-0.47; implications for personal life ρ=-0.52; financial burden ρ=-0.44; perception of efficacy and control mechanisms ρ=-0.42; p < 0.01). Two linear regression models were tested to predict QASCI total score including as predictors: 1) HPAQ alone (p = 0.001; r2=0.23); 2) HPAQ and caregiving h/week (p < 0.001; r2=0.34). Higher self-reported PA levels are related to decreased levels of distress associated with caregiver burden in COPD caregivers. Duration of caregiving may negatively influence this relationship.
- Reliability and validity of the QASCI questionnaire to assess caregiving burden in COPDPublication . Hipólito, Nádia; Ruivo, Adriana; Martins, Sara; Flora, Sofia; Marques, Alda; Brooks, Dina; Silva, Cândida G.; Januário, Filipa; Cruz, JoanaIntroduction: 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). Several instruments have been used to assess carer burden in COPD; however, their measurement properties have been poorly assessed in this population (2). The Questionário de Avaliação de Sobrecarga do Cuidador Informal (QASCI) is a Portuguese questionnaire, originally created for carers of patients with stroke (3) and later validated in a sample with various chronic diseases, including respiratory diseases (4). 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≤-.4) (3, 4). 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 .767 and the subscales presented values between .633 and .929. QASCI and ZBI had a very strong positive correlation (r=.914; p=.01). QASCI had a strong positive correlation with HADS anxiety (r=.608; p=.01) and depression (ρ=.617; p=.01) subscales and moderate to strong negative correlations with all the WHOQOL-Bref subscales (-.418 to .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.