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Psychometric Testing of the Caregiver Quality of Life Index-Cancer on a Taiwanese Family Caregiver Sample

Tang, Woung-Ru RN, PhD; Tang, Siew-Tzuh RN, DNS; Kao, Chen-Yi MD

doi: 10.1097/NCC.0b013e31819b5ae8

Family caregivers' quality of life (QOL) is an important indicator for end-of-life care, but appropriate assessment tools are unavailable in Taiwan. This correlational study therefore tested the psychometric properties of the Caregiver Quality of Life Index-Cancer Mandarin version (CQOLC-M) in 359 dyads of cancer patients with terminal illness and their family caregivers from 5 teaching hospitals throughout Taiwan. Caregivers' QOL, spiritual well-being, social support, pain intensity, and economic situation were assessed using the CQOLC-M and 4 established scales. The CQOLC-M had internal consistency reliability of .87. Construct validity was supported by factor analysis, hypothesis testing, and known-group comparison. Exploratory factor analysis showed 7 underlying factors explaining 48.15% of the variance. Caregiver Quality of Life Index-Cancer Mandarin version scores correlated moderately with caregivers' social support (P < .01) and spiritual well-being (P < .01). Caregivers' QOL was inversely related to both patients' (F = 4.90; P = .008) and caregivers' average pain (t = −4.22; P < .001) in the past 24 hours. We suggest removing 4 items with factor loading of less than 0.4. Since caregivers' QOL depends on patients' and caregivers' physical dimensions, we recommend adding physical-related items to the CQOLC-M. Clinicians can improve caregivers' QOL not only by maintaining their health, social support, and spirituality but also by better managing the pain of patients with terminal illness.

Authors' Affiliations: Graduate Institute of Nursing, Chang Gung University, Taiwan (Drs W.R. Tang and S.T. Tang); and Department of Internal Medicine, Chang Gung Memorial Hospital, Taiwan (Dr Kao).

This article was funded by the Chang Gung Memorial Hospital (Chang-Gung Medical Research Program 32009).

Corresponding author: Woung-Ru Tang, RN, PhD, Graduate Institute of Nursing, Chang Gung University, 259 Wen-Hwa 1st Road, Kwei-Shan, Tao-Yuan, Taiwan, ROC (

Accepted for publication November 6, 2008.

© 2009 Lippincott Williams & Wilkins, Inc.