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The Validity and Reliability of a Chinese Version of the Family Burden Interview Schedule

Chien, Wai-Tong; Norman, Ian


Background: The caregiver burden within the family is one of the most commonly used outcome variables in research studies of patient care provision. However, few measures of family caregiver burden have been validated for use with Asian populations.

Objective: To examine the reliability and validity of the Chinese version of the Family Burden Interview Schedule.

Method: The first phase of the investigation involved translation and back translation of the measure for burden and a review by an expert panel. In this phase, equivalence between the Chinese and English versions, content validity, and test-retest reliability of the Family Burden Interview Schedule were assessed using a sample including 30 family caregivers of mental patients. The second phase established the internal consistency and construct validity of the scale using a sample comprising 185 family caregivers of patients with schizophrenia. Sensitivity of the scale for families of schizophrenic patients was examined through comparison with 40 caregivers of patients who had major affective disorder.

Results: The Chinese version of the Family Burden Interview Schedule adequately addressed the original concepts and dimensions, achieving 96% on the Content Validity Index. These results demonstrated high levels of equivalence with the original English version (intra-class correlation [ICC] of .87 for the overall scale and .80–.89 for the six domains). It also demonstrated a high internal consistency (Cronbach alpha of .87 for the scale and .78–.88 for the domains) and adequate test - retest response stability (r = .83 for the scale and r = .88–.92 for the domains).The mean scores for the overall scale and domains of the Family Burden Interview Schedule differed significantly between the family providers of care for the two illness groups and between the groups with high and low time involvement in caregiving.The principal components analysis showed the presence of five factors that together explained 65.85% of the variance. It also demonstrated high factor loadings as well as item-to-scale and between-subscales intercorrelations, indicating good construct validity of the burden measure.

Discussion: The findings for the psychometric properties of the Chinese version of the Family Burden Interview Schedule established its potential as a research instrument for measuring caregiver burden among Chinese patients with schizophrenia.

Wai-Tong Chien, MPhil, RMN, RTN, is Associate Professor, The Nethersole School of Nursing Faculty of Medicine, The Chinese University of Hong Kong, SAR, China.

Ian Norman, BA, MSc, PhD, RN, CQSW, is Professor of Nursing and Interdisciplinary Care, The Florence Nightingale School of Nursing and Midwifery, King’s College, University of London, UK.

Accepted for publication January 21, 2004.

The authors thank the psychiatric outpatient clinics and their staff for their assistance in data collection from the families of patients with schizophrenia.

Corresponding author: Wai-Tong Chien, MPhil, RMN, RTN, The Nethersole School of Nursing, 7/F, Esther Lee Building, Chung Chi College, The Chinese University of Hong Kong, Shatin, New Territories, Hong Kong (e-mail:

© 2004 Lippincott Williams & Wilkins, Inc.