Skip to main content
SpringerLink
Log in

Confirmatory and exploratory factor analysis of the caregiver quality of life index-cancer with Turkish samples

  • Published:
Quality of Life Research Aims and scope Submit manuscript

Abstract

Purpose

The purpose of this study was to test the reliability and validity of the Turkish version of the CQOLC in Turkey.

Methods

The 35-item English version of the CQOLC was translated into Turkish following the standard translation methodology. The questionnaire was administered to 237 caregivers of patients with cancer. Confirmatory and exploratory factor analyses (CFA and EFA) were carried out using principal component analysis with varimax rotation and Kaiser Normalization to test its construct validity. We used Cronbach’s alpha to examine the CQOLC’s reliability (internal consistency).

Results

The CFA did not confirm the original factor model. The EFA yielded a 25-item measure with a four-factor solution with different labels for three of the four original scales (shown in parentheses): Psychological Distress (Burden), Disruption in Daily Life (Disruptiveness), Caregiving Responsibility (Positive Adaptation), and Financial Concerns (Financial Concerns). Cronbach’s alpha for the total scale was 0.88 and subscale alpha coefficients ranged from 0.73 to 0.83.

Conclusions

The results indicate some differences in the factor structures of the CQOLC scale between Turkish and American samples but provided preliminary support for the Turkish version of the CQOLC as a reliable and valid measure of the quality of life of Turkish cancer caregivers.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

QoL:

Quality of life

CQOLC:

Caregiver quality of life index-cancer

CQOLC-T:

Turkish version of the CQOLC

CFA:

Confirmatory factor analysis

EFA:

Exploratory factor analysis

GFI:

Goodness-of-fit index

AGFI:

Adjusted goodness-of-fit index

RMSEA:

Root mean square error of approximation

NFI:

Normed-fit index

TLC:

Tucker and Lewis’s reliability coefficient

AIC:

Akaike’s information criterion

SBC:

Schwarz’s Bayesian criterion

SD:

Standard deviation

References

  1. Jacobsen, P. B., & Holland, J. C. (1991). The stress of cancer: Psychological responses to diagnosis and treatment. In C. L. Cooper & M. Watson (Eds.), Cancer and stress: Psychological, biological and coping studies (pp. 147–169). New York: Wiley.

    Google Scholar 

  2. McGee, R. F. (1993). Overview: Psychological aspect of cancer. In S. L. Groenwald, M. H. Frogge, M. Goodman, & C. H. Yarbro (Eds.), Cancer nursing: Principles and practice (pp. 437–448). Boston: Jones and Bartlett.

    Google Scholar 

  3. Lewis, F. M. (1990). Strengthening family supports. Cancer and the family. Cancer, 65(Suppl. 3), 752–759.

    Article  PubMed  CAS  Google Scholar 

  4. Laizner, A. M., Yost, L. M., Barg, F. K., & McCorkle, R. (1993). Needs of family caregivers of persons with cancer: A review. Seminars in Oncology Nursing, 9(2), 114–120.

    Article  PubMed  CAS  Google Scholar 

  5. Northouse, L. L., & Peters-Golden, H. (1993). Cancer and the family: Strategies to assist spouses. Seminars in Oncology Nursing, 9, 74–82.

    Article  PubMed  CAS  Google Scholar 

  6. Sales, E. (1991). Psychosocial impact of the phase of cancer on the family: An updated review. Journal of Psychosocial Oncology, 9, 1–18.

    Article  Google Scholar 

  7. Ell, K., Nishimoto, R., Mantell, J., & Hamovitch, M. (1988). Longitudinal analysis of psychosocial adaptation among family members of patients with cancer. Journal of Psychosomatic Research, 32, 429–438.

    Article  PubMed  CAS  Google Scholar 

  8. Johnson, J. (1988). Cancer: A family disruption. Recent Results in Cancer Research, 108, 306–310.

    PubMed  CAS  Google Scholar 

  9. Northouse, L. L. (1988). Social support in patients’ and husbands’ adjustment to breast cancer. Nursing Research, 37, 91–95.

    Article  PubMed  CAS  Google Scholar 

  10. Oberst, M. T., Thomas, S. E., Gass, K. A., & Ward, S. E. (1989). Caregiving demands and appraisal of stress among family caregivers. Cancer Nursing, 12, 209–215.

    Article  PubMed  CAS  Google Scholar 

  11. Pederson, L. M., & Valanis, B. G. (1988). The effects of breast cancer on the family: A review of the literature. Journal of Psychosocial Oncology, 6, 95–118.

    Article  Google Scholar 

  12. Toseland, R. W., Blanchard, C. G., & McCallion, P. (1995). A problem solving intervention for caregivers of cancer patients. Social Science and Medicine, 40, 517–528.

    Article  PubMed  CAS  Google Scholar 

  13. Kurtz, M. E., Kurtz, J. C., Given, C. W., & Given, B. A. (2004). Depression and physical health among family caregivers of geriatric patients with cancer—A longitudinal view. Medical Science Monitor, 10, CR447–CR456.

    PubMed  Google Scholar 

  14. Longo, C. J., Fitch, M., Deber, R. B., & Williams, A. P. (2006). Financial and family burden associated with cancer treatment in Ontario, Canada. Support Care in Cancer, 14, 1077–1085.

    Article  Google Scholar 

  15. Stetz, K. M., & Brown, M. A. (2004). Physical and psychosocial health in family caregiving: A comparison of AIDS and cancer caregivers. Public Health Nursing, 21, 533–540.

    Article  PubMed  Google Scholar 

  16. Bluglass, K. (1991). Care of the cancer patient’s family. In M. Watson (Ed.), Cancer patient care: Psychosocial treatment methods (pp. 159–189). Cambridge: British Psychological Society and Cambridge University Press.

    Google Scholar 

  17. Given, B. A., Given, C. W., & Kozachik, S. (2001). Family support in advanced cancer. CA: A Cancer Journal for Clinicians, 51, 213–231.

    Article  CAS  Google Scholar 

  18. Hodges, L. J., Humphris, G. M., & Macfarlane, G. (2005). A meta-analytic investigation of the relationship between the psychological distress of cancer patients and their carers. Social Science and Medicine, 60, 1–12.

    Article  PubMed  CAS  Google Scholar 

  19. Northouse, L. L., Kershaw, T., Mood, D., & Schafenacker, A. (2005). Effects of a family intervention on the quality of life of women with recurrent breast cancer and their family caregivers. Psycho-Oncology, 14, 478–491.

    Article  PubMed  Google Scholar 

  20. Grunfeld, E., Coyle, D., Whelan, T., Clinch, J., Reyno, L., Earle, C. C., et al. (2004). Family caregiver burden: Results of a longitudinal study of breast cancer patients and their principal caregivers. Canadian Medical Association Journal, 170, 1795–1801.

    Article  PubMed  Google Scholar 

  21. Pasacreta, J. V., & McCorkle, R. (2000). Cancer care: Impact of interventions on caregiver outcomes. Annual Review of Nursing Research, 18, 127–148.

    PubMed  CAS  Google Scholar 

  22. Cameron, J. I., Franche, R. L., Cheung, A. M., & Stewart, D. E. (2002). Lifestyle interference and emotional distress in family caregivers of advanced cancer patients. Cancer, 94(2), 521–527.

    Article  PubMed  Google Scholar 

  23. Jang, S. R., & Lee, S. J. (2000). A study on burden of family for caring of terminal cancer patients. Journal of Korean Public Health Association, 26(1), 29–37.

    Google Scholar 

  24. Siegel, K., Raveis, V. H., Houts, P., & Mor, V. (1991). Caregiver burden and unmet patient needs. Cancer, 68(5), 1131–1140.

    Article  PubMed  CAS  Google Scholar 

  25. Weitzner, M. A., Jacobsen, P. B., Wagner, H., Jr., Friedland, J., & Cox, C. (1999). The caregiver QoL index-cancer (CQOLC) scale: Development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Quality of Life Research, 8(1–2), 55–63.

    Article  PubMed  CAS  Google Scholar 

  26. Weitzner, M. A., & McMillan, S. C. (1999). The caregiver quality of life index-cancer (CQOLC) scale: Revalidation in a home hospice setting. Journal of Palliative Care, 15(2), 13–20.

    PubMed  CAS  Google Scholar 

  27. Weitzner, M. A., McMillan, S. C., & Jacobsen, P. B. (1999). Family caregiver quality of life: Differences between curative and palliative cancer treatment settings. Journal of Pain and Symptom Management, 17(6), 418–428.

    Article  PubMed  CAS  Google Scholar 

  28. Weitzner, M. A., Meyers, C. A., Steinbruecker, S., Saleeba, A. K., & Sandifer, S. D. (1997). Developing a care giver quality-of-life instrument. Preliminary steps. Cancer Practice, 5(1), 25–31.

    PubMed  CAS  Google Scholar 

  29. Cull, A., Sprangers, M., Bjordal, K., Aaronson, N., West, K., & Bottomley, A. (2002). EORTC quality of life group translation procedure (2nd ed., pp. 3–15). Brussels: EORTC.

    Google Scholar 

  30. Hu, L., & Bentler, P. M. (1999). Cutoff criteria for fit indexes in covariance structure analysis: Conventional criteria versus new alternatives. Structural Equation Modeling, 6, 1–55.

    Article  Google Scholar 

  31. Browne, M. W., & Cudeck, R. (1993). Alternative ways of assessing model fit. In K. A. Bollen & J. S. Long (Eds.), Testing structural equation models (pp. 136–162). Newbury Park, CA: Sage.

    Google Scholar 

  32. Bollen, K. A. (1989). Structural equations with latent variables. New York: Wiley.

    Google Scholar 

  33. Bentler, P. M. (1990). Comparative fit indices in structural models. Psychological Bulletin, 107, 238–246.

    Article  PubMed  CAS  Google Scholar 

  34. Kline, R. B. (2005). Principles and practise of structural equation modeling. New York: Guilford Press.

    Google Scholar 

  35. Tucker, L. R., & Lewis, C. (1973). A reliability coefficient for maximum likelihood factor analysis. Psychometrika, 38, 1–10.

    Article  Google Scholar 

  36. Akaike, H. (1987). Factor analysis and AIC. Psychometrika, 52, 317–332.

    Article  Google Scholar 

  37. Schwarz, G. (1978). Estimating the dimension of a model. The Annals of Statistics, 6, 461–464.

    Article  Google Scholar 

  38. Albinsson, L., & Strang, P. (2003). Differences in supporting families of dementia patients and cancer patients: A palliative perspective. Palliative Medicine, 17, 359–367.

    Article  PubMed  Google Scholar 

  39. Given, B., Wyatt, G., Given, C., Sherwood, P., Gift, A., DeVoss, D., et al. (2004). Burden and depression among caregivers of patients with cancer at the end of life. Oncology Nursing Forum, 31, 1105–1117.

    Article  PubMed  Google Scholar 

  40. Kim, Y., Baker, F., & Spillers, R. L. (2007). Cancer caregivers’ quality of life: Effects of gender, relationship, and appraisal. Journal of Pain and Symptom Management, 34, 294–304.

    Article  PubMed  Google Scholar 

  41. Mellon, S., Northouse, L. L., & Weiss, L. K. (2006). A population-based study of the quality of life of cancer survivors and their family caregivers. Cancer Nursing, 29, 120–131.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

We are grateful to all the individuals who participated in this study. This study received external funding from Akdeniz University Scientific Research Projects Management Unit.

Author information

Authors and Affiliations

  1. Medical Nursing Department, Antalya School of Health, Akdeniz University, Antalya, Turkey

    Zeynep C. Ozer & Hicran A. Bektas

  2. Faculty of Agriculture, Department of Animal Science, Biometry and Genetics Unit, Akdeniz University, Antalya, Turkey

    Mehmet Z. Firat

Authors
  1. Zeynep C. Ozer
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Mehmet Z. Firat
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Hicran A. Bektas
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Mehmet Z. Firat.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ozer, Z.C., Firat, M.Z. & Bektas, H.A. Confirmatory and exploratory factor analysis of the caregiver quality of life index-cancer with Turkish samples. Qual Life Res 18, 913–921 (2009). https://doi.org/10.1007/s11136-009-9503-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11136-009-9503-1

Keywords

Search

Navigation