Psychometric Properties of the “Quality of Life in Life-Threatening Illness—Family Carer Version” (QOLLTI-F) in Persian-Speaking Carers of COVID-19 Patients

Abstract

BackgroundMeasuring family caregivers’ quality of life plays a significant role in improving the quality, efficiency, development, and provision of efficient services for patients with COVID-19. As a result, evaluating the quality of life requires the use of valid and reliable measures that are culturally appropriate. This study was conducted to determine the psychometric properties of the Persian version of the Quality of Life in Life-Threatening Illness–Family Carer Version (QOLLTI – F) in patients with COVID-19.MethodsThis methodological study was carried out in 2021 at Baqiyatallah Hospital in Tehran. After gaining approval from the tool creator, the translation was carried out utilizing the forward-backward approach. Cognitive interviews with 10 family caregivers of COVID-19 patients were used to demonstrate face validity. Moreover, construct validity was identified by performing exploratory factor analysis (EFA) (n = 251), confirmatory factor analysis (CFA) (n = 200), and convergent validation using Zarit Burden Interview (ZBI) questionnaire. For scale reliability, internal consistency and stability were performed using Cronbach’s Alpha Coefficient and test-retest, respectively.Results451 family caregivers of patients with COVID-19 were enrolled in this study. Three factors with a cumulative variance of 51.85% were extracted during EFA: (1) Caregiver’s physical-emotional status, (2) Satisfaction with the situation, and (3) Caregiver’s concerns. CFA showed that the model enjoyed a moderate to a good fit of information (RMSEA: 0.087; NFI: 0.98; CFI: 0.91; IFI: 0.91; GFI 0.89; standardized RMR: 0.070). A significant correlation was found between the Persian version of the ZBI and participants’ total scores of QOLLTI – F v3 (r = –0.196, P = 0.000). Cronbach’s Alpha Coefficient = 0.719 and ICC stability reliability = 0.71 of the questionnaire were confirmed.ConclusionThe Persian version of the QOLLTI – F v3 is a valid and reliable scale that can measure family caregivers’ quality of life during a Life-Threatening illness in patients with COVID-19. This instrument may be utilized in clinical trials and research to enhance the quality of life for family carers in Iranian society.

Psychometric properties of the Chinese version of quality of life in life-threatening illness-family carer version

“…All 16 items of the original QOLLTI-F were retained in the QOLLTI-F-CV, but our study has revealed a stable three-factor solution. This is consistent with the results of the study by Arias-Rojas et al (2021) and Fereidouni et al (2022) . Although some entries have a slightly different distribution of domains, we conducted PA to determine the number of factor extraction, which is more robust than the K1 method used by O’Conner (2000) , Mu and Gu (2011) , and Schur et al (2014) .…”

“…Although some entries have a slightly different distribution of domains, we conducted PA to determine the number of factor extraction, which is more robust than the K1 method used by O’Conner (2000) , Mu and Gu (2011) , and Schur et al (2014) . Since ESEM has the advantage in terms of exploring factor structure flexibly and verifying the factor model systematically ( Liu and Liu, 2013 ), it can make the model structure more consistent with the actual situation and the fitting more robust, compared with EFA which is used by Schur et al (2014) , Arias-Rojas et al (2021) , and Fereidouni et al (2022) . The results showed that the three-factor structured model fitted the empirical data well, as indicated by the fit indices.…”

“…Furthermore, under the family norms of Chinese Confucianism, self-sacrifice is often made to provide “perfect” care for family patients. In the Persian version, items 2 ( I still have the private space I need ) and 9 ( Being able to take care of patients makes me feel good ) are classified as “satisfied with the situation.” Fereidouni et al (2022) pointed out that this difference may be caused by the nature of the disease and the sample size.…”

“…The QOLLTI-F, originally designed in English and French, has been translated into several languages, such as German, Malaysian, Indian, Czech, Chinese, Swedish, Spanish, and Persian ( Alnjadat et al, 2014 ; Nayak et al, 2014 ; Schur et al, 2014 ; Bužgová et al, 2015 ; Xiao et al, 2015 ; Axelsson et al, 2020 ; Arias-Rojas et al, 2021 ; Fereidouni et al, 2022 ). Previous studies have indicated that the QOLLTI-F may produce various domains under different cultural backgrounds.…”

“…They named the extracted three factors as impact of caregiving, social and health interactions, and measuring of life. Additionally, Fereidouni et al (2022) also used the EFA method to extract three factors and employed confirmative factor analysis (CFA) to verify the structure. The three factors are caregiver’s physical emotional status, satisfaction with the situation, and caregiver’s concerns.…”