Validity and Reliability of the Beck Anxiety Inventory (BAI) for Family Caregivers of Children with Cancer

Abstract

Currently, information about the psychometric properties of the Beck Anxiety Inventory (BAI) in family caregivers of children with cancer is not available; thus, there is no empirical evidence of its validity and reliability to support its use in this population in Mexico or in other countries. This study examined the psychometric properties of the BAI in family caregivers of children with cancer and pursued four objectives: to determine the factor structure of the BAI, estimate its internal consistency reliability, describe the distribution of BAI scores and the level of anxiety in the sample and test its concurrent validity in relation to depression and resilience. This cross-sectional study was carried out with convenience sampling. A sociodemographic questionnaire, the BAI, the Beck Depression Inventory and the Measurement Scale of Resilience were administered to an incidental sample of 445 family caregivers of children with cancer hospitalized at the National Institute of Health in Mexico City. Confirmatory factor analysis using the maximum likelihood method was performed to determine the factor structure and exploratory factor analysis using axis factorization with oblique rotation was conducted. The two-, three- and four-factor models originally proposed for the BAI did not hold. The exploratory factor analysis showed a model of two correlated factors (physiological and emotional symptoms). Confirmatory factor analysis revealed a lack of discriminant validity between these two factors and supported a single-factor model. The internal consistency of the scale reduced to 11 items (BAI-11) was good (alpha = 0.89). The distribution of BAI-11 scores was skewed to the left. High levels of symptoms of anxiety were present in 49.4% of caregivers. The scale was positively correlated with depression and negatively correlated with resilience. These findings suggest that a reduced single-factor version of the BAI is valid for Mexican family caregivers of children with cancer.

Predictors of Quality of Life among Parents of Children with Chronic Diseases: A Cross-Sectional Study

“…The associations of QOL with resilience [ 77 ], support networks [ 25 , 38 , 42 ], well-being [ 50 ], family functioning [ 8 ], and family support [ 43 ] were positive. In contrast, the associations of QOL with depressive symptoms [ 6 , 16 ], caregiver burden [ 46 ], and parental stress [ 20 , 36 ] were negative. However, there were four variables with true predictive power for QOL: high levels of resilience, social support, and family functioning and low levels of depressive symptoms predicted better QOL among the parental caregivers.…”

“…Consequently, the data were analyzed as a single set. This approach is neither new nor exclusive to this study [ 13 , 15 , 16 , 17 , 19 , 20 , 28 , 36 , 40 , 42 , 44 ]. In future studies, analyses can be performed by diagnostic subgroups to deepen the understanding of the similarities and differences between subgroups.…”

“…Among the main child sociodemographic variables associated with a higher QOL of the family caregiver are older age [ 22 ], male gender [ 23 ], an established medical diagnosis with a good prognosis [ 24 ], positive evolution and greater control of the disease [ 25 , 26 ], type of noninvasive treatment [ 27 ], and adaptive psychosocial functioning [ 28 , 29 ]. In addition, empirical evidence has shown that the main sociodemographic variables of caregivers that affect their QOL include male gender [ 30 ], older age [ 31 ], higher levels of schooling and income [ 32 , 33 ], being married [ 34 ], decreased caregiving time [ 35 , 36 ], reduced family caregiver burden [ 13 ], a shorter caregiving duration [ 37 ], less financial impact [ 38 ], a professional occupation [ 39 ], and greater religiosity or spirituality [ 40 ].…”

“…However, psychosocial variables seem to have a greater influence on caregivers’ QOL than sociodemographic variables [ 8 , 36 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 ]. Recent empirical findings show that family caregivers’ QOL is related to psychosocial variables, such as their parental stress [ 22 , 41 ], social support [ 25 , 38 , 42 ], family support [ 43 ], adaptation to the disease [ 44 ], depression [ 6 , 16 ], anxiety [ 20 , 36 ], coping styles [ 45 ], caregiver burden [ 46 ], self-perceived health [ 47 ], family functioning [ 8 ], and resilience [ 48 ].…”

Psychosocial Factors Predicting Resilience in Family Caregivers of Children with Cancer: A Cross-Sectional Study

“…Beck Anxiety Inventory (BAI; [ 50 ]), this instrument has been validated in family caregivers of children with cancer, by Toledano-Toledano et al [ 51 ]. Through 16 items, this inventory assesses anxious symptomatology using a four-point scale, ranging from 0 “Little or nothing” to 3 “Severely.” The level of anxiety obtained is minimum (1–5 points), mild (6–15), moderate (16–30) and severe (31–63).…”