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Informal caregivers play an important role in chronic disease management but their experience is often neglected. The objective of this study was to explore the content validity of the Zarit Burden Interview (ZBI) in caregivers of individuals with COPD in Canada and Portugal.Cognitive debriefing interviews were conducted with informal caregivers of individuals with moderate to very severe COPD. Participants completed the ZBI and verbalised their thinking process to assess the adequacy of the questionnaire's content and instructions. Content validity was assessed using deductive content analysis of interviews and descriptive statistics of questionnaire responses.Nine caregivers from Canada (age = 67 ± 8 years) and 13 from Portugal (age = 69 ± 7 years) participated. For Canadian caregivers, 3/22 items were not understood, and 8/22 items were not relevant to at least 1/3 of them. For Portuguese caregivers, 1/22 items were not understood, and 20/22 items were not relevant to at least 1/3 of them. The distribution of response choices was approximately symmetrical for 17/22 items in the Canadian sample. The response option "no/never" was selected by at least 75% of Portuguese participants for 18/22 items.The instrument was well understood by caregivers of people with COPD, but its relevance is uncertain.IMPLICATIONS FOR REHABILITATIONInformal caregivers provide essential care for people living with disability and chronic disease, but their experience is often neglected.The Zarit Burden Interview assesses caregiver burden but has not been validated in caregivers of people with chronic obstructive pulmonary disease.In its current form, the Zarit Burden Interview does not adequately represent the experience of COPD caregivers.We recommend selecting tools that assess caregiver burden that have been validated in the caregiver population of interest.

This study aims at assessing the factorial structure and psychometric properties of the Trauma Exposure Checklist, a psychometric tool developed and applied to the COVID-19 pandemic composed of two...

Students engagement with school is a concern of the educational community, research and policy makers. It has been conceptualized as a multidimensional construct conditioned by several individual a...

Chronic obstructive pulmonary disease (COPD) can lead to increased dependence on the informal caregiver and, consequently, to distress associated with caregiving burden. In the general population, higher levels of physical activity (PA) are related to lower distress levels; however, this relationship has been scarcely studied in COPD. This study aimed to explore the relationship between distress and PA in informal caregivers of patients with COPD, and the influence of caregivers’ (age, sex) and patients’ (age, sex, lung function) characteristics and caregiving duration on this relationship. A cross-sectional study was conducted with 50 caregivers (62.7 ± 9.8 years, 88% female; 78% caring for a spouse/partner; 38% caring >40 h/week; patients’ FEV1=45.2 ± 21.3% predicted). Data collection comprised questions related to the caregiving context, distress related to caregiving burden assessed with the Informal Caregiver Burden Assessment Questionnaire (QASCI; total score, 7 subscales), and self-reported PA with the Habitual Physical Activity Questionnaire (HPAQ). Spearman’s correlation coefficient and linear regressions were used. Significant, negative and moderate correlations were found between the QASCI (28.5 ± 19.8) and the HPAQ (5.2 ± 1.3) (ρ=-0.46; p = 0.01); and between the HPAQ and some QASCI subscales (emotional burden ρ=-0.47; implications for personal life ρ=-0.52; financial burden ρ=-0.44; perception of efficacy and control mechanisms ρ=-0.42; p

Introduction: Chronic obstructive pulmonary disease (COPD) often leads to an increased dependence on the informal carer, which can result in higher levels of distress, anxiety or depression associated with the burden of caregiving and, consequently, reduced quality of life (1). Several instruments have been used to assess carer burden in COPD; however, their measurement properties have been poorly assessed in this population (2). The Questionário de Avaliação de Sobrecarga do Cuidador Informal (QASCI) is a Portuguese questionnaire, originally created for carers of patients with stroke (3) and later validated in a sample with various chronic diseases, including respiratory diseases (4). However, its reliability and validity in informal carers of patients with COPD have yet to be established. Therefore, this study aimed to assess the reliability and validity of the QASCI questionnaire for informal carers of patients with COPD. Materials and Methods: The Portuguese questionnaire QASCI evaluates the distress associated with burden of caregiving (scores range from 0 to 100, with higher scores indicating higher levels of burden). It has 32 items divided in 7 subscales (emotional burden; personal life implications; financial burden; reactions to demands; mechanism of efficacy and control; familiar support; and satisfaction with the role). Each item is scored with a 5-point Likert scale. Reliability included internal consistency assessment using the Cronbach’s alpha. Construct validity was assessed using the following questionnaires: Zarit Burden Interview (ZBI) for concurrent validity; the Hospital Anxiety and Depression Scale (HADS) (anxiety and depression) and WHOQOL-Bref (quality of life) for convergent validity. Pearson’s (r) or Spearman’s (ρ) correlation coefficients were used according to the distribution of each variable. QASCI was expected to present a stronger (positive) correlation with ZBI than with HADS (r≥0.5) and a negative correlation with WHOQOL-Bref (r≤-.4) (3, 4). Results: Forty-one carers (62.4±10.1 years, 90.2% female; patients’ FEV1=43.7±19.7%pred) completed the questionnaires. Cronbach’s alpha of the full QASCI scale was .767 and the subscales presented values between .633 and .929. QASCI and ZBI had a very strong positive correlation (r=.914; p=.01). QASCI had a strong positive correlation with HADS anxiety (r=.608; p=.01) and depression (ρ=.617; p=.01) subscales and moderate to strong negative correlations with all the WHOQOL-Bref subscales (-.418 to .723, p=.01). Discussion and Conclusions: QASCI presented good internal consistency and construct validity results. QASCI seems to be a promising measure to evaluate distress levels associated with burden of caregiving in informal carers of patients with COPD. info:eu-repo/semantics/publishedVersion

This study aimed to determine the interrater and intrarater reliability and agreement and the minimal detectable change (MDC) of the Timed Up & Go (TUG) test and the 10-Meter Walk Test (10MWT) in older patients with Chronic Obstructive Pulmonary Disease (COPD). Patients (≥ 60 years old) living in the community were asked to attend 2 sessions with 48-72-hour interval. In session 1, participants completed the TUG and 10MWT twice (2 trials) and were assessed by 2 raters. In session 2, they repeated the tests twice and were assessed by 1 rater. Interrater and intrarater reliability were calculated for the exact scores (using data from trial 1) and mean scores (mean of 2 trials) using Intraclass Correlation Coefficients (ICC2,1 and ICC2,2, respectively). Interrater and intrarater agreement were explored with the Bland & Altman method. The MDC95 was calculated from the standard error of measurement. Sixty participants (72.43 ± 6.90 years old) completed session 1 and 41 participants session 2. Excellent ICC values were found for the TUG test (interrater: ICC2,1 = 0.997 ICC2,2 = 0.999; intrarater: ICC2,1 = 0.921 ICC2,2 = 0.964) and 10MWT (interrater: ICC2,1 = 0.992 ICC2,2 = 0.997; intrarater: ICC2,1 = 0.903 ICC2,2 = 0.946). Good interrater and intrarater agreement was also found for both tests. The MDC95 was 2.68 s and 1.84 s for the TUG and 0.40 m/s and 0.30 m/s for the 10MWT considering the exact and mean scores, respectively. Findings suggest that the TUG test and the 10MWT are reliable and have acceptable measurement error. Therefore, these measures may be used to assess functional balance (TUG) and gait (10MWT) deficits in older patients with COPD. published

Balance impairment is a common manifestation in older people with COPD and may contribute to overall functional decline; however, the relationship between balance and global functioning has not been studied. This study aimed to explore the global functioning of COPD patients with and without functional balance impairment. Functional balance was assessed with the Timed Up-and-Go (TUG) test and global functioning with the Comprehensive ICF Core Set for Obstructive Pulmonary Diseases. Participants (n = 134) were divided in 2 groups according to their performance in TUG (with and without balance impairment) and the ICF Core Set results were compared between groups. Fifty-four (40.3%) participants had functional balance impairment. The groups presented a similar extent of problems in several categories of the ICF components. However, participants with balance impairment were more severely affected (p < 0.05) in energy, pain, respiratory system, weight maintenance, exercise tolerance, neuromusculoskeletal and movement-related functions, and structure of head and neck. They also presented a significantly worse performance in handling psychological demands and activities related to mobility, self-care, domestic, community and social life, and a more negative perception of Environmental factors related to products and technology of buildings for private use and social support services (p < 0.05). Patients with functional balance impairment have more functional problems and are more severely restricted in daily life than patients without compromised balance. Understanding the relationship between balance control and global functioning will contribute to guide interventions aimed at maintaining functioning and minimizing disability.