Caregiver Difficulties Scale (CDS): Translation and Psychometric Evaluation Among Iranian Mothers of Cerebral Palsy Children

Abstract

The aim of this study was to investigate of psychometric properties of the Caregiver Difficulties Scale (CDS) for Iranian caregivers of children with cerebral palsy (CP). After a forward-backward translation, the Persian version of CDS (P-CDS) was administered to 151 Iranian mothers of CP children. The confirmatory factor analysis (CFA) was applied to measure the factor structure of P-CDS. The reliability was evaluated by examining internal consistency and test-retest method over a 2-week period using Cronbach's alpha and the intraclass correlation coefficient (ICC), respectively. The construct validity was assessed by measuring the association between the scores of the P-CDS and Caregiver Burden Scale (CBS), World Health Organization Quality of Life (WHOQOL-BREF), the Beck Depression Index (BDI II), and the Fatigue Severity Scale (FSS). The fit indices showed that the original model of CDS was relatively adequate (χ/df = 2.03, CFI = 0.90, TLI = 0.88 and RMSEA = 0.08). All domains of P-CDS met the minimum reliability standards (Cronbach'salpha and ICC > 0.7). All subscales of P-CDS were positively correlated with the CBS, BDI-II and FSS and negatively correlated with the WHOQOL-BREF. The results showed that P-CDS is a valid and reliable measure for assessing the burden of care in Iranian mothers of CP children.

Quality of life and burden of caregivers of children and adolescents with disabilities

“…Notably, despite the working age of these caregivers, most of the sample was unemployed, and most were female housewives . Evaluating the QoL of parents of disabled individuals, it was observed that only one of the spouses was employed.…”

“…12,13 The correlation matrix between the ZBI scale and the WHOQOL-BREF instrument showed that the presence of burden negatively influenced all WHOQOL-BREF domains, which indicates that the individuals most burdened by the care task present decrease subjective perception of their QoL. 20 Studies with caregivers not only of children but also of adults with intellectual disabilities 27 and with physical disabilities 31 also found an inverse proportional statistical significance between QoL and level of burden, so that the role of providing care leads to burden and negatively affects the QoL of caregivers.…”

Assessment of pain, care burden, depression level, sleep quality, fatigue and quality of life in the mothers of children with cerebral palsy

“…When the amount of the burden and difficulties of caregiving increases, mothers feel hopeless and as a result their QoL decreases significantly (Farajzadeh et al, 2018; Garip et al, 2017). Some of the studies found that providing care for a child with functional limitations and long-term dependence influenced mothers’ QoL (Garip et al, 2017; Khayatzadeh et al, 2013).…”

“…Many children with CP may have limitations in self-care functions such as feeding, bathing, dressing, grooming, ambulation and experience communicative, sensory and intellectual impairments (Svedberg et al, 2010; Tseng et al, 2016). The most children with CP are cared for by their mothers who are primary caregivers in developing countries such as Turkey (Farajzadeh et al, 2018; Garip et al, 2017). Caregiving covers a very wide range of activities such as heavy lifting and turning, bathing, helping the child to use the toilet, getting the child to sleep, dressing and assisting the transfer.…”

Factors Affecting the Caregiver Difficulties in Caring of Children With Cerebral Palsy

“…Higher scores indicate higher caregiver's difficulties. This tool has sufficient validity and reliability among Iranian mothers of children with CP [21].…”