Validation of Bakas Caregiving Outcome Scale for brazilian portuguese

this is a cross-sectional methodological study conducted with 151 informal caregivers of people with cerebral vascular accident sequelae enrolled in Family Health Units. To assess reliability, Cronbach’s alpha was used. Construct validity was verified through exploratory factor analysis, confirmatory factor analysis and correlation with measures of instruments that evaluate correlated constructs.

Results:

Cronbach’s alpha for the total BCOS score was 0.89. Factor and exploratory analysis generated a one-factor structure, which was confirmed by confirmatory factor analysis. Construct validity was supported by the high positive correlations with Negative Affect (r = 0.51) and Negative Experience (r = 0.47) of the Well-being Scale and the Depression Anxiety and Stress Scale -21 (r = 0.53) and negative correlations with Positive Affect (r =-0.47) and Positive Experience (r = -0.17) of the Well-being scale.

Conclusion:

Bakas Caregiving Outcome Scale shows evidence of satisfactory reliability and validity in family caregivers of cerebral vascular accident survivors.

Descriptors:
Validation Studies; Reproducibility of Results; Nursing Methodology Research; Stroke; Caregivers; Nursing

Factor	Eigenvalue	Variance percentage	Cumulative percentage	Parallel Analysis
1	6.382	42.546	42.546	1.57
2	1.257	8.377	50.923	1.44
3	1.034	6.893	57.817	1.33

Items	Burden	Commonality
15. My overall health (State of complete physical, mental and social well-being and not just absence of disease)	0.705	0.498
8. My emotional well-being (Thoughts of joy and pleasure in my experiences)	0.701	0.545
7. My energy level (Readiness to perform daily activities)	0.709	0.503
5. My relationship with friends (Affection relationship)	0.711	0.505
3. My time for family activities	0.677	0.458
4. My ability to deal with stress (Situations that I perceive as threatening)	0.641	0.411
14. My physical performance (My muscle strength, without body aches for daily activities)	0.641	0.411
1. My self-esteem (What I think about myself, my emotions and my behaviors in life)	0.613	0.376
6. My vision of the future (Ability to plan for the near or far future)	0.640	0.410
10. My time for social activities with friends
9. Social roles (Being a mother or a father, a wife/husband, a sister/brother, a friend, a daughter/son)	0.608	0.370
2. My physical health (General condition of the body in relation to disease and physical ability to perform daily activities)	0.579	0.336
11. My relationship with relatives (Affection relationship)	0.530	0.281
13. My relationship with the patient with stroke sequel (Affection relationship)	0.418	0.174
12. My financial stability (Organization with expenses, control of money, spending, savings)	0.403	0.162
Eigenvalue = 6.382 Variance explained = 42.546%

Items	Burden construct
Items	λ^* * λ =Factor Scores of the Structure;	ε^†	CR^‡ ‡ CR = Composite Reliability;	AVE^§ § AVE = Average Variance Extracted. BCOS mean = 48.62; Standard deviation = 12.790. All BCOS items ranged from one to seven and had medians = 4.0 (Possible range 1-7, item midpoints = 4.0, higher scores mean greater positive changes)
1. My self-esteem (What I think about myself, my emotions and my behaviors in life)	0.64	0.41	0,91	0,66
2. My physical health (General condition of the body in relation to illness and physical ability to perform daily activities)	0.54	0.26
3. My time for family activities	0.66	0.40
4. My ability to deal with stress (situations that I perceive as threatening)	0.66	0.44
5. My relationship with friends (Affection relationship, friendship, love, loyalty and protection)	0.71	0.51
6. My vision of the future (Ability to make plans in the near or distant future)	0.62	0.38
7. My energy level (Readiness to perform daily activities)	0.70	0.50
8. My emotional well-being (Thoughts of joy and pleasure in daily experiences)	0.75	0.57
9. Social roles (Being a mother or a father, a sister/brother, a friend, a daughter/son)	0.65	0.42
10. My time for social activities with friends	0.59	0.35
11. My relationship with my family (Affection relationship, friendship, love, loyalty and protection)	0.55	0.31
12. My financial stability (Organization with expenses, control of money, spending, savings)	0.42	0.18
13. My relationship with the stroke survivor (Relationship of affection, friendship, love, loyalty and protection)	0.42	0.17
14. My physical performance (My muscle strength, without body aches for daily activities)	0.55	0.30
15. My overall health (state of complete physical, mental and social well-being and not just absence of disease)	0.68	0.46

Factors	BCOS^* * BCOS = Bakas Caregiving Outcomes Scale
Subjective well-being
Positive
Positive Affect	-0.50
Positive Experience	-0.17
Positive Well-being	-0.41
Negative
Negative Affect	0.51
Negative Experience	0.47
General Well-being	-0.47
Stress, Anxiety and Depression (DASS-21)	0.56

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E-mail: rlae@eerp.usp.br

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[1] Corresponding author: Tatiana Ferreira da Costa E-mail: tatxianaferreira@hotmail.com https://orcid.org/0000-0002-6448-4302