Marcel W M Post1, Helma Festen, Ingrid G van de Port, Johanna M A Visser-Meily. 1. Post Rehabilitation Centre De Hoogstraat and Department of Rehabilitation and Rudolf Magnus Institute for Neuroscience, University Medical Centre Utrecht, Utrecht, The Netherlands. m.post@dehoogstraat.nl
Abstract
OBJECTIVE: To examine the reproducibility and responsiveness of two often-used instruments for caregiver burden: the Caregiver Strain Index and the Caregiver Reaction Assessment. DESIGN: Repeated administration of self-report questionnaires three years post stroke. SUBJECTS: Convenience sample of partners of stroke patients. METHODS: Weighted kappa and percentage agreement at item level and intraclass correlations (ICCs) for subscale and total scores. Responsiveness was expressed as smallest detectable difference (SDD) and standard error of measurement (SEM). RESULTS: Reproducibility of the total Caregiver Strain Index score (N = 26) was very good (0.93; 95% confidence interval 0.84-0.97). For the Caregiver Reaction Assessment (N = 21), the subscales disrupted schedule, financial problems and health problems showed sufficient reproducibility (ICC 0.79-0.86), but the ICCs of the subscales lack of family support (0.67) and self-esteem (0.58) were insufficient. Relating the SDD and SEM to the standard deviation and maximum scale range, responsiveness appears moderate for the Caregiver Strain Index and unsatisfactory for the Caregiver Reaction Assessment. CONCLUSION: The Caregiver Strain Index showed good reproducibility and moderate responsiveness. The Caregiver Reaction Assessment showed insufficient reproducibility and responsiveness.
OBJECTIVE: To examine the reproducibility and responsiveness of two often-used instruments for caregiver burden: the Caregiver Strain Index and the Caregiver Reaction Assessment. DESIGN: Repeated administration of self-report questionnaires three years post stroke. SUBJECTS: Convenience sample of partners of strokepatients. METHODS: Weighted kappa and percentage agreement at item level and intraclass correlations (ICCs) for subscale and total scores. Responsiveness was expressed as smallest detectable difference (SDD) and standard error of measurement (SEM). RESULTS: Reproducibility of the total Caregiver Strain Index score (N = 26) was very good (0.93; 95% confidence interval 0.84-0.97). For the Caregiver Reaction Assessment (N = 21), the subscales disrupted schedule, financial problems and health problems showed sufficient reproducibility (ICC 0.79-0.86), but the ICCs of the subscales lack of family support (0.67) and self-esteem (0.58) were insufficient. Relating the SDD and SEM to the standard deviation and maximum scale range, responsiveness appears moderate for the Caregiver Strain Index and unsatisfactory for the Caregiver Reaction Assessment. CONCLUSION: The Caregiver Strain Index showed good reproducibility and moderate responsiveness. The Caregiver Reaction Assessment showed insufficient reproducibility and responsiveness.
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