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The Caregiver Quality of Life Index–Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer

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Abstract

Family caregivers have become increasingly responsible for providing home care for cancer patients. Research has documented the distress of family caregivers; however, little has been done to evaluate the broader impact of caregiving on quality of life (QoL). The objectives of this study were to evaluate the reliability and validity of the Caregiver Quality of Life Index–Cancer (CQOLC), a new self-report instrument. Two hundred and sixty-three family caregivers of patients with lung, breast or prostate neoplasms participated. Test–retest reliability was 0.95 and internal consistency was 0.91. As expected, there were moderate correlations with overall mental health (r=0.64), emotional distress (r=–0.50 to −0.52), burden (r=−0.65) and patient's performance status (r=−0.47) and low correlations with overall physical health (r=0.13), social support (r=0.22) and social desirability (r=0.08). These results show that increased overall mental health is associated with better QoL, while more emotional distress and worsening patient performance status are associated with poorer QoL. Thus, the CQOLC appears to possess adequate validity, test-retest reliability and internal consistency. Future directions include further evaluation of sensitivity to change and factor analysis to determine the principal health-related QoL domains evaluated by the CQOLC.

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References

  1. Jacobsen PB, Holland JC. The stress of cancer: psychological responses to diagnosis and treatment. In: Cooper CL, Watson M, eds. Cancer and Stress: Psychological, Biological and Coping Studies. New York: John Wiley &; Sons, 1991: 147–169.

    Google Scholar 

  2. McGee RF. Overview: psychosocial aspects of cancer. In: Groenwals SL, Frogge MH, Goodman M, Yarbro CH, eds. Cancer Nursing: Principles and Practice. Boston: Jones and Bartlett, 1993: 437–448.

    Google Scholar 

  3. Cassileth BR, Chou JN. Psychosocial issues in the older patient with cancer. In: Balducci L, Lyman GH, Ershler WB, eds. Geriatric Oncology. New York: J.B. Lippincott Co., 1992: 311–319.

    Google Scholar 

  4. Sabo D. Men, death, and anxiety: critical feminist interpretations of adjustment to mastectomy. In: Clark C, Fritz J, Rieder P, eds. Clinical Sociological Perspectives on Illness and Loss. Philadelphia: Charles Press, 1990: 71–84.

    Google Scholar 

  5. Lewis FM. Strengthening family supports. Cancer 1990; 65: 752–759.

    Google Scholar 

  6. Northouse LL, Peters-Golden H. Cancer and the family: strategies to assist spouses. Sem Oncol Nursing 1993; 9: 74–82.

    Google Scholar 

  7. Sales E. Psychosocial impact of the phase of cancer on the family: an updated review. J Psychosoc Oncol 1991; 9: 1–9.

    Google Scholar 

  8. Ell K, Nishimoto R, Mantell J, Hamovitch M. Longitudinal analysis of psychosocial adaptation among family members of patients with cancer. J Psychosom Res 1988; 32: 429–438.

    Google Scholar 

  9. Johnson J. Cancer: a family disruption. Rec Res Cancer Res 1988; 108: 306–310.

    Google Scholar 

  10. Northouse LL. Social support in patients' and husbands' adjustment to breast cancer. Nursing Res 1988; 37: 91–95.

    Google Scholar 

  11. Oberst MT, Thomas SE, Gass KA, Ward SE. Caregiving demands and appraisal of stress among family caregivers. Cancer Nursing 1989; 12: 209–215.

    Google Scholar 

  12. Pederson LM, Valanis BG. The effects of breast cancer on the family: a review of the literature. J Psychosoc Oncol 1988; 6: 95–118.

    Google Scholar 

  13. Toseland RW, Blanchard CG, McCallion P. A problem solving intervention for caregivers of cancer patients. Soc Sci Med 1995; 40: 517–528.

    Google Scholar 

  14. Baider L, Kaplan De-Nour A. Adjustment to cancer: who is the patient–the husband or the wife. Israel J Med Sci 1988; 24: 631–636.

    Google Scholar 

  15. Baider L, Perez T, Kaplan De-Nour A. Gender and adjustment to chronic disease: a study of couples with colon cancer. Gen Hospital Psychiatr 1989; 11: 1–8.

    Google Scholar 

  16. Laizner AM, Shegda Yost LM, Barg FK, McCorckle R. Needs of family caregivers of persons with cancer: a review. Sem Oncol Nursing 1993; 9: 114–120.

    Google Scholar 

  17. Given B, Stommel M, Collins C, King S, Given C. Responses of elderly spouse caregivers. Res Nursing Health 1990; 13: 73–85.

    Google Scholar 

  18. Schott-Baer D. Dependent care, caregiver burden, and self care agency of spouse caregivers. Cancer Nursing 1993; 16: 230–236.

    Google Scholar 

  19. Bluglass K. Care of the cancer patient's family. In: Watson M, ed. Cancer Patient Care: Psychosocial Treatment Methods. Cambridge: British Psychological Society and Cambridge University Press, 1991: 159–189.

    Google Scholar 

  20. Northouse L. A longitudinal study of the adjustment of patients and husbands to breast cancer. Oncol Nursing M.A.Weitzner et al. 62 Quality of Life Research.Vol 8. 1999 Forum 1989; 16: 511–516.

  21. Vess JD, Moreland JR, Schwebel AI. An empirical assessment of the effects of cancer on family role functioning. J Psychosoc Oncol 1985; 3: 1–16.

    Google Scholar 

  22. Kissane DW, Bloch S, Burns WI, Patrick JD, Wallace CS, McKenzie DP. Perceptions of family functioning and cancer. Psycho-Oncology 1994; 3: 259–269.

    Google Scholar 

  23. Kissane DW, Bloch S, Burns WI, McKenzie D, Posterino M. Psychological morbidity in the families of patients with cancer. Psycho-Oncology 1994; 3: 47–56.

    Google Scholar 

  24. McCorkle R, Yost LS, Jepson C, Malone D, Baird S, Lusk E. A cancer experience: relationship of patient psychosocial responses to care-giver burden over time. Psycho-Oncology 1993; 2: 21–32.

    Google Scholar 

  25. McCorkle R, Benoliel JQ, Donaldson G, Georgiadou F, Moinpour C, Goodell B. Randomized clinical trial of home nursing care for lung cancer patient. Cancer 1989; 64: 199–206.

    Google Scholar 

  26. Stetz KM, Hanson WK. Alterations in perceptions of caregiving demands in advanced cancer during and after the experience. Hospice J 1992; 8: 21–34.

    Google Scholar 

  27. Blank JJ, Longman AJ, Atwood JR. Perceived home care needs of cancer patients and their caregivers. Cancer Nursing 1989; 12: 78–84.

    Google Scholar 

  28. Yang C, Kirschling JM. Exploration of factors related to direct care and outcomes of caregiving: caregivers of terminally ill older persons. Cancer Nursing 1992; 15: 173–181.

    Google Scholar 

  29. Hinds C. Suffering: a relatively unexplored phenomenon among family caregivers of non-institutionalized patients with cancer. J Adv Nursing 1992; 17: 918–925.

    Google Scholar 

  30. Given CW, Stommel M, Given B, Osuch J, Kurtz ME, Kurtz JC. The influence of the cancer patient's symptoms, functional states on patient's depression and family caregiver's reaction and depression. Health Psychol 1993; 12: 277–285.

    Google Scholar 

  31. Sales E, Schulz R, Biegal D. Predictors of strain in families of cancer patients: a review of the literature. J Psychosoc Oncol 1992; 10: 1–26.

    Google Scholar 

  32. Kurtz ME, Kurtz JC, Given CW, Given B. Relationship of caregiver reactions and depression to cancer patients' symptoms, functional states and depression – a longitudinal view. Soc Sci Med 1995; 40: 837–846.

    Google Scholar 

  33. Lewis FM, Hammond MA, Woods NF. The family's functioning with newly diagnosed breast cancer in the mother: the development of an explanatory model. J Behav Med 1993; 16: 351–370.

    Google Scholar 

  34. Carey PJ, Oberst MT, McCubbin MA, Hughes SH. Appraisal and caregiving burden in family members caring for patients receiving chemotherapy. Oncol Nursing Forum 1991; 18: 1341–1348.

    Google Scholar 

  35. Hileman JW, Lackey NR, Hassanein RS. Identifying the needs of home caregivers of patients with cancer. Oncol Nursing Forum 1992; 19: 771–777.

    Google Scholar 

  36. Wingate AL, Lackey NR. A description of the needs of noninstitutionalized cancer patients and their primary caregiver. Cancer Nursing 1989; 12: 216–225.

    Google Scholar 

  37. Northouse LL, Cracchiolo-Caraway A, Pappas Appel C. Psychologic consequences of breast cancer on partner and family. Sem Oncol Nursing 1991; 7: 216–223.

    Google Scholar 

  38. Sharp JW. Expanding the definition of quality of life for prostate cancer. Cancer 1992; 71 (3 Suppl): 1078–1082.

    Google Scholar 

  39. Vitaliano PP, Russo J, Young HM, Becker J, Maiuro RD. The screen for caregiver burden. Gerontologist 1991; 31: 76–83.

    Google Scholar 

  40. Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 1980; 20: 649–655.

    Google Scholar 

  41. Robinson BC. Validation of a caregiver strain index. J Gerontol 1983; 38: 344–348.

    Google Scholar 

  42. Weitzner MA, Meyers CA, Steinbruecker S, Saleeba AK, Sandifer SD. Developing a care giver quality-of-life instrument: preliminary steps. Cancer Pract 1997; 5: 25–31.

    Google Scholar 

  43. Ware JE, Snow KK, Kosinski M, Gandek B. SF-36 Health Survey Manual and Interpretation Guide. Boston: The Health Institute, 1993.

    Google Scholar 

  44. Ware JE, Kosinski M, Keller SD.SF-36 Physical and Mental Health Summary Scales: a User's Manual. Boston, MA: The Health Institute, 1994.

    Google Scholar 

  45. McHorney CA, Ware JE, Raczek AE. The MOS 36-item Short-form Health Survey (SF-36): II. Psychometric and clinical tests of validity in measuring physical and mental health constructs. Med Care 1993; 31: 247–263.

    Google Scholar 

  46. Beck AT, Ward CH, Mendelson M, Mock J, Erbaugh J. An inventory for measuring depression. Arch Gen Psychiatr 1961; 4: 561–571.

    Google Scholar 

  47. Steer RA, Beck AT, Riskind J, Brown G. Differentiation of depressive disorders from generalized anxiety by the Beck Depression Inventory. J Clin Psychol1986; 40: 475–478.

    Google Scholar 

  48. Steer RA, Beck AT, Brown G, Berchick RJ. Self-reported depressive symptoms differentiating major depression from dysthymic disorders. J Clin Psychol 1987; 43: 246–250.

    Google Scholar 

  49. Spielberger C, Gorsuch R, Lushene R. State–Trait Anxiety Inventory Manual. Palo Alto: Consulting Psychologists Press, Inc., 1970.

    Google Scholar 

  50. Kendall PC, Finch AJ, Jr, Auerbach, SM, Hooke J, Mikulka P. The State–Trait Anxiety Inventory: a systematic evaluation. J Consult Clin Psychol 1976; 44: 406–412.

    Google Scholar 

  51. Zimet GD, Dahlem NW, Zimet SG, Farley GK. The Muldimensional Scale of Perceived Social Support. J Personal Assess 1988; 52: 30–41.

    Google Scholar 

  52. Crowne DP, Marlowe D. Anew scale of social desirability independent of psychopathology. J Consult Psychol 1960; 24: 349–354.

    Google Scholar 

  53. Strahan R, Gerbasi KC. Short homogenous versions of the Marlowe–Crowne Social Desirability Scale. J Clin Psychol 1972; 28: 191–193.

    Google Scholar 

  54. Zubrod CG, Schneiderman M, Frei E et al. Appraisal of methods for the study of chemotherapy of cancer in man: comparative therapeutic trial of nitrogen mustard and trimethylene thiophosphoramide. J Chronic Dis 1960; 11: 7–33.

    Google Scholar 

  55. Cohen J. Statistical Power Analysis for the Behavioral Sciences, 2nd edn. Hillsdale: Lawrence Erlbaum Associates, 1988.

    Google Scholar 

  56. Stetz KM. Caregiving demands during advanced cancer: the spouse's needs. Cancer Nursing 1987; 10: 260–268.

    Google Scholar 

  57. Given CW, Given B, Stommel M, Collins C, King S, Franklin S. The caregiver reaction assessment (CRA) for caregivers of persons with chronic physical and mental impairments. Res Nursing Health 1992; 15: 271–283.

    Google Scholar 

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Weitzner, M.A., Jacobsen, P.B., Wagner, H. et al. The Caregiver Quality of Life Index–Cancer (CQOLC) scale: development and validation of an instrument to measure quality of life of the family caregiver of patients with cancer. Qual Life Res 8, 55–63 (1999). https://doi.org/10.1023/A:1026407010614

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