照顾者内疚感量表的汉化及在老年痴呆患者家庭照顾者中的信效度检验

doi:10.3761/j.issn.0254-1769.2023.04.018

摘要/Abstract

摘要：

目的汉化照顾者内疚感量表（Caregiver Guilt Questionnaire，CGQ），并在老年痴呆患者家庭照顾者中检验其信效度。方法依据Brislin翻译模型，翻译、回译量表，通过专家咨询和预调查，调试、修订量表。2021年4月— 9月，对大连市120名老年痴呆患者的家庭照顾者进行调查，验证量表的信效度。结果中文版CGQ共22个条目，总量表和各维度的Cronbach’s α系数为0.953、0.799~0.941；总量表和各维度的分半信度为0.881、0.799~0.936。内容效度指数为0.91，各条目均≥0.80，共析出5个公因子，分别为对受照顾者做错了事感到内疚、忽视其他亲人的内疚感、对他人有负面感觉的内疚感、未能应对护理挑战的内疚感、自我照顾的内疚感，累计方差贡献率为76.821%。结论中文版CGQ的信效度良好，适合国内老年痴呆患者照顾者内疚感水平的测量。

关键词: 照顾者, 内疚感, 老年人, 痴呆, 信度, 效度, 社区护理

Abstract:

Objective To translate the English version of the Caregiver Guilt Questionnaire（CGQ） into Chinese，and to test its reliability and validity. Methods The scale was translated and retranslated according to the Brislin’s translation model，and the Chinese version was revised through experts’ consultations and a pre-experiment. For testing the reliability and validity of the scale，120 family caregivers of elderly patients with dementia were selected as the subjects of study from April to September 2021. Results The CGQ has 22 items，and the Cronbach’s alpha coefficient for the 22-item scale was 0.953 with 0.799~0.941 for each dimension. The split-half reliability was 0.881 with 0.799~0.936 for each dimension. The scale-level content validity index was 0.91，and the item-level content validity index were over 0.80. Factor analysis showed that a total of 5 factors were extracted explaining 76.821% of the total variance，namely guilt for doing wrong to the care recipient，guilt for neglecting other relatives，guilt for having negative feelings towards other people，guilt for not coping with nursing challenges as caregivers，guilt for self-care. Conclusion The Chinese version CGQ has good reliability and validity，which can be used to assess the level of guilt among caregivers of elderly patients with dementia in China.

Key words: Caregiver, Guilt, Aged, Dementia, Reliability, Validity, Community Nursing

王楠, 安力彬, 宋泽超, 王熙, 李文涛. 照顾者内疚感量表的汉化及在老年痴呆患者家庭照顾者中的信效度检验[J]. 中华护理杂志, 2023, 58(4): 507-512.

WANG Nan, AN Libin, SONG Zechao, WANG Xi, LI Wentao. Validity and reliability test of the Chinese version of the Caregiver Guilt Questionnaire in caregivers of elderly patients with dementia[J]. Chinese Journal of Nursing, 2023, 58(4): 507-512.

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参考文献 28

[1]	任汝静, 殷鹏, 王志会, 等. 中国阿尔茨海默病报告2021[J]. 诊断学理论与实践, 2021, 20(4):317-337.
	Ren RJ, Yin P, Wang ZH, et al. China Alzheimer disease report 2021[J]. J Diagn Concepts & Pract, 2021, 20(4):317-337.
[2]	李峥. 老年痴呆相关概念辨析[J]. 中华护理杂志, 2011, 46(10):1045.
	Li Z. Discrimination of related concepts of senile dementia[J]. Chin J Nurs, 2011, 46(10):1045.
[3]	Zhang M, Chang YP, Liu YJ, et al. Burden and strain among familial caregivers of patients with dementia in China[J]. Issues Ment Health Nurs, 2018, 39(5):427-432. DOI URL
[4]	Spillers RL, Wellisch DK, Kim Y, et al. Family caregivers and guilt in the context of cancer care[J]. Psychosomatics, 2008, 49(6):511-519. DOI PMID
[5]	Conde-Sala JL, Garre-Olmo J, Turró-Garriga O, et al. Quality of life of patients with Alzheimer’s disease:differential perceptions between spouse and adult child caregivers[J]. Dement Geriatr Cogn Disord, 2010, 29(2):97-108. DOI URL
[6]	Corey KL, McCurry MK, Sethares KA, et al. Predictors of psychological distress and sleep quality in former family caregivers of people with dementia[J]. Aging Ment Health, 2020, 24(2):233-241. DOI PMID
[7]	Corey KL, McCurry MK. When caregiving ends:the experiences of former family caregivers of people with dementia[J]. Gerontologist, 2018, 58(2):e87-e96.
[8]	Losada A, Márquez-González M, Peñacoba C, et al. Development and validation of the Caregiver Guilt Questionnaire[J]. Int Psy-chogeriatr, 2010, 22(4):650-660.
[9]	Zarit SH, Reever KE, Bach-Peterson J. Relatives of the impai-red elderly:correlates of feelings of burden[J]. Gerontologist, 1980, 20(6):649-655. DOI PMID
[10]	Davis JD, Hill BD, Pillemer S, et al. Guilt after placement questionnaire:a new instrument to assess caregiver emotional functioning following nursing home placement[J]. Aging Ment Health, 2019, 23(3):352-356. DOI URL
[11]	Roach L, Laidlaw K, Gillanders D, et al. Validation of the Ca-regiver Guilt Questionnaire(CGQ) in a sample of British dementia caregivers[J]. Int Psychogeriatr, 2013, 25(12):2001-2010. DOI URL
[12]	Duggleby W, Thomas J, Montford K, et al. Transitions of male partners of women with breast cancer:hope,guilt,and quality of life[J]. Oncol Nurs Forum, 2015, 42(2):134-141. To (a) describe the types of transitions experienced by male spousal caregivers of women with breast cancer and the strategies used by male spouses to deal with these transitions and (b) examine factors related to their quality of life, including demographic variables, self-efficacy, caregiver guilt, hope, the quality of life of their partner with breast cancer, and transitions.Cross-sectional, transformational, mixed-methods approach.Participants' homes.105 dyads of male spouses and their female partners diagnosed with stages I-III breast cancer.600 surveys were mailed to women with breast cancer and their male partners. Significant variables were entered into a multivariate model.Male caregiver quality of life.The quality of life of male spouse participants was positively influenced by hope (p < 0.01). It was negatively influenced by caregiver guilt scores (p < 0.01) and the method of dealing with their transitions by "doing what needs to be done" (p = 0.04).The male caregivers with higher quality-of-life scores reported higher hope and lower caregiver guilt scores. They reported lower quality-of-life scores if they dealt with transitions by "doing what needs to be done." Strategies to support male spouses of women with breast cancer should involve ways to foster hope, reduce feelings of guilt, and encourage male caregivers to engage more in supporting their spouses. DOI PMID
[13]	Butler L. Caregiver wellbeing in psychosis services[D]. London: Canterbury Christ Church University, 2016
[14]	Jones PS, Lee JW, Phillips LR, et al. An adaptation of Brislin’s translation model for cross-cultural research[J]. Nurs Res, 2001, 50(5):300-304. DOI PMID
[15]	美国精神医学学会. 精神障碍诊断与统计手册[M]. 北京: 北京大学出版社, 2015.
	American Psychiatric Association. Diagnostic and statistical ma-nual of mental disorders[M]. Beijing: Peking University Press, 2015.
[16]	王烈, 杨小湜, 侯哲, 等. 护理者负担量表中文版的应用与评价[J]. 中国公共卫生, 2006, 22(8):970-972.
	Wang L, Yang XS, Hou Z, et al. Application and evaluation of Chinese version of Zarit Caregiver Burden Interview[J]. Chin J Public Health, 2006, 22(8):970-972.
[17]	吴明隆. 问卷统计分析实务SPSS操作与应用[M]. 重庆: 重庆大学出版社, 2010.
	Wu ML. Statistical analysis practice:operation and application of SPSS[M]. Chongqing: Chongqing University Press, 2010.
[18]	史静琤, 莫显昆, 孙振球. 量表编制中内容效度指数的应用[J]. 中南大学学报(医学版), 2012, 37(2):49-52.
	Shi JC, Mo XK, Sun ZQ. Content validity index in scale deve-lopment[J]. J Central South Univ Med Sci, 2012, 37(2):49-52.
[19]	倪青, 王祥生. 糖尿病中医临床路径与PRO构建方法与应用[M]. 北京: 科学技术文献出版社, 2016.
	Ni Q, Wang XS. Clinical pathway and PRO of diabetes mellitus:construction method and application[M]. Beijing: Scientific and Technical Documents Publishing House, 2016.
[20]	魏高文, 魏歆然. 医学统计设计与数据分析的SPSS应用[M]. 北京: 中国中医药出版社, 2020.
	Wei GW, Wei XR. Application of SPSS in medical statistical design and data analysis[M]. Beijing: China Traditional Chinese Medicine Press, 2020.
[21]	王志稳, 李小卫, 郝薇, 等. 痴呆老人愉悦性活动问卷的汉化及信效度检验[J]. 中华护理杂志, 2015, 50(5):522-526.
	Wang ZW, Li XW, Hao W, et al. The psychometric properties of the Chinese version of the Pleasant Events Schedule for older adults with dementia[J]. Chin J Nurs, 2015, 50(5):522-526.
[22]	胡雁. 护理研究[M]. 4版. 北京: 人民卫生出版社, 2012.
	Hu Y. Nursing research[M]. 4th ed. Beijing: People’s Medical Publishing House, 2012.
[23]	Velicer WF. Determining the number of components from the matrix of partial correlations[J]. Psychometrika, 1976, 41(3):321-327. DOI URL
[24]	万崇华, 许传志. 调查研究方法与分析新编[M]. 北京: 中国统计出版社, 2016.
	Wan CH, Xu CZ. Research methods and analysis:new edition[M]. Beijing: China Statistics Press, 2016.
[25]	何云峰, 惠中, 郑百伟. 现代基础教育研究[M]. 上海: 上海教育出版社, 2019.
	He YF, Hui Z, Zheng BW. Research on modern basic education[M]. Shanghai: Shanghai Educational Publishing House, 2019.
[26]	Eisinga R, Grotenhuis MT, Pelzer B. The reliability of a two-item scale:Pearson,Cronbach,or Spearman-Brown?[J]. Int J Public Health, 2013, 58(4):637-642. DOI PMID
[27]	冷敏敏, 赵雅洁, 李立玉, 等. 网络干预在痴呆老年人居家照护中应用的范围综述[J]. 中华护理杂志, 2021, 56(5):694-699. DOI
	Leng MM, Zhao YJ, Li LY, et al. Internet-based interventions for family care of older people with dementia:a scoping review[J]. Chin J Nurs, 2021, 56(5):694-699.
[28]	Cha ES, Kim KH, Erlen JA. Translation of scales in cross-cultural research:issues and techniques[J]. J Adv Nurs, 2007, 58(4):386-395. DOI URL