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caregivers, heart failure, quality of life, outcomes assessment, psychometrics



  1. Nauser, Julie A. PhD, RN
  2. Bakas, Tamilyn DNS, RN, FAHA, FAAN
  3. Welch, Janet L. DNS, RN


Background and Purpose: Family caregivers of heart failure (HF) patients experience poor physical and mental health leading to poor quality of life. Although several quality-of-life measures exist, they are often too generic to capture the unique experience of this population. The purpose of this study was to evaluate the psychometric properties of the Family Caregiver Quality of Life (FAMQOL) Scale that was designed to assess the physical, psychological, social, and spiritual dimensions of quality of life among caregivers of HF patients.


Sample and Methods: Psychometric testing of the FAMQOL with 100 HF family caregivers was conducted using item analysis, Cronbach [alpha], intraclass correlation, factor analysis, and hierarchical multiple regression guided by a conceptual model. Caregivers were predominately female (89%), white, (73%), and spouses (62%).


Results: Evidence of internal consistency reliability ([alpha] = .89) was provided for the FAMQOL, with item-total correlations of 0.39 to 0.74. Two-week test-retest reliability was supported by an intraclass correlation coefficient of 0.91. Using a 1-factor solution and principal axis factoring, loadings ranged from 0.31 to 0.78, with 41% of the variance explained by the first factor (eigenvalue = 6.5). With hierarchical multiple regression, 56% of the FAMQOL variance was explained by model constructs (F8,91 = 16.56, P < .001). Criterion-related validity was supported by correlations with SF-36 General (r = 0.45, P < .001) and Mental (r = 0.59, P < .001) Health subscales and Bakas Caregiving Outcomes Scale (r = 0.73, P < .001). Evidence of internal and test-retest reliability and construct and criterion validity was provided for physical, psychological, and social well-being subscales.


Conclusions: The 16-item FAMQOL is a brief, easy-to-administer instrument that has evidence of reliability and validity in HF family caregivers. Physical, psychological, and social well-being can be measured with 4-item subscales. The FAMQOL scale could serve as a valuable measure in research, as well as an assessment tool to identify caregivers in need of intervention.