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Presentation

Session: Posters
Room: TBA
Time: Fri 13:00-14:30

Presenter: Renske Hoefman (Erasmus University Rotterdam. Institute for Medical Technology Assessment / Department of Health Policy and Management)

Abstract

Rationale
In general, informal care is still ignored in economic evaluations of health care interventions at risk of informing policymakers with unrealistic cost-effectiveness information. In specific, little attention is paid to caregivers who provide support to their loved ones who receive day care from a nursing home or who are permanent residents of this care institution. Although most of the personal care and nursing activities are handed over to professional caregivers, informal caregivers continue to be involved in the care giving process. Hence caring for a loved one may still burden these informal caregivers.

Objectives
The recently developed CarerQol instrument provides a tool to include effects of informal care in economic evaluations by measuring and valuing these effects. The CarerQol has been validated once in a heterogeneous sample of informal caregivers. This paper provides insight in the burden experienced by a specific group of caregivers; carers of institutionalized elderly. This paper reports on the convergent, clinical validity and test-retest reliability of the CarerQol of this atypical group.

Methods
Data was obtained with written questionnaires distributed by mail to informal caregivers of residents and day care users of a nursing home in the Netherlands (n=319, brute response rate=39.18). A second questionnaire was sent at a two week interval for test-retest purposes (brute response rate=28.16).
Spearman's correlation coefficients were used to assess the convergent validity of the two parts of the CarerQol; the seven descriptive burden dimensions (CarerQol-7D) and the valuation component of general happiness (CarerQol-VAS). Convergent validity was also assessed by the correlation between this instrument and two other measures of subjective burden of care giving; self-rated burden (SRB) and self-rated care giving situation (CS).
Clinical validity was evaluated by the multivariate correlation between CarerQol-VAS and CarerQol-7D, characteristics of caregivers, care recipients and care situation.
Test-retest reliability was assessed with percentages of complete agreement, kappa statistics (κ values) and intraclass correlation coefficients (ICC).

Results
Results on convergent validity of the CarerQol confirm earlier research. The burden dimensions of the CarerQol-7D were negatively associated with CarerQol-VAS scores. In addition, SRB was negatively and CS was positively associated with CarerQol-VAS.
Preliminary results show that the CarerQol is clinically useful among this subgroup of caregivers. Type of relationship between caregiver and care recipient, health of the caregiver and intensity of care giving seemed explanatory factors of CarerQol-VAS.
The CarerQol has relatively good test-retest reliability, based on κ values and ICCs between 0.55 and 0.94 for all items of the instrument.

Conclusions
The CarerQol seems a valid instrument to assess the burden of care giving in caregivers of institutionalized elderly. Hence this instrument may be used to incorporate informal care effects in economic evaluations, especially when in future research valuation scores of the CarerQol-7D will be obtained.

Key Terms

Economic evaluations, Informal care, Psychometric properties, Institutionalized elderly, CarerQol instrument

Authors:

Renske Hoefman (Erasmus University Rotterdam. Institute for Medical Technology Assessment / Department of Health Policy and Management) , Job van Exel (Erasmus University Rotterdam. Institute for Medical Technology Assessment / Department of Health Policy and Management) and Werner Brouwer (Erasmus University Rotterdam. Institute for Medical Technology Assessment / Department of Health Policy and Management)

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