第24屆 海報式論文醫療類【中文版照顧兒童難易度量表於腦性麻痺兒童之信效度初步研究 Traditional Chinese Version of the Ease of Caregiving for Children Measure (Version 2) in Children with Cerebral Palsy: Translation, Cros

賴靜暄¹、劉文瑜^1,2*、葉國光^1,2、徐琳雅³、汪世婕²、陳姵亘¹
Ching-Hsuan Lai¹, Wen-Yu Liu^1,2*, Kuo-Kuang Yeh^1,2, Lin-Ya Hsu³, Shih-Chieh Wang², Pei-Hsuan Chen¹

¹長庚大學醫學院物理治療學系、
²林口長庚紀念醫院復健科、
³美國華盛頓大學(西雅圖)復健醫學系
¹Department of Physical Therapy, Chang Gung University, Taoyuan, Taiwan,
²Department of Physical Medicine and Rehabilitation, Chang Gung Medical Foundation, Linkou Medical Center, Taoyuan, Taiwan,
 ³Department of Rehabilitation Medicine, University of Washington Seattle, USA

Background and Purpose:Cerebral palsy (CP) describes a group of permanent disorders affecting the development of movement and posture, leading to limitations in activities. Consequently, children with CP often require more physical assistance for self-care tasks from their caregivers compared to children without motor delays. The physical demands of caregiving have been noted to influence the physical health and overall well-being of caregivers (Raina et al, 2005). The Ease of Caregiving for Children Measure, developed by Chiarello et al. (2013), is a reliable, valid, and feasible tool for assessing the physical caregiving by parents of children with CP. Ward et al. (2014) conducted testing of the Ease of Caregiving for Children Measure, involving 429 parents of children with CP and 110 parents of children without motor delay. The calculated Cronbach's alpha coefficient of 0.92 demonstrated a high internal consistency among the items. Additionally, among the subset of the 33 parents who completed the measure twice, the interclass correlation coefficient ICC_(2,1) of 0.76 (95% CI: 0.56–0.87) indicates acceptable test-retest reliability. Chiarello et al. (2017) revised it to the second version. Alghamdi et al. (2020) undertook a re-validation of the psychometric properties of this measure. The study involved 613 parents of children with CP ranging in age from 1.5 to 11 years. The calculated ICC_(2,1) was 0.69 (95% CI, 0.52–0.81), indicating good reliability. In terms of construct validity, it was observed that among parents of children with CP, parents of children with higher motor abilities demonstrated greater ease of caregiving than parents of children with lower motor abilities. The Ease of Caregiving for Children Measure has been translated into various multiple languages, such as Turkish, Arabic, and Japanese. Notably, the Arabic version exhibited a high level of internal consistency, as evidenced by Cronbach’s alpha values of 0.91. Furthermore, this version demonstrated excellent test-retest reliability, with an ICC_(3,1) was 0.96 (95 % CI, 0.91–0.98). Currently, there is no existing Traditional Chinese version tailored for the Chinese population. Therefore, the primary objective of this study was to undertake a cross-culturally adaptation of the Ease of Caregiving for Children Measure (Version 2) into Traditional Chinese. Additionally, the study aimed to delve into the clinimetric properties of this adapted measure within the context of the Chinese population.

Methods: Modified the cross-cultural adaptation procedure outlined by Beaton et al. (2000) to incorporate the participation of three experts for the evaluation of content validity. Using the content validity index (CVI) results as a guide, modifications were introduced to certain items and descriptions within the measure, guided by feedback from three experts, in preparation for subsequent assessments of reliability and validity. A total cohort of 12 parents/caregivers of children aged from 6 to 12 years with CP, residing in northern Taiwan, has been recruited for participation. Reliability was assessed through the analysis of internal consistency using Cronbach's alpha, where a value of 0.90 or higher signifies strong internal consistency. Spearman correlation coefficients were computed to analyze the relationships among the Ease of Caregiving for Children Measure (Version 2), the Gross Motor Function Classification System (GMFCS) levels, the Manual Ability Classification System (MACS) levels, and Communication Function Classification System (CFCS) levels, aiming to assess discriminant validity. Spearman's correlation coefficients of

Results: Regarding content validity, the scale-level content validity index based on the universal agreement method (S-CVI/UA) for relevancy, clarity, and simplicity were 0.92, 0.42, and 0.81, respectively. The calculated Cronbach's alpha coefficient of 0.92 demonstrated a high internal consistency among the items. The correlation between scaled scores of the Ease of Caregiving for Children Measure (Version 2) and GMFCS, MACS, and CFCS levels was -0.63, -0.74, and -0.74, respectively, indicating a strong correlation between this measure and three classification system levels.

Conclusions:Due to the limited sample size, drawing definitive conclusions from the current study is premature; however, based on the existing data, it is suggested that the Traditional Chinese of the Ease of Caregiving for Children Measure (Version 2) has the potential to be a reliable, valid, and feasible tool for assessing the physical caregiving provided by parents of children with CP. In the future, more participants will continue to be recruited, and the completion of test-retest reliability will be carried out.

Keywords: psychometrics, cerebral palsy, ease of caregiving for children measure