title: Caregiving Consequences Inventory: a measure for evaluating caregiving consequences from the bereaved family member's perspective.
abstract: OBJECTIVE
  The aims of this study were to validate an instrument for measuring bereaved family members' perceptions of caregiving consequences and to examine the association between caregiving consequences and psychological distress.
  
  
  METHODS
  Cross-sectional questionnaires were administered to family members of patients who had died in regional cancer centers. We measured the Caregiving Consequences Inventory (CCI), respondent's optimism, overall reward scale, and psychological distress and collected background data. A retest was conducted.
  
  
  RESULTS
  Bereaved families from two regional cancer centers were surveyed (N=189 and 109; effective response rate, 57 and 80%). By exploratory and confirmatory factor analyses, we identified four perceived reward domains: 'mastery', 'appreciation for others', 'meaning in life', and 'reprioritization', and one perceived burden domain. Although the four reward domains were highly correlated with each other (0.47<r<0.69), the 4-domain model was superior. The respondents with less education, strong faith, and less optimism reported fewer perceived rewards, thus demonstrating known group validity. In addition, perceived reward had little or no correlation with psychological distress. The psychometric properties of this scale were good (alpha=0.78-0.93, ICC=0.60-0.73) and construct validity was supported (GFI=0.929; AGFI=0.819; CFI=0.749; RMSEA=0.097).
  
  
  CONCLUSIONS
  The CCI is valid for measuring caregiving consequences from the bereaved family member's perspective in Japan. Furthermore, it is important to use perceived rewards and burdens as a measure of caregiving consequences for improving the quality of the caregiving and bereavement experience.
authors.affiliation: Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan. shibagaki-tky@umin.ac.jp
authors.forename: Makiko
authors.initials: M
authors.lastname: Sanjo
authors.forename: Tatsuya
authors.initials: T
authors.lastname: Morita
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.forename: Mariko
authors.initials: M
authors.lastname: Shiozaki
authors.forename: Kazuki
authors.initials: K
authors.lastname: Sato
authors.forename: Kei
authors.initials: K
authors.lastname: Hirai
authors.forename: Yasuo
authors.initials: Y
authors.lastname: Shima
authors.forename: Yosuke
authors.initials: Y
authors.lastname: Uchitomi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000175:diagnosis / Q000523:psychology; D001601:Bereavement; D002173:Cancer Care Facilities; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D003863:Depression / Q000175:diagnosis / Q000523:psychology; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000523:psychology*; D006306:Health Surveys; D006801:Humans; D007564:Japan; D008175:Lung Neoplasms / Q000523:psychology*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care / Q000523:psychology; D010555:Personality Inventory / Q000706:statistics & numerical data*; D011594:Psychometrics / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D012201:Reward