title: Measuring health and well-being effects in family caregivers of children with craniofacial malformations.
abstract: OBJECTIVE
  This research explores the sensitivity of three generic instruments for preference-weighting health states of family caregivers of children with craniofacial malformations (CFM). We also examine the construct validity of the new CarerQol instrument measuring caregiver burden and general quality of life.
  
  
  METHODS
  Caregivers of children born with CFM were identified through the Arkansas Reproductive Health Monitoring System. A mailed survey included the HUI3, the SF-6D, the QWB-SA to measure health-related quality of life; the CES-D measuring depressive symptoms as well as the SRB scale, and the CarerQol. The HUI3, the SF-6D, and the QWB-SA were examined in relation to the CES-D the SRB, the CarerQol, and each other.
  
  
  RESULTS
  A total of 65 (63%) parents of children (≤17 years) responded. The mean SF-6D, HUI3, and QWB-SA scores were 0.81 (SD = 0.13), 0.84 (SD = 0.23), and 0.67 (SD = 0.14), respectively. The mean CES-D score was 13.3 (SD = 13.4) and 28.6% of the sample met a threshold for depressive symptoms (CES-D ≥ 16). The mean CarerQol-VAS and SRB scores were 7.5 (SD = 2.3) and 15.1 (SD = 23.5), respectively. The Spearman correlations (ρ) of the HUI3 and the SF-6D with the CES-D were similar (-0.81 and -0.76) while the ρ was lower (-0.57) for the QWB-SA. Preference-weighted scores of caregivers with CES-D scores ≥ 16 differed significantly for both the SF-6D and the HUI3, but not the QWB-SA. All three generic instruments showed moderate to strong relationships with the CarerQol.
  
  
  CONCLUSIONS
  The HUI3 and SF-6D were more sensitive predictors of depressive symptoms in this caregiver sample than was the QWB-SA. The CarerQol showed good construct validity and may be useful for measuring well-being effects associated with caregiving.
authors.affiliation: Division of Pharmaceutical Evaluation and Policy, Department of Pharmacy Practice, University of Arkansas for Medical Sciences, 4301 W. Markham St., #522, Little Rock, AR 72205, USA. npayakachat@uams.edu
authors.forename: Nalin
authors.initials: N
authors.lastname: Payakachat
authors.forename: J Mick
authors.initials: JM
authors.lastname: Tilford
authors.forename: Werner Bf
authors.initials: WB
authors.lastname: Brouwer
authors.forename: N Job
authors.initials: NJ
authors.lastname: van Exel
authors.forename: Scott D
authors.initials: SD
authors.lastname: Grosse
mesh_terms: D000328:Adult; D001131:Arkansas; D017028:Caregivers / Q000523:psychology*; D002675:Child, Preschool; D019465:Craniofacial Abnormalities / Q000451:nursing*; D003430:Cross-Sectional Studies; D019988:Children with Disabilities; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010549:Personal Satisfaction; D011446:Prospective Studies; D011788:Quality of Life; D013315:Stress, Psychological / Q000175:diagnosis; D011795:Surveys and Questionnaires; D055815:Young Adult