title: Validation of the revised Bakas Caregiving Outcomes Scale in Greek caregivers of patients with advanced cancer receiving palliative radiotherapy.
abstract: OBJECTIVE
  Caregiver burden considerably affects the lives of families providing care to people with advanced cancer. The aim of this study was to validate the Greek translation of the revised Bakas Caregiving Outcomes Scale (BCOS) with a sample of informal caregivers of people with advanced cancer receiving outpatient palliative radiotherapy.
  
  
  METHODS
  Following a formal "forward-backward" method to translate the original BCOS into Greek, the scale was administered to 100 consecutive family caregivers. Participants also completed the Greek Hospital Anxiety and Depression Scale (G-HADS) and five quality-of-life related linear analogue scale assessment (LASA) scales. Validity and reliability analyses were performed.
  
  
  RESULTS
  The Cronbach's α coefficient for the total BCOS score was 0.83. Test-retest reliability analysis in a subgroup of caregivers (n = 40) revealed good short-term stability over a 2-week interval. Exploratory factor analysis generated a one-factor structure for the Greek translation, which was further confirmed through confirmatory factor analysis. Construct validity was supported through the scale's high correlations with G-HADS anxiety (-0.524; p < 0.001) and depression (-0.533; p < 0.001) scores, and LASA quality of life scores (0.696; p < 0.001). The BCOS discriminated well between groups of caregivers with different levels of quality of life. A total score of 52.5 offered high sensitivity (91 %) and specificity (86 %) in detecting highly burdened caregivers.
  
  
  CONCLUSIONS
  The Greek version of the BCOS is a psychometrically sound instrument that can be usefully implemented into clinical practice to identify family caregivers in need for support, and stimulate relevant research in our country.
authors.affiliation: Faculty of Nursing, Technological Educational Institute of Athens, Agiou Spiridonos 28, 122 10, Athens, Greece. ugovina@teiath.gr
authors.forename: Ourania
authors.initials: O
authors.lastname: Govina
authors.forename: Grigorios
authors.initials: G
authors.lastname: Kotronoulas
authors.forename: Kyriaki
authors.initials: K
authors.lastname: Mystakidou
authors.forename: Margarita
authors.initials: M
authors.lastname: Giannakopoulou
authors.forename: Antonios
authors.initials: A
authors.lastname: Galanos
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Patiraki
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000553:Ambulatory Care / Q000379:methods; D017028:Caregivers / Q000523:psychology*; D003430:Cross-Sectional Studies; D005163:Factor Analysis, Statistical; D005260:Female; D006115:Greece; D006801:Humans; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000532:radiotherapy*; D017063:Outcome Assessment, Health Care; D010166:Palliative Care / Q000379:methods / Q000523:psychology*; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D011594:Psychometrics; D011788:Quality of Life; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D011795:Surveys and Questionnaires; D013997:Time Factors