Measuring cancer caregiver health literacy: Validation of the Health Literacy of Caregivers Scale-Cancer (HLCS-C) in an Australian population.
Caregivers have been largely neglected in health literacy measurement. We assess the construct validity, and internal consistency of the Health Literacy of Caregivers Scale-Cancer (HLCS-C), and present a revised, psychometrically robust scale. Using data from 297 cancer caregivers (12.4% response rate) recruited from Melbourne, Australia between January-July 2014, confirmatory factor analysis (CFA) was conducted to evaluate the HLCS-C's proposed factor structure. Items were evaluated for: item difficulty, unidimensionality and overall item fit within their domain. Item-threshold-ordering was examined though one-parameter Item Response Theory models. Internal consistency was assessed using Raykov's reliability coefficient. CFA results identified 42 poorly performing/redundant items which were subsequently removed. A 10-factor model was fitted to 46 acceptable items with no correlated residuals or factor cross-loadings accepted. Adequate fit was revealed (χ2WLSMV  = 1463.807[df = 944], p < .001, RMSEA = 0.043, CFI = 0.980, TLI = 0.978, WRMR = 1.00). Ten domains were identified: Proactivity and determination to seek information; Adequate information about cancer and cancer management; Supported by healthcare providers (HCP) to understand information; Social support; Cancer-related communication with the care recipient (CR); Understanding CR needs and preferences; Self-care; Understanding the healthcare system; Capacity to process health information; and Active engagement with HCP. Internal consistency was adequate across domains (0.78-0.92). The revised HLCS-C demonstrated good structural, convergent, and discriminant validity, and high internal consistency. The scale may be useful for the development and evaluation of caregiver interventions.
['Yuen|Eva|E|0000-0002-7956-5797', 'Knight|Tess|T|', 'Dodson|Sarity|S|', 'Chirgwin|Jacqueline|J|', 'Busija|Lucy|L|', 'Ricciardelli|Lina A|LA|', 'Burney|Susan|S|', 'Parente|Phillip|P|', 'Livingston|Patricia M|PM|']
D000293:Adolescent D000328:Adult D000368:Aged D000369:Aged, 80 and over D001315:Australia D017028:Caregivers D054626:Consumer Health Information D005163:Factor Analysis, Statistical D005260:Female D057220:Health Literacy D006801:Humans D008297:Male D008875:Middle Aged D009369:Neoplasms D011594:Psychometrics D015203:Reproducibility of Results D012648:Self Care D012944:Social Support D011795:Surveys and Questionnaires D055815:Young Adult
cancer caregivers health literacy confirmatory factor analysis psychometric assessment questionnaire development