Validación en población española de la entrevista de carga familiar objetiva y subjetiva (ECFOS-II) en familiares de pacientes con esquizofrenia / Validation in Spanish population of the family objective and subjective burden interview (ECFOS-II) for relatives of patients with schizophrenia

Introducción. La carga familiar experimentada por los cuidadores de personas afectas de esquizofrenia constituye una de las consecuencias más relevantes del trastorno. Debido a esto se ha llevado a cabo la validación de la versión castellana del instrumento Family Burden Interview Schedule (FBIS), de carga familiar objetiva y subjetiva para personas con esquizofrenia. Método. Diseño: estudio de corte transversal. Participantes: se evaluaron 356 pacientes con diagnóstico DSM-IV de esquizofrenia de cuatro áreas geográficas españolas (Barcelona, Madrid, Pamplona y Granada) y 205 cuidadores principales de estos pacientes. Material: Entrevista de Carga Objetiva y Subjetiva ECFOS-II, que mide la carga familiar en ocho módulos distintos: actividades de la vida cotidiana, contención, comportamientos alterados, gastos, rutina del cuidador, preocupación, ayuda, repercusión en la salud y evaluación del nivel de carga global. Además se evaluaron a los pacientes con la PANSS, la DAS-sv y el EEAG. Análisis estadístico: para evaluar la consistencia interna se utilizaron las pruebas paramétricas de alfa de Cronbach. Para el cálculo de la fiabilidad test-retest se utilizó el coeficiente kappa de Cohen y el kappa ponderado. Se realizó un análisis de componentes principales con el fin valorar la validez de constructo. Asimismo, la validación convergente fue evaluada con el coeficiente de correlación de Spearman y de Pearson, relacionando el instrumento con escalas psicopatológicas (PANSS), de discapacidad (DAS-sv) y de funcionamiento general (EEAG). Por último se describió la viabilidad del ECFOS-II a través de un cuestionario elaborado al efecto. Resultados. Los coeficientes de alfa de Cronbach fueron de 0,85 para la entrevista global. Los coeficientes estudiados para la fiabilidad test-retest fueron muy altos, tanto para el kappa de Cohen como para el kappa ponderado, situándose los valores en la mayoría de los casos entre 0,61 y 1. El análisis de componentes principales detectó cuatro factores que coinciden con los módulos del cuestionario original. En la evaluación de la validez convergente encontramos que estos factores están relacionados con las características sintomatológicas, de discapacidad y de funcionamiento general del paciente. Conclusiones. El ECFOS-II se muestra como un instrumento válido y fiable en su versión castellana para evaluar la carga familiar existente en los cuidadores de personas con esquizofrenia

Introduction. The family burden experienced by caregivers of people with schizophrenia is one of the most relevant consequences of this disorder. This paper aims to show the validity and reliability of the Spanish version of the Family Burden Interview Schedule (FBIS) designed to assess objective and subjective family burden for people with schizophrenia. Method. Design: cross sectional study. Participants: 356 patients fulfilling DSM-IV criteria for schizophrenia from four Spanish geographic areas (Barcelona, Madrid, Pamplona and Granada) and 205 main caregivers of these patients were assessed. Material: caregivers were assessed with the Family Burden Interview Schedule (FBIS) Spanish version (ECFOS-II), which assesses family burden in eight different modules: activities of daily living, disrupted behaviors restraint, expenses, caregiver’s routine, concern, help, repercussions on health, and assessment of general burden. Patients were also assessed with PANSS, DAS-sv and GAF. Statistical analysis: in order to assess internal consistency, parametrical tests of Cronbach’s alpha were undertaken. To compute test-retest reliability Cohen’s kappa and Weighted kappa were used. A principal component analysis was undertaken for assessing construct validity. Convergent validity was assessed with Spearman and Pearson correlation coefficients respectively, relating the instrument with the psychopathological (PANSS) and disability scale (DAS-sv) and general functioning (GAF). Moreover, a description of the viability of the ECFOS-II was described by a questionnaire especially designed for this purpose. Results. Cronbach’s Alpha coefficient was 0.85 for the global assessment. Test-retest coefficients were very high, both for Cohen’s kappa and for Weighted kappa, most values being between 0.61 and 1. Principal component analysis detected four factors that coincide with the modules of the original schedule. In the convergent validity we found that these factors are related with the symptom, disability and global functioning characteristics of the patients. Conclusions. ECFOS-II results in a valid and reliable instrument for assessing family burden experienced by caregivers of people with schizophrenia

Validation in Spanish population of the family objective and subjective burden interview (ECFOS-II) for relatives of patients with schizophrenia.

INTRODUCTION: The family burden experienced by caregivers of people with schizophrenia is one of the most relevant consequences of this disorder. This paper aims to show the validity and reliability of the Spanish version of the Family Burden Interview Schedule (FBIS) designed to assess objective and subjective family burden for people with schizophrenia. DESIGN: cross sectional study. PARTICIPANTS: 356 patients fulfilling DSM-IV criteria for schizophrenia from four Spanish geographic areas (Barcelona, Madrid, Pamplona and Granada) and 205 main caregivers of these patients were assessed. MATERIAL: caregivers were assessed with the Family Burden Interview Schedule (FBIS) Spanish version (ECFOS-II), which assesses family burden in eight different modules: activities of daily living, disrupted behaviors restraint, expenses, caregiver's routine, concern, help, repercussions on health, and assessment of general burden. Patients were also assessed with PANSS, DAS-sv and GAF. STATISTICAL ANALYSIS: in order to assess internal consistency, parametrical tests of Cronbach's alpha were undertaken. To compute test-retest reliability Cohen's kappa and Weighted kappa were used. A principal component analysis was undertaken for assessing construct validity. Convergent validity was assessed with Spearman and Pearson correlation coefficients respectively, relating the instrument with the psychopathological (PANSS) and disability scale (DAS-sv) and general functioning (GAF). Moreover, a description of the viability of the ECFOS-II was described by a questionnaire especially designed for this purpose. RESULTS: Cronbach's alpha coefficient was 0.85 for the global assessment. Test-retest coefficients were very high, both for Cohen's kappa and for Weighted kappa, most values being between 0.61 and 1. Principal component analysis detected four factors that coincide with the modules of the original schedule. In the convergent validity we found that these factors are related with the symptom, disability and global functioning characteristics of the patients. CONCLUSIONS: ECFOS-II results in a valid and reliable instrument for assessing family burden experienced by caregivers of people with schizophrenia.