Validation of the Holistic Comfort Questionnaire- caregiver in Portuguese-Brazil in a cohort of informal caregivers of palliative care cancer patients

The aims of this study were to perform a cross-cultural adaptation and to assess the psychometric properties of the Portuguese (Brazil) version of the Holistic Comfort Questionnaire-caregiver (HCQ-caregiver) in a sample of family caregivers (FCs) of palliative care (PC) cancer patients. The HCQ-caregiver was applied by a trained interviewer to a sample of 150 FCs of PC patients with advanced cancer; 50 participants were subjected to a retest 2 to 7 days after the initial test. The mean score, ceiling and floor effects, and skewness of each HCQ-caregiver item were measured. The instrument's internal consistency was assessed by means of Cronbach's alpha, and the test-retest reliability was assessed using the intraclass correlation coefficient (ICC). The convergent validity was assessed through the correlation between HCQ-caregiver and quality of life scores. Scores on the HCQ-caregiver were compared (discriminant validity) as a function of treatment setting and FC's self-perception of emotional health. A ceiling effect was found in 19 items, four of which exhibited maximum response rates above 90 % and inadequate results regarding skewness. Cronbach's alpha was 0.858, and the ICC was 0.961. The scores on the HCQ-caregiver exhibited moderate-to-strong correlations with the scores of quality of life. The FCs' perceptions of comfort did not differ as a function of the treatment setting but were greater when the FCs had a better self-perception of their emotional health. The present study demonstrates the validity and reliability of the Brazilian version of the HCQ-caregiver.