Development and psychometric testing of the Bakas Caregiving Outcomes Scale

Nurs Res. 1999 Sep-Oct;48(5):250-9. doi: 10.1097/00006199-199909000-00005.


Background: Family caregivers of stroke survivors experience more depression, emotional problems, social inactivity, and general ill-health than noncaregiving individuals. While a number of instruments measure these variables in family caregivers, they are often too global, indicating the need for a situation-specific instrument measuring life changes resulting from providing care.

Objectives: To develop and psychometrically test the Bakas Caregiving Outcomes Scale (BCOS) measuring changes in family caregiving outcomes in the stroke population.

Method: 48 items were developed, with 27 being judged as content valid by a panel of five experts. Psychometric testing with two convenience samples of family caregivers of stroke survivors (ns = 92, 104) was conducted using item analysis, Cronbach's alpha, factor analysis, and hierarchical multiple regression.

Results: Item analysis in sample no. 1 resulted in a 12-item scale with alpha = .90. The scale was further shortened to a 10-item scale in sample no. 2 with alpha = .77. Unidimensionality was supported by factor analysis in both samples. Using hierarchical multiple regression, 63% of the variance of the 12-item BCOS in sample no. 1, and 45% of the variance of the 10-item BCOS in sample no. 2 was accounted for by the constructs in the conceptual model. Criterion-related validity was supported in both samples by significant correlations with the LIFE-3 and a criterion variable with the same response format as the BCOS. Significant BCOS correlations with the SF-36 Health Survey subscales in sample no. 2 provided further evidence of criterion-related validity.

Conclusion: The 10-item BCOS is a brief, easy to administer instrument that has evidence of reliability and validity in family caregivers of stroke survivors. The 10-item BCOS could serve as a valuable measure in research, as well as an assessment tool to identify family caregivers in need of intervention.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Caregivers / psychology*
  • Cerebrovascular Disorders / therapy*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Needs Assessment*
  • Outcome Assessment, Health Care / statistics & numerical data*
  • Psychometrics
  • Reproducibility of Results