Abstract
BACKGROUND: Interventions for people with chronic illness have increasingly got involvement and partnership with family members in China and worldwide. The patient-family interactions in chronic illness care can greatly influence not only family dyadic relationship or collaboration in caregiving but also both patient's and caregiver's health and well-being. To date, very few instruments have been developed to measure the family dyadic relationship; and none has been found in Chinese language. This study aimed to translate the original English Dyadic Relationship Scales (DRS), including DRS-patient and DRS-caregiver, into simplified Chinese language (DRS-C) and examine their psychometric properties in Chinese people with hypertension in a rural community. METHODS: The Brislin's model of translation was adopted for translation. Face and content validity and semantic equivalence of the translated Chinese version of the two DRS-patient and DRS-caregiver scales were examined. A sample of 132 adults with hypertension and their family caregivers were recruited to test the psychometric properties of the DRS-C scales. RESULTS: The DRS-C scales indicated very satisfactory face validity with 10 family dyads in hypertension care, content validity rated by five experts (Item CVI = 0.8-1.0; Scale CVI = 0.98) and semantic equivalence rated by 22 panel members (i.e., all items were rated as 3 = relevant or 4 = very relevant by > 18 members). A well-fitting model of DRS-C-patient was identified with χ(2)/df = 1.47, p = 0.04, RMSEA = 0.06, GFI = 0.941, CFI = 0.961, TLI = 0.947, and SRMR = 0.019. A well-fitting model of DRS-C-caregiver was identified with χ(2)/df = 1.340, p = 0.092, RMSEA = 0.039, GFI = 0.940, CFI = 0.975, TLI = 0.965, and SRMR = 0.014. The Chinese DRS-patient and DRS-caregiver had satisfactory internal consistency with Cronbach's α coefficients of 0.82 and 0.83, respectively, and test-retest reliabilities with intra-correlation coefficients of 0.97 and 0.96, respectively. The convergent validities of the Chinese versions of the DRS-patient and DRS-caregiver were very satisfactory with the self-efficacy subscale of Hypertension Self-Care Profile, and Zarit Burden Interview, respectively (Pearson's r = - 0.70 and 0.79; both p < 0.001). Significant differences on mean scores of the Chinese versions of the DRS-patient (t = - 8.10, p < 0.001) and the DRS-caregiver (t = - 9.15, p < 0.001), between the groups of adults with hypertension and normal blood pressure counterparts. CONCLUSION: Both Chinese versions of the DRS-patient and DRS-caregiver have sound psychometric properties and similar factor structure to the original English version. The Chinese versions can be valid measures of family dyadic relationship among Chinese adults with hypertension.