Mandarin Chinese Translation and Cultural Adaptation of the Caregiver Analysis of Reported Experiences With Swallowing Disorders Screening Tool

Am J Speech Lang Pathol. 2025 Jan 6:1-15. doi: 10.1044/2024_AJSLP-23-00492. Online ahead of print.

Abstract

Purpose: The caregiver burden of individuals with dysphagia is a major concern. Currently, assessment tools specifically designed for this population are lacking. The present study aimed to translate the Caregiver Analysis of Reported Experiences with Swallowing Disorders (CARES) Questionnaire into Mandarin Chinese and evaluate its psychometric properties.

Method: This study analyzed the psychometric properties of the Mandarin Chinese version of the CARES questionnaire using classical measurement theory and Rasch model analysis.

Results: Classical measurement theory: The item-level content validity index of the Mandarin Chinese version of the CARES questionnaire ranged from .83 to 1.00, and the scale-level content validity index ranged from .93 to .95. The correlation coefficient between the total scores, subscale scores of the CARES questionnaire, and Zarit Caregiver Burden Interview scores was between .82 and .87 (p < .01). There were significant relationships between dysphagia-specific burden (CARES) and perceived swallowing impairment (Eating Assessment Tool-10) and diet restrictiveness (International Dysphagia Diet Standardisation Initiative Functional Diet Scale). The overall Cronbach's α coefficient of the Mandarin Chinese version of the CARES questionnaire was .81. Item response theory: The Mandarin Chinese version of the CARES questionnaire was unidimensional. The item difficulty and individual ability were evenly distributed. The total item reliability was .96, the person reliability was .79, the item separation index was 4.95, and the person separation index was 1.93.

Conclusion: The Mandarin Chinese version of the CARES questionnaire demonstrates satisfactory reliability and validity and can be utilized as a specific assessment tool for evaluating the informal caregiver burden of individuals with dysphagia.