Measurement Properties of the Caregiver Reaction Assessment Scale: A Systematic Review and Meta-Analysis

IF 1.6 4区医学 Q4 GERIATRICS & GERONTOLOGY

International Journal of Older People Nursing Pub Date : 2025-04-05 DOI:10.1111/opn.70024

Wanting Luo, Minyan Liu, Yue Yao, Yanli Zeng

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引用次数: 0

Abstract

Background

The Caregiver Reaction Assessment Scale is a widely used tool for evaluating the experiences of informal caregivers of older adults. Despite its global application, researchers from different countries have reported varying psychometric properties for the CRA, and a comprehensive evaluation of its overall psychometric quality remains lacking. Given the increasing reliance on informal caregivers in ageing populations worldwide, understanding the reliability and validity of the CRA is critical for improving caregiver support and enhancing care outcomes for older adults.

Objectives

This study aims to (1) systematically review the psychometric properties of the CRA scale using the Consensus-based Standards for the Selection of Health Measurement Instruments methodology and (2) conduct a meta-analysis of Cronbach's alpha across different versions of the CRA scale to assess its internal consistency.

Methods

We systematically searched 10 electronic databases from their inception to May 17, 2024, with an update on February 13, 2025. Two researchers independently screened and extracted data. Methodological quality was assessed using the COSMIN checklist, and a random-effects meta-analysis of Cronbach's alpha was performed. Measurement properties were rated according to updated COSMIN standards, and the quality of evidence was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) system.

Results

A total of 21 studies were included in the review. The meta-analysis revealed acceptable internal consistency for the CRA scale, with Cronbach's alpha values ranging from 0.76 to 0.79. Based on COSMIN standards, one version of the CRA scale is recommended for use, 14 versions are weakly recommended and six versions do not meet validity or consistency standards.

Conclusion

The CRA scale is a reliable tool for assessing the experiences of informal caregivers of older adults and demonstrates potential for broader application in other informal caregiver groups. However, limited research on cross-cultural validity, stability, measurement error and criterion validity highlights the need for future studies to address these gaps by rigorously following COSMIN methodology.

Implications for Practice

The findings suggest that the CRA scale enables researchers and practitioners to more accurately assess the experiences of informal caregivers of older adults, facilitating targeted interventions and support. Future research should focus on localising the scale and testing its cultural adaptability for diverse caregiver populations, ensuring its relevance and effectiveness in global caregiving contexts.

Prospero ID

The review was registered on PROSPERO (registration number: CRD42024508176).

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照顾者反应评估量表的测量性质：系统回顾与元分析

照顾者反应评估量表是一种广泛使用的评估老年人非正式照顾者体验的工具。尽管CRA在全球范围内得到广泛应用，但不同国家的研究人员对其心理测量特性的研究存在差异，缺乏对其整体心理测量质量的综合评价。鉴于全球老龄化人口对非正式照顾者的依赖日益增加，了解CRA的可靠性和有效性对于改善照顾者支持和提高老年人的护理结果至关重要。本研究旨在(1)采用基于共识的健康测量工具选择标准方法，系统回顾CRA量表的心理测量特性；(2)对不同版本的CRA量表进行Cronbach's alpha元分析，以评估其内部一致性。方法系统检索10个电子数据库，检索时间自建库至2024年5月17日，更新时间为2025年2月13日。两名研究人员独立筛选和提取数据。使用COSMIN检查表评估方法学质量，并进行Cronbach’s alpha随机效应荟萃分析。根据更新的COSMIN标准对测量特性进行评级，并使用推荐、评估、开发和评价分级（GRADE）系统对证据质量进行评估。结果共纳入21项研究。meta分析显示CRA量表具有可接受的内部一致性，Cronbach's alpha值在0.76 - 0.79之间。根据COSMIN标准，CRA量表推荐使用1个版本，弱推荐14个版本，6个版本不符合有效性或一致性标准。结论CRA量表是评估老年人非正式照顾者体验的可靠工具，在其他非正式照顾者群体中具有推广应用的潜力。然而，在跨文化效度、稳定性、测量误差和标准效度方面的有限研究表明，未来的研究需要严格遵循COSMIN方法来解决这些差距。研究结果表明，CRA量表使研究人员和从业人员能够更准确地评估老年人非正式照顾者的经历，促进有针对性的干预和支持。未来的研究应侧重于本地化量表，并测试其对不同护理人群的文化适应性，以确保其在全球护理背景下的相关性和有效性。该评论已在Prospero上注册（注册号：CRD42024508176）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Older People Nursing Nursing-Gerontology

CiteScore

3.60

自引率

9.10%

发文量

期刊介绍： International Journal of Older People Nursing welcomes scholarly papers on all aspects of older people nursing including research, practice, education, management, and policy. We publish manuscripts that further scholarly inquiry and improve practice through innovation and creativity in all aspects of gerontological nursing. We encourage submission of integrative and systematic reviews; original quantitative, qualitative, and mixed methods research; secondary analyses of existing data; historical works; theoretical and conceptual analyses; evidence based practice projects and other practice improvement reports; and policy analyses. All submissions must reflect consideration of IJOPN''s international readership and include explicit perspective on gerontological nursing. We particularly welcome submissions from regions of the world underrepresented in the gerontological nursing literature and from settings and situations not typically addressed in that literature. Editorial perspectives are published in each issue. Editorial perspectives are submitted by invitation only.