Translation, cultural adaptation, and psychometric validation of the Persian caregiver empowerment scale for stroke survivors for use in Iran.

Abstract

BACKGROUND: Empowering family caregivers (FCGs) of stroke survivors can improve the quality of care they provide and reduce their stress levels. This study focused on translating, culturally adapting and testing the Persian version of Caregiver Empowerment Scale (CES) for FCGs of stroke survivors. METHODS: This methodological investigation was conducted in two large hospitals in Tehran, Iran, during the 2024–25 academic year. It comprised the following five steps: First, the CES was translated. Secondly, face validity was evaluated with 20 FCGs. Third, content validity was examined with ten experts. Fourthly, construct validity was assessed via exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with 150 and 165 FCGs, respectively. Data analysis was performed using SPSS 26 and the lavaan package in R at a significance level of 0.05. RESULTS: After translating the CES into Persian, face validity confirmed that all items were clear and consistent, and none required removal. However, a quantitative content validity analysis led to the removal of items 28, 29 and 30 due to a low content validity ratio and index. EFA retained 25 items, which had loadings ranging from 0.438 to 0.918. Two items (1 and 19) were removed because their loadings were below 0.43. Four components were extracted — Personal, Social, Adaptive and Informational Self-Efficacy — explaining 80.66% of the total variance. Confirmatory factor analysis (CFA) confirmed the fit of the four-factor model (TLI = 0.903, df = 266, RMSEA = 0.077, SRMR = 0.065, CFI = 0.914). Cronbach’s alpha, McDonald’s omega coefficients and the intraclass correlation coefficient (ICC) were all above 0.90, indicating high reliability. CONCLUSIONS: The findings showed that the Persian version of the 25-item CES for Stroke Survivors is both valid and reliable. This tool allows healthcare providers to evaluate the empowerment of FCGs and identify training requirements for targeted interventions.