Psychometric properties of the heart failure caregiver burden questionnaire among Korean family caregivers: a methodological study

Heart failure (HF) can limit the capacity of patients to perform daily activities, increasing their dependence on caregivers and contributing to significant caregiver burden. Accurate assessment of this burden is crucial for elucidating its impact and guiding the development of evidence-based strategies to support both patients and their caregivers. This study aims to translate, culturally adapt, and evaluate the psychometric properties of the heart failure caregiver burden questionnaire (HF-CQ) for application among Korean caregivers of individuals with HF. The HF-CQ was translated into Korean and culturally adapted in accordance with the World Health Organization guidelines. A total of 328 caregivers of patients with HF were enrolled between June 2021 and December 2023. To evaluate construct validity, a confirmatory factor analysis was used, including the assessments of convergent and discriminant validity of the instrument. Criterion validity and known-group validity were also examined. Reliability was determined by calculating Cronbach’s α for internal consistency and the intraclass correlation coefficient (ICC) for test–retest stability. The Korean version of the HF-CQ confirmed a three-factor structure—physical wellbeing, emotional wellbeing, and lifestyle—comprising 20 items. The instrument demonstrated excellent content validity. Construct validity was supported using acceptable model fit, standardized factor loadings and average variance extracted values > 0.50, composite reliability values > 0.70, and heterotrait–monotrait ratios < 0.85. Criterion validity was verified via significant correlations with depressive symptoms (r = 0.44, p < 0.001) and with health-related quality of life (r = -0.23, p < 0.001). Known-group validity was not demonstrated, with no significant differences in caregiver burden scores caregivers of patients in NYHA Class II and those in Class III/IV (t = -1.680, p = 0.094). Internal consistency was excellent (Cronbach’s α = 0.95), and test–retest reliability was good (ICC = 0.73). The 20-item Korean HF-CQ demonstrated sound psychometric properties, offering a culturally adapted tool for evaluating caregiver burden in HF. Implementation in clinical and community settings can facilitate early detection of caregivers experiencing high levels of burden, thereby allowing prompt recognition and the development of individualized support strategies.