Translation, Adaptation, and Validation of a Traditional Chinese Version of the Family Caregiver Medication Administration Hassle Scale

Te-Lien Ku,1,* Shu-Ying Wu,2 Wei-Chu Chie,3 Yen-Ming Huang4– 6,* 1Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin–Madison, Madison, WI, 53705, USA; 2Department of Pharmacy, Sijhih Cathay General Hospital, New Taipei City, 221037, Taiwan; 3Institute of Epidemiology and Preventive Medicine, School of Public Health, National Taiwan University, Taipei, 100025, Taiwan; 4Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, 100025, Taiwan; 5School of Pharmacy, College of Medicine, National Taiwan University, Taipei, 100025, Taiwan; 6Department of Pharmacy, National Taiwan University Hospital, Taipei, 100229, Taiwan*These authors contributed equally to this workCorrespondence: Yen-Ming Huang, Graduate Institute of Clinical Pharmacy, College of Medicine, National Taiwan University, Taipei, 100025, Taiwan, Tel +886-2-3366-8784, Email [email protected] Te-Lien Ku, Social and Administrative Sciences Division, School of Pharmacy, University of Wisconsin-Madison, 2506 Rennebohm Hall, 777 highland Ave, Madison, WI, 53705, USA, Tel +1-608-960-5765;, Email [email protected]: The Family Caregiver Medication Administration Hassle Scale (FCMAHS) assesses the stress experienced by family caregivers in managing daily medication regimens for older adults. However, its suitability for the Taiwanese healthcare context has not yet been established.Objective: To translate, cross-culturally adapt, and evaluate the reliability and validity of a Traditional Chinese version of the FCMAHS (FCMAHS-TC).Methods: A two-phase cross-sectional study was conducted. In Phase I, the FCMAHS was translated into Traditional Chinese. In Phase II, a convergent mixed-methods study was carried out with a convenience sample of 138 family caregivers who completed the FCMAHS-TC. In parallel, 12 of those participants were interviewed to explore their experiences with medication administration tasks and associated stress. Content validity was assessed using the content validity index (CVI), whereas reliability was evaluated through Cronbach’s alpha and intraclass correlation coefficients (ICCs). Exploratory factor analysis (EFA) was performed to investigate the FCMAHS-TC’s factor structure. Qualitative data from interviews were analyzed using content analysis to provide triangulated evidence of scale adaptability.Results: The FCMAHS-TC demonstrated strong internal consistency (Cronbach’s alpha = 0.94) and test-retest reliability (ICC = 0.78). Expert evaluation indicated strong content validity, with the item- and scale-CVI value reaching 1.0. The EFA identified four key factors: information seeking and sharing, scheduling logistics, medication filling and prescription management, and safety issues, accounting for 59.57% of the total variance. Qualitative findings supported the factor structure identified and further highlighted care coordination among caregivers as an additional challenge.Conclusion: The FCMAHS-TC is a valid and reliable tool for healthcare professionals in Taiwan to assess the challenges and stress associated with medication administration among family caregivers. Future research should explore social and demographic determinants of medication-related caregiving stress and develop targeted interventions to support caregivers in Taiwan.Keywords: caregiving, hassle, medication, medication administration, older adult