Document Type : Original Article


1 Department of Epidemiology and Biostatistics, School of Health, Modeling in Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran

2 Community-Oriented Nursing Midwifery Research Center, Department of Adult and Geriatric Nursing, Nursing and Midwifery School, Shahr-e-Kord University of Medical Sciences, Shahr-e-Kord, IR Iran


BACKGROUND : The complex, multifaceted care environment and the threatening situation of caring
for hemodialysis patients cause tension in their family caregivers. Due to the severe tension, family
caregivers are likely to ignore their basic needs and only pay attention to the patient’s needs and
related issues. This study was conducted with the aim of designing and evaluating the Perceived
Care tension Questionnaire for Caregivers of Hemodialysis Patients (PCTQHFC).
MATERIALS AND METHODS: The present study was a sequential exploratory mixed methods
study of scale development variant conducted in two phases: qualitative and quantitative. This study
was conducted in 2019 in Shahrekord. The qualitative phase included item development and scale
development. In the quantitative phase (Item Analysis), the validation characteristics of the tool were
examined using face, content and construct validity, and its reliability by internal consistency and
stability. Findings were performed using software SPSS 18.
RESULTS: Principal components analysis with orthogonal rotation to generate factors, showed that
five factors, namely emotional exhaustion, inadequate social support, care burden, confusion and
ambiguity and lack of adaptability skills had an eigenvalue of higher than 1, so that they explained,
respectively, 75.98%, 61.36%, 72.49%, 76.33%, and 70.31% of the total variance. The internal
consistency was obtained 0.811 and the inter‑class correlation coefficient for the whole instrument
CONCLUSION: PCTQHFC is a culturally appropriate measure with strong psychometric properties.
The instrument designed in this study measures the care tension of hemodialysis patients. Therefore,
researchers, health‑care providers, and community health policymakers can plan and implement
interventions to reduce the tension of caregivers of hemodialysis patients by analyzing and identifying
the tensions of caregivers.


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