Development and Psychometric Validation of the ICU Caregiver Distress Scale (ICU-CDS)

AbstractObjectives: The objectives of this study were to (i) develop a self-report instrument to measure psychological distress specific to family caregivers of ICU patients, (ii) explore the core dimensional structure of the scale, and (iii) evaluate its psychometric properties through rigorous validation procedures.Method: The development and validation of the ICU-CDS were executed in multiple phases, including item generation, content validation, and pilot testing. The study sample included 313 family caregivers of ICU patients. Exploratory factor analysis (EFA) was conducted to identify the scale's underlying dimensions, followed by confirmatory factor analysis (CFA) to confirm the factor structure. Additionally, assessments of reliability and validity were performed.Results: The ICU-CDS demonstrated a clear multidimensional structure reflecting ICU-specific distress domains. The overall Cronbach's alpha coefficient was 0.72. The scale also showed satisfactory convergent validity through positive correlations with Mishel Uncertainty in Illness Scale.Discussion: The ICU-CDS provides a robust, contextually sensitive measure of psychological distress among ICU family caregivers. By capturing specific stressors unique to the ICU setting, this scale addresses limitations of existing general caregiver instruments. Additionally, the scale can also be used to assess distress among ICU patient family caregivers and improve family-centred care in an intensive care setting.Keywords: ICU, distress, caregivers, exploratory factor analysis, confirmatory factor analysis, scale development