Validation of the Portuguese Version of the Adult Carers Quality of Life Questionnaire (AC-QoL) among Informal Carers of Stroke Survivors

Abstract— Stroke is a leading cause of disability worldwide, significantly affecting not only the health and quality of life of survivors but also of those who provide daily care to these individuals, requiring reliable measurement tools to assess these impacts. The Adult Carer Quality of Life Questionnaire (AC-QoL) is a recent and valid instrument, surpassing the limitations of previous tools. Given the lack of validated measures to assess the quality of life (QoL) of carers of stroke survivors, this study aimed to explore the psychometric properties of the AC-QoL among Portuguese informal carers of stroke survivors. After a linguistic adaptation to Portuguese of the AC-QoL, informal carers (n = 443) of stroke survivors hospitalized in all Stroke Units of the North of Portugal (n = 12), were invited to complete the AC-QoL and a structured questionnaire assessing their sociodemographic, caregiving-related, and psychological features, 18 to 24 months post-stroke (November 2019 and August 2021). Psychometric properties were investigated through confirmatory factor analyses and reliability evaluation. Linear regression models assessed convergent-discriminant validity with carers’ sociodemographic, caregiving-related, and psychological characteristics. Our results found a replicable eight-factor structure from the original AC-QoL, revealing good adequacy (CFI = 0.899] and high internal consistency (alpha = 0.904]. Convergent-discriminant validity was satisfactory with burden, anxiety, and depression being inversely associated with the overall score of the AC-QoL. Being younger, married, with higher education, being the son/daughter, and living with the stroke survivor were associated with higher scores of QoL. The Portuguese version of the AC-QoL is a comprehensive, simple, reliable and valid instrument to assess informal stroke carers’ QoL. The AC-QoL can be a valuable tool contributing to devise strategies promoting the well-being and social integration of stroke survivors and their informal carers.