© 2003 by Oxford University Press and the Maryland Psychiatric Research Center (MPRC)
People With Schizophrenia in Five Countries: Conceptual Similarities and Intercultural Differences in Family Caregiving
Social Psychologist and Research Associate, Netherlands Institute of Mental Health and Addiction Utrecht, The Netherlands
Professor of Psychiatry, Department of Psychiatry, Academic Medical Center, University of Amsterdam Amsterdam, The Netherlands
Clinical Epidemiologist, Department of Psychiatry, Academic Medical Center, University of Amsterdam Amsterdam, The Netherlands
Professor of Psychiatry and Head of the Department of Psychiatry II, University of Ulm Bezirkskranenhaus Günzburg, Günzburg, Germany
Professor of Health Economics at the Institute of Psychiatry, and Professor of Social Policy at the London School of Economics, University of London London, U.K.
Psychiatrist and Head of the Department of Psychiatry, Psychiatric Centre North, Næstved, Sygehus, Næstved Denmark
Professor of Psychiatry, Director of the Department of Medicine and Public Health, and Director of the World Health Organization Collaborating Centre for Research and Training in Mental Health and Service Evaluation at the University of Verona Verona, Italy
Professor of Psychiatry and Head of the Health Services Research Department at the Institute of Psychiatry, King's College London, U.K.
Professor of Psychiatry and Director of the Deparment of Psychiatry at the University Hospital "Marqués de Valdecilla," University of Cantabria Santander, Spain
Consultant Psychiatrist at the Department of Medicine and Public Health, Section of Psychiatry, University of Verona Verona, Italy
Senior Lecturer in Medical Statistics, Health Services Research Department, Institute of Psychiatry, King's College London, U.K.
Send reprint requests to B. van Wijngaarden, Netherlands Institute of Mental Health and Addiction, P.O. Box 725, 3500 AS Utrecht, The Netherlands; e-mail: bwijngaarden{at}trimbos.nl
The European Psychiatric Services: Inputs Linked to Outcomes and Needs (EPSILON) study was a EUBIOMED-2-funded comparative, cross-national, cross-sectional study aimed (1) to produce standardized versions of five key research instruments in five languages, and (2) to compare the characteristics, needs, and life qualities of people with schizophrenia and their caregivers in these five countries. One of the key instruments was the Involvement Evaluation Questionnaire (IEQ), an instrument to assess caregiving consequences. In this article, the intercultural validity of the IEQ is described. It was concluded that the IEQ covers the same caregiving domains in all five countries: interpersonal tension, worrying, urging, and supervision. Differences in score levels between countries were found. When adjusted for variables known to correlate with IEQ scores (patient, caregiver, and relationship), these differences still persisted. It could not be determined how far the remaining variation could be explained by site-level characteristics, because only limited site-level data had been collected. This means that researchers must still resolve the question of whether levels of caregiver consequences that cannot be explained by the data presented here are caused by cultural factors or by differences in mental health care provision. As long as cultural bias cannot be ruled out, researchers are advised to compose their own national norm groups and use these as a local standard.
Keywords: Caregiving consequences / family burden / schizophrenia / intercultural validity / instruments
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