# Validation of the Malay Version of the Caregiver Quality of Life Index–Cancer (MCQoL) among caregivers of cancer patients in Malaysia

## TL;DR

This study validates a Malay version of a quality of life scale for cancer caregivers in Malaysia, showing it is reliable and can help improve caregiver support.

## Contribution

The study introduces and validates a culturally adapted Malay version of the Caregiver Quality of Life (MCQoL) scale for use in Malaysia.

## Key findings

- The Malay version of the MCQoL scale showed strong validity and reliability after removing three problematic items.
- The final four-factor model had acceptable fit indices (RMSEA = 0.06, CFI = 0.90) and strong internal consistency (Cronbach’s alpha = 0.879).
- The scale can be used to assess and monitor cancer caregivers' quality of life in Malaysia.

## Abstract

Cancer caregivers frequently experience significant psychological distress as they manage the increasing treatment burden of cancer patients, which adversely impacts their quality of life. In Malaysia, there has been a notable absence of disease-specific instruments to measure cancer caregivers’ quality of life. Our study aimed to validate the Malay version of the Caregiver Quality of Life (MCQoL) scale among Malaysian cancer caregivers. This cross-sectional study was conducted from 01-09-2022 to 31-07-2023, involving 310 cancer caregivers from a cancer centre in southern Peninsular Malaysia. The MCQoL scale comprises 35 items across four domains: burden, positive adaptation, disruptiveness, and financial concern. Construct validity was assessed using Exploratory Factor Analysis (EFA) and Confirmatory Factor Analysis (CFA). Meanwhile, internal consistency and test-retest reliability were determined using Cronbach’s alpha coefficient and intra-class correlation respectively. The study population were predominantly female (62.80%), married (68.30%) and Malay ethnicity (70.60%), with a mean age of 44.00 (± 14.22) years. The mean MCQoL score was 59.32 (±20.96), with higher scores indicating poorer quality of life. EFA led to the removal of three problematic items, resulting in a modified scale with excellent sampling adequacy (KMO = 0.891, p < 0.001) and a total variance explained of 53.81%. The final CFA supported a four-factor model with an acceptable fit (RMSEA = 0.06, CFI (Comparative Fit Index) = 0.90, Chisq/df ratio χ2/df = 2.32, Tucker-Lewis Index (TLI) = 0.89) and strong internal consistency (Cronbach’s alpha = 0.879). The MCQoL scale demonstrated adequate validity and reliability for assessing quality of life of cancer caregivers in Malaysia. This tool can be implemented within local oncology services to systematically assess and monitor caregiver quality of life, enabling healthcare teams to identify specific areas of need or distress and there by tailor interventions, provide targeted support, and improve overall caregiver well-being.