Translation, Cross-Cultural Adaptation, and Psychometric Validation of the Chinese Version of the Life Change Adaptation Scale for Family Caregivers of Individuals of Stroke Survivors

Objective: This study aimed to translate and cross-culturally adapt the original English version of the Life Change Adaptation Scale (LCAS) into Chinese and to examine its reliability and validity among family caregivers of stroke survivors in China. Methods: A methodological study was conducted in two phases. Phase 1 involved the cross-cultural adaptation of the LCAS using Brislin’s translation model, including forward and back-translation, expert review by the original author, and cultural adaptation via a Delphi expert consultation panel (n=8). A pilot test (n=20) assessed feasibility. In Phase 2, psychometric testing was performed with a convenience sample of 260 family caregivers of stroke survivors from a tertiary hospital. Participants completed the Chinese LCAS and the Kessler Psychological Distress Scale (K10). Internal consistency, test-retest reliability (2-week interval, n=30), content validity, construct validity (Exploratory Factor Analysis), and convergent validation were evaluated. Results: The cross-cultural adaptation process ensured semantic and conceptual equivalence. This 8-item scale is feasible for clinical use, requiring approximately 3– 5 minutes to complete. The Chinese LCAS demonstrated excellent content validity (S-CVI/Ave = 0.922). Exploratory Factor Analysis (Kaiser-Meyer-Olkin measure = 0.716, Bartlett’s test of sphericity p < 0.001) supported the original two-factor structure (factor loadings ranged from 0.568 to 0.843), explaining 54.449% of the total variance. The scale showed good internal consistency (Cronbach’s α = 0.764 for the total scale; 0.776 and 0.781 for subscales) and excellent test-retest reliability (ICC = 0.936). A significant but small-magnitude positive correlation with the K10 (r = 0.168, p=0.006) supported its convergent validation. Conclusion: The Chinese version of the LCAS is a brief, reliable, valid, and practical tool for assessing life-change adaptation among family caregivers of stroke survivors in China. It is recommended for use by clinicians and researchers to screen caregiver adaptation needs and evaluate support interventions.