Reliability and Validity of the COPE Index among Caregivers of Hemodialysis Patients in Pakistan

Sumaira Nasim, Nicola M. Lowe, Victoria Hall Moran, Stephanie Dillon, Sidra Zaheer, Ian Philp


Objective: To assess the reliability and validity of the COPE (Carers of Older People in Europe) index tool among the caregivers of dialysis-dependent patients in Pakistan.
Study Design: Cross-sectional study.
Place and Duration of Study: The study was conducted at the Dialysis Unit of Pakistan Kidney Patients Association Rawalpindi, Bahria International Hospital Rawalpindi and Fauji Foundation Hospital Rawalpindi, Pakistan, from December 2018 to January 2019.
Methods: A 15-item COPE index questionnaire was administered, and data were collected from 124 caregivers of patients undergoing regular hemodialysis. A Principal Component Analysis (PCA) was performed on all items of the COPE index to retain the underlying components. Further, Cronbach’s alpha was used to assess the internal consistency of the retained component structure and loadings obtained from the PCA and the entire instrument separately.
Results: The PCA analysis revealed that, with the context of this study, the COPE index had good internal consistency for the negative aspects of caregiving and social support (Cronbach’s alpha scores were 0.864 and 0.781, respectively). For the positive impact items, a Cronbach’s alpha score of 0.655 indicated modest internal consistency. Cronbach’s alpha of 0.714 for the entire 15 items indicated that the COPE index had good overall internal consistency in our study population.
Conclusion: The COPE index was found to be a valid tool for use in Pakistan to assess the caregiver experience, including both positive and negative aspects of caregiving.

Keywords: Caregivers, COPE-index, Validation, Pakistan.

How to cite this: Nasim S, Lowe NM, Moran VH, Dillon S, Zaheer S, Philp I. Reliability and Validity of the COPE Index among Caregivers of Hemodialysis Patients in Pakistan. Life and Science. 2023; 4(4): 393-400. doi:

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