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Assessing the burden of caregivers of patients with mental disorders: translating and validating the involvement evaluation questionnaire into Greek

Vasiliki Sapouna1*, Vasilis Dafermos2, Marios Chatziarsenis3, Victoria Vivilaki4, Panos Bitsios5, Aart H Schene6 and Christos Lionis1

Author Affiliations

1 Clinic of Social and Family Medicine, Department of Social Medicine, School of Medicine, University of Crete, P.O. Box 2208, Heraklion, 71003, Greece

2 Department of Political Sciences, University of Crete, Rethymno, 74100, Greece

3 Health Center of Elefsina, Thriassion General Hospital of Elefsina, Elefsina, 19200, Greece

4 Department of Midwifery, Technological Educational Institute of Athens, Athens, 10441, Greece

5 Department of Psychiatry and Behavioral Sciences, University of Crete, Heraklion, 71003, Greece

6 Department of Psychiatry Academic Medical Center, University of Amsterdam, Amsterdam, 1105 AZ, the Netherlands

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Annals of General Psychiatry 2013, 12:3  doi:10.1186/1744-859X-12-3

Published: 12 February 2013



The changes in the organization of mental health care services have made the role of the family even more important in caring for patients with mental disorders. Caring may have serious consequences for family caregivers, with a great impact on the quality of family life. This study reports on the translation, cultural adaptation, and validation of the Involvement Evaluation Questionnaire-European Union (IEQ-EU) into the Greek language.


Caregivers of patients with major mental disorders were interviewed to test a modified version of the IEQ-EU questionnaire. Psychometric measurements included reliability coefficients, exploratory factor analysis and confirmatory analysis by linear structural relations. To measure the concurrent validity we used the Nottingham Health Profile (NHP).


Most caregivers were female (83%), mainly mothers living with the patient (80%), with quite a high level of burden. The Greek version of the IEQ-EU (G-IEQ-EU) demonstrated a good reliability with high internal consistency (α = 0.88), Guttman split-half correlation of 0.71, high test-retest reliability (ICC = 0.82) and good concurrent validity with the NHP. A four-factor structure was confirmed for the G-IEQ-EU, slightly different from the original IEQ. The confirmatory factor analysis demonstrated that the four-factor model offered modest fit to our data.


The G-IEQ-EU is a reasonably valid and reliable tool for use in both clinical and research contexts in order to assess the burden of caregivers of patients with mental disorders.

Caregivers; Mental disorders; Validation