Validation of the Psychometric Properties of the German Version of OBI-Care in Informal Caregivers of Stroke Survivors

Background: In occupational science and therapy, occupations are understood as meaningful activities. Satisfaction with the amount and variety of occupations is called occupational balance. The "Occupational Balance in Informal Caregivers" (OBI-Care) questionnaire assesses satisfaction with occupations across three subscales: occupational areas, characteristics, and resilience. In doing so, it also addresses occupational contingency, i.e., the ability to adapt occupations in response to unforeseen events. While previous studies have confirmed its validity in other populations, psychometric properties have not been explored in informal caregivers of stroke survivors. This study aimed to evaluate the construct validity, internal consistency, and suitability of the German OBI-Care for assessing occupational balance for this target group. Methods: A validation study was conducted using data collected via an online survey. Measurement properties of the three subscales were examined using Rasch Rating Scale analysis, exploring construct validity, internal consistency, and interpretability. Construct validity was assessed via dimensionality analyses, item fit, model fit, and threshold ordering. Internal consistency was evaluated using inter-item correlations, item-total correlations, person separation index, and Cronbach's alpha. Interpretability was examined through floor and ceiling effects. Results: A total of 156 informal caregivers of stroke survivors participated, with 84% ( n = 131) women and a median age of 58 (IQR: 49-66) years. All subscales showed unidimensionality with acceptable item and model fit and ordered thresholds. Internal consistency was excellent across all subscales. No floor and ceiling effects were observed. Conclusions: This study demonstrates good construct validity, internal consistency, and interpretability of the German OBI-Care. It is suitable for assessing occupational balance and may help identify and support occupational contingency in informal caregivers of stroke survivors.