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Sorrentino G, Bayen E, Câmara-Costa H, Francillette L, Toure H, Laurent-Vannier A, Meyer P, Dellatolas G, Chevignard M. Long-term burden of informal caregiver 7-years after severe childhood traumatic brain injury in the traumatisme grave de l'Enfant (TGE) study. Brain Inj 2024; 38:467-478. [PMID: 38379310 DOI: 10.1080/02699052.2024.2318588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Accepted: 02/09/2024] [Indexed: 02/22/2024]
Abstract
OBJECTIVE To investigate reported burden by the Primary Family Caregiver (PFC) 7-years after severe pediatric traumatic brain injury in the TGE (Traumatisme Grave de l'Enfant) longitudinal study. METHODS Subjective burden was estimated with the Zarit Burden Inventory (ZBI) in 36 PFC (parents), who rated their own health status (Medical Outcome Study Short Form-12), family functioning and their child's level of care and needs (Pediatric/Adult Care And Needs Scale [PCANS/CANS]). Data collection included: child and PFC sociodemographic characteristics, injury-related factors, 'objective' (e.g. overall level of disability: Glasgow Outcome Scale - Extended, GOS-E/GOS-E-Peds) and 'subjective' outcomes (e.g. participation, behavior, executive functions, quality of life and fatigue). RESULTS 25% of PFC reported mild-moderate burden, and 19% moderate-severe burden. Higher burden correlated with worse outcomes in all 'subjective' PFC-rated outcomes, and with self-reported participation. The ZBI correlated strongly with CANS/PCANS and GOS-E/GOS-E-Peds. Overall level of disability and PFC-reported executive functioning explained 62% of the ZBI variance. For equal levels of disability, burden was higher when PFC reported a 'negative' picture of their child. CONCLUSION Significant PFC-reported burden 7-years post-injury was associated with overall disability and 'subjective' PFC-rated outcomes. Factors influencing parental burden in the long term should be identified and psychological support implemented over time.
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Affiliation(s)
- Gregorio Sorrentino
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
| | - Eléonore Bayen
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
| | - Hugo Câmara-Costa
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Leila Francillette
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Hanna Toure
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Anne Laurent-Vannier
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
| | - Philippe Meyer
- Pediatric Anesthesiology Department, Hôpital Necker Enfants Malades, Paris, France
- Faculty of Medicine, Paris Descartes University, Paris, France
| | - Georges Dellatolas
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
| | - Mathilde Chevignard
- Sorbonne Université, GRC 24 Handicap Moteur et Cognitif et Réadaptation (HaMCRe), Paris, France
- Sorbonne Université, INSERM, CNRS, Laboratoire d'Imagerie Biomédicale, LIB, Paris, France
- Rehabilitation Department for Children with Acquired Neurological Injury, Saint Maurice Hospitals, Saint Maurice, France
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Ishida J, Murai T, Ueda K, Furukawa TA, Tanemura R. Utility of a novel tablet computer software for memory impairment in participants with brain injuries: A randomized control trial. Neuropsychol Rehabil 2023; 33:85-102. [PMID: 34635005 DOI: 10.1080/09602011.2021.1987276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
This study examined the effectiveness of a novel information and communication technology (ICT) tool developed for external memory compensation to improve memory function in participants with brain injuries. In this 3-month randomized control study, participants with memory impairment secondary to brain injury were randomly assigned on a 1:1 basis to either intervention (the ICT tool [ARATA]) or 3-month waitlist control groups. This study's primary outcome measure was memory-related difficulties in everyday life, assessed using the Everyday Memory Checklist (EMC). Secondary outcomes included tests for memory function and psychosocial status, all of which were administered by blinded assessors. Seventy-eight participants (53 males, 25 females; mean age, 43.5 ± 12.7 [SD] years) were enrolled and 39 participants were allocated to each group (intervention and control). There was no significant difference in EMC scores between the two groups throughout the study (mean 0.26; 95% CI: -2.55-3.07; p=0.853); however, the intervention group scored significantly higher on the Rivermead Behavioural Memory and General Self-Efficacy tests compared to the control group. While the ICT tool did not improve the primary study outcome, evidence suggests that the ICT tool can improve memory functions related to activities of daily living.
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Affiliation(s)
- Junko Ishida
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
| | - Toshiya Murai
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Keita Ueda
- Department of Psychiatry, Kyoto University Graduate School of Medicine, Kyoto, Japan.,Department of medical Welfare, Kyoto Koka Women's University, Faculty of Health Sciences, Kyoto, Japan
| | - Toshiaki A Furukawa
- Department of Health Promotion and Human Behavior, Kyoto University Graduate School of Medicine/School of Public Health, Kyoto, Japan
| | - Rumi Tanemura
- Department of Rehabilitation Science, Kobe University Graduate School of Health Sciences, Hyogo, Japan
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3
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Siponkoski ST, Pitkäniemi A, Laitinen S, Särkämö ER, Pentikäinen E, Eloranta H, Tuomiranta L, Melkas S, Schlaug G, Sihvonen AJ, Särkämö T. Efficacy of a multicomponent singing intervention on communication and psychosocial functioning in chronic aphasia: a randomized controlled crossover trial. Brain Commun 2022; 5:fcac337. [PMID: 36687394 PMCID: PMC9847537 DOI: 10.1093/braincomms/fcac337] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 10/10/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022] Open
Abstract
The ability to produce words through singing can be preserved in severe aphasia, but the benefits of group-based singing rehabilitation in aphasia are largely unknown. Our aim was to determine the efficacy of a multicomponent singing intervention on communication and speech production, emotional-social functioning and caregiver well-being in aphasia. Fifty-four patients with acquired brain injury and chronic aphasia and their family caregivers (n = 43) were recruited. Using a crossover randomized controlled trial design, participants were randomized to two groups who received a 4-month singing intervention either during the first or second half of the study in addition to standard care. The intervention comprised weekly group-based training (including choir singing and group-level melodic intonation therapy) and tablet-assisted singing training at home. At baseline, 5- and 9-month stages, patients were assessed with tests and questionnaires on communication and speech production, mood, social functioning, and quality of life and family caregivers with questionnaires on caregiver burden. All participants who participated in the baseline measurement (n = 50) were included in linear mixed model analyses. Compared with standard care, the singing intervention improved everyday communication and responsive speech production from baseline to 5-month stage, and these changes were sustained also longitudinally (baseline to 9-month stage). Additionally, the intervention enhanced patients' social participation and reduced caregiver burden. This study provides novel evidence that group-based multicomponent singing training can enhance communication and spoken language production in chronic aphasia as well as improve psychosocial wellbeing in patients and caregivers. https://www.clinicaltrials.gov, Unique identifier: NCT03501797.
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Affiliation(s)
| | - Anni Pitkäniemi
- Correspondence to: Anni Pitkäniemi Cognitive Brain Research Unit Department of Psychology and Logopedics University of Helsinki, Helsinki, Finland E-mail:
| | - Sari Laitinen
- Centre of Excellence in Music, Mind, Body and Brain, University of Helsinki, 00014 Helsingin yliopisto, Helsinki, Finland,Espoo Hospital, 00029 HUS, Espoo, Finland
| | | | - Emmi Pentikäinen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, University of Helsinki, 00014 Helsingin yliopisto, Helsinki, Finland,Centre of Excellence in Music, Mind, Body and Brain, University of Helsinki, 00014 Helsingin yliopisto, Helsinki, Finland
| | - Heidi Eloranta
- Helsinki-Uusimaa Stroke Association, 00610 Helsinki, Finland
| | - Leena Tuomiranta
- Department of Psychology and Logopedics, University of Helsinki, 00014 Helsingin yliopisto, Helsinki, Finland
| | - Susanna Melkas
- Department of Neurology, University of Helsinki and Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland
| | - Gottfried Schlaug
- Department of Neurology, UMass Medical School, Springfield & Department of Biomedical Engineering and Institute of Applied Life Sciences, UMass Amherst, Amherst, MA 01003, USA
| | - Aleksi J Sihvonen
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, University of Helsinki, 00014 Helsingin yliopisto, Helsinki, Finland,Centre of Excellence in Music, Mind, Body and Brain, University of Helsinki, 00014 Helsingin yliopisto, Helsinki, Finland,Department of Neurology, University of Helsinki and Helsinki University Central Hospital, 00029 HUS, Helsinki, Finland,School of Health and Rehabilitation Sciences, Queensland Aphasia Research Centre and UQ Centre for Clinical Research, The University of Queensland, QLD 4029, Brisbane, Australia
| | - Teppo Särkämö
- Cognitive Brain Research Unit, Department of Psychology and Logopedics, University of Helsinki, 00014 Helsingin yliopisto, Helsinki, Finland,Centre of Excellence in Music, Mind, Body and Brain, University of Helsinki, 00014 Helsingin yliopisto, Helsinki, Finland
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4
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Martin JT, Chapman KR, Was C, Spitznagel MB. Factors of Dementia Caregiver Burden Differentially Contribute to Desire to Institutionalize. J Geriatr Psychiatry Neurol 2022; 35:594-600. [PMID: 34350782 DOI: 10.1177/08919887211036183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The experience of dementia caregiver burden is multidimensional. Little is known about how different aspects of burden contribute to the consideration of moving a loved one to a structured living facility. In the present study, caregiver burden (Zarit Burden Interview; ZBI) and consideration of structured living arrangements (Desire to Institutionalize Scale; DIS) were self-reported by 339 caregivers. Exploratory factor analysis was used to determine the ZBI factor structure; these factors were then examined via hierarchical linear regression for prediction of DIS. Factor analysis indicated a 4-factor ZBI solution: Impact on Life, Guilt, Embarrassment/Frustration, and Escape/Uncertainty. Regression analyses indicated that only Escape/Uncertainty (p < .001) was associated with DIS. Of the 4 identified factors of caregiver burden, desire to escape the caregiving role was most related to consideration of structured living arrangements. Future work should explore longitudinal contribution of this factor to determine its role in actual changes made in living arrangements.
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Affiliation(s)
- John T Martin
- Department of Psychological Sciences, 4229Kent State University, Kent, OH, USA
| | - Kimberly R Chapman
- Department of Psychological Sciences, 4229Kent State University, Kent, OH, USA.,Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA.,Department of Psychiatry, Rhode Island Hospital, Providence, RI, USA
| | - Christopher Was
- Department of Psychological Sciences, 4229Kent State University, Kent, OH, USA
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5
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Lee SJ, Seo HJ, Choo ILH, Kim SM, Park JM, Yang EY, Choi YM. Evaluating the Effectiveness of Community-Based Dementia Caregiver Intervention on Caregiving Burden, Depression, and Attitude Toward Dementia: A Quasi-experimental Study. Clin Interv Aging 2022; 17:937-946. [PMID: 35711677 PMCID: PMC9196278 DOI: 10.2147/cia.s361071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 05/29/2022] [Indexed: 11/23/2022] Open
Abstract
Objective Accumulating evidence of the effects of dementia caregiving on individuals, society, and health has generated intervention studies to reduce the stress among family caregivers of people with dementia. This study aims to evaluate the effectiveness of a family support program, community-based dementia caregiver intervention (CDCI), among family caregivers of people with dementia compared with a control group (no intervention). Patients and Methods This study is a quasi-experimental, non-randomized controlled trial conducted in six dementia relief centers of a community healthcare center in Korea. Family caregivers of 83 patients with dementia were recruited; of these 78 were included in the final study, with 40 in the intervention group and 38 in the control group. Analysis of covariance (ANCOVA) was used to compare the mean difference in the scores of the total short-form Zarit Burden Interview (SZBI), personal strain, role strain, depression, and attitude between the groups. Results Compared with controls, in the intervention group, the adjusted mean score of personal strain (F = 4.353, t = 0.041) and attitude toward dementia (F = 10.284, t = 0.002) differed significantly after the intervention, with a small to moderate effect. There was no significant difference in the total SZBI, role strain, or depression mean score. Conclusion The findings suggest that CDCI may be an effective intervention strategy to reduce personal strain and enhance the attitudes of family caregivers of people with dementia.
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Affiliation(s)
- Su Jung Lee
- College of Nursing, Inje University, Gimhae, South Korea
| | - Hyun-Ju Seo
- College of Nursing, Chungnam National University, Daejeon, South Korea
| | - I L Han Choo
- Department of Neuropsychiatry, Chosun University and Chosun University Hospital, Gwangju, South Korea
| | - Seong Min Kim
- Department of Nursing, Donggang University, Gwangju, South Korea
| | - Jeong Min Park
- Department of Nursing, Nambu University, Gwangju, South Korea
| | - Eun-Young Yang
- Department of Nursing, Donggang University, Gwangju, South Korea
| | - Yu Mi Choi
- College of Nursing, Graduate School of Chungnam National University, Daejeon, South Korea
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6
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Schein J, Houle CR, Urganus AL, Jones E, Pike J, Husbands J, Willey CJ. The Impact of Agitation in Dementia on Caregivers: A Real-World Survey. J Alzheimers Dis 2022; 88:663-677. [PMID: 35694920 PMCID: PMC9398061 DOI: 10.3233/jad-215670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Dementia patients frequently depend on caregivers. Agitation is a common behavioral dementia symptom particularly burdensome to patients and caregivers. Objective: To assess the association of agitation severity with non-professional caregiver hours, burden, health status, and productivity. Secondarily, to assess the association of agitation severity with these outcomes for patients receiving remote (not living with the patient) and proximate (living with the patient) caregiving. Methods: A retrospective analysis of physician and non-professional caregiver-reported data from a US point-in-time survey. Patients were aged ≥50 years, with early cognitive impairment or dementia. Regression analyses compared outcomes by agitation severity; covariates included age, sex, and clinical characteristics. Results: Data were included for 1,349 patients (non-agitated n = 656, agitated n = 693; no care n = 305, remote care n = 248, proximate care n = 691; unknown care n = 105). Greater agitation was significantly associated (p < 0.05) in all caregivers with increasing: Zarit Burden Interview (ZBI) Total Caregiver Burden, Personal Strain, Role Strain, and Guilt; Work Productivity and Activity Index (WPAI) presenteeism, overall work impairment, and total activity impairment. Higher ZBI Total Caregiver Burden, Personal Strain, and Role Strain were associated with greater agitation in proximate caregivers and higher ZBI Guilt associated with greater agitation in remote caregivers (p < 0.05). Higher WPAI presenteeism and total activity impairment were associated (p < 0.05) with greater agitation in proximate caregivers. Caregiving hours increased with increasing agitation for proximate caregiving (p = 0.001). Conclusion: Greater agitation severity was associated with higher caregiver burden and lower productivity, with higher indirect costs a likely outcome of agitation.
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Affiliation(s)
- Jeff Schein
- Otsuka Pharmaceutical Development & Commercialization Inc., Princeton, NJ, USA
| | | | | | | | | | | | - Cynthia J. Willey
- Division of Health Outcomes, College of Pharmacy, University of Rhode Island, Kingston, RI, USA
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7
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Boluarte-Carbajal A, Paredes-Angeles R, Tafur-Mendoza AA. Psychometric Properties of the Zarit Burden Interview in Informal Caregivers of Persons With Intellectual Disabilities. Front Psychol 2022; 13:792805. [PMID: 35356334 PMCID: PMC8959923 DOI: 10.3389/fpsyg.2022.792805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2021] [Accepted: 01/28/2022] [Indexed: 11/24/2022] Open
Abstract
Intellectual disability leads to a loss of autonomy and a high level of dependence, requiring support from another person permanently. Therefore, it is necessary to incorporate the assessment of caregiver burden in healthcare actions, to avoid putting the health of caregivers and patients at risk. In this sense, the study aimed to analyze the internal structure of the Zarit Burden Interview (ZBI) in a sample of caregivers of people with intellectual disabilities, to provide convergent and discriminant evidence with a measure of the risk of maltreatment, and to estimate the reliability of the scores from the Classical Test Theory and the Rasch Measurement Theory. The study was instrumental. The sample consisted of 287 Peruvian informal primary caregivers of persons diagnosed with intellectual disabilities. To collect validity evidence, the internal structure (confirmatory factor analysis, CFA) and the relationship with other variables (convergent and discriminant evidence) were used, while reliability was estimated through the omega coefficient and Rasch analysis. The internal structure of the ZBI corroborated a unidimensional structure. In terms of convergent and discriminant evidence, the scale presents adequate evidence. Reliability levels were also good. Previously, the psychometric properties of the ZBI have not been studied in caregivers of people with intellectual disabilities, and it represents the first study of the scale in Peru. The results obtained will allow the use of this scale to design actions in the work with caregivers and studies to understand the psychology of the caregiver.
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Affiliation(s)
| | - Rubí Paredes-Angeles
- Grupo de Estudios Avances en Medición Psicológica, Universidad Nacional Mayor de San Marcos, Lima, Peru.,Instituto Peruano de Orientación Psicológica, Lima, Peru
| | - Arnold Alejandro Tafur-Mendoza
- Grupo de Estudios Avances en Medición Psicológica, Universidad Nacional Mayor de San Marcos, Lima, Peru.,Research Center (CIUP), Universidad del Pacífico, Lima, Peru
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James K, Chin-Bailey C, Holder-Nevins D, Thompson C, Donaldson-Davis K, Eldemire-Shearer D. Zarit burden interview among caregivers of community-dwelling older adults in a caribbean setting (Jamaica): Reliability and factor structure. HEALTH & SOCIAL CARE IN THE COMMUNITY 2021; 29:e79-e88. [PMID: 33252838 DOI: 10.1111/hsc.13244] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/30/2020] [Revised: 11/02/2020] [Accepted: 11/05/2020] [Indexed: 06/12/2023]
Abstract
The Zarit Burden Interview has been the most popularly used tool for measuring caregiver burden and with the 60 years and over population in Jamaica and developing countries expected to increase, caregiver burden and its assessment assume increased importance. Establishing the reliability and underlying factor structure of instruments such as the ZBI is critical. This study sought to determine the reliability of the Zarit Burden Interview and to assess its underlying factor structure. The ZBI was administered to 180 caregivers of community dwelling older persons in Jamaica in a nationally representative sample across four geographic health regions in 2016. The factor structure was identified using exploratory factor analysis (EFA) with Varimax rotation. Cronbach's alpha was used to assess internal consistency/reliability of the instrument. The internal consistency/reliability of the ZBI instrument was high (Cronbach's α = 0.859) and the corrected item-total correlations ranged from 0.134 to 0.730. The ZBI mean score was found to be 16.92 ± 12.04. EFA produced a six-factor model comprised of 19 items which explained 48.97% of total variance, and was subsequently reduced to four (37.27% of total variance) via the use of parallel analysis and scrutiny of confidence intervals. The four factors identified were 'personal strain', 'social relations disruption', 'resource strain/imbalance' and 'role intensity'. The ZBI-22 tool is a reliable instrument for evaluating caregiver burden among community dwelling older persons in Jamaica. A four factor model has emerged providing greater insights on the underlying constructs of the ZBI, the most widely used caregiver burden assessment tool.
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Affiliation(s)
- Kenneth James
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
| | - Cameal Chin-Bailey
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
| | - Desmalee Holder-Nevins
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
| | - Camelia Thompson
- Department of Community Health and Psychiatry, The University of the West Indies, Mona, Jamaica
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9
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Investigation of the factor structure of the Turkish version of the State-Trait Anxiety Inventory. ANADOLU KLINIĞI TIP BILIMLERI DERGISI 2021. [DOI: 10.21673/anadoluklin.889735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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10
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Abstract
BACKGROUND Informal caregiving of stroke survivors often begins with intensity compared with the linear caregiving trajectories in progressive conditions. Informal caregivers of stroke survivors are often inadequately prepared for their caregiving role, which can have detrimental effects on their well-being. A greater depth of understanding about caregiving burden is needed to identify caregivers in most need of intervention. The purpose of this study was to examine caregiver burden and associated factors among a cohort of informal caregivers of stroke survivors. METHODS A cross-sectional study of 88 informal caregivers of stroke survivors was completed. Caregiver burden was determined with the Zarit Burden Interview, caregiver depressive symptoms were measured with the Patient Health Questionnaire-9, and stroke survivor functional disability was assessed with the Barthel Index. Ordinal logistic regression was used to identify independent factors associated with caregiver burden. RESULTS Forty-three informal caregivers (49%) reported minimal or no caregiver burden, 30 (34%) reported mild to moderate caregiver burden, and 15 (17%) reported moderate to severe caregiver burden. Stroke survivor functional disability was associated with informal caregiver burden (P = .0387). The odds of having mild to moderate caregiver burden were 3.7 times higher for informal caregivers of stroke survivors with moderate to severe functional disability than for caregivers of stroke survivors with no functional disability. The presence of caregiver depressive symptoms was highly correlated with caregiver burden (P < .001). CONCLUSION Caregivers of stroke survivors with functional disabilities and caregivers experiencing depressive symptoms may have severer caregiver burden. Trials of interventions aimed at decreasing informal caregiver burden should consider the potential impact of stroke survivors' functional disability and the presence of depressive symptoms.
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Kayadjanian N, Vrana-Diaz C, Bohonowych J, Strong TV, Morin J, Potvin D, Schwartz L. Characteristics and relationship between hyperphagia, anxiety, behavioral challenges and caregiver burden in Prader-Willi syndrome. PLoS One 2021; 16:e0248739. [PMID: 33765021 PMCID: PMC7993772 DOI: 10.1371/journal.pone.0248739] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Accepted: 03/04/2021] [Indexed: 11/18/2022] Open
Abstract
Objectives Prader-Willi syndrome (PWS) is a rare genetic disorder characterized by maladaptive behaviors, amongst which hyperphagia is a life-long concern for individuals with PWS and their caregivers. The current study examined the contribution of hyperphagia and other factors to caregiver burden across lifespan, in 204 caregivers of individuals with PWS living in the US, using the Zarit Burden Interview (ZBI) and the hyperphagia questionnaire (HQ-CT). Results We found a strong relationship between ZBI and HQ-CT especially in individuals with PWS older than 4 y and showed that HQ-CT scores of individuals with PWS is positively correlated with ZBI scores of their caregivers. The weight status of individuals with PWS was not associated with HQ-CT and ZBI scores, except for obese individuals who had significantly higher HQ-CT scores when compared to normal weight PWS individuals. We looked at PWS symptoms and care-related issues that impacted individuals and caregivers the most. We found that care-related tasks had the biggest negative impact on caregivers of children aged 0–4 y, whereas anxiety, temper tantrums, and oppositional behaviors of older individuals with PWS had the biggest impact on their caregivers concomitant with their high caregiver burden. Finally, we assessed the variability of HQ-CT and ZBI over 6 months in a subgroup of 83 participants. Overall, neither measure differed between 6 months and baseline. Most individual’s absolute HQ-CT score changes were between 0–2 units, whereas absolute ZBI score changes were between 0–6 points. Changes in the caregiver’s or individual’s life had little or no effect on HQ-CT and ZBI scores. Conclusions This study demonstrates a relationship between hyperphagia and caregiver burden and sheds light on predominant symptoms in children and adolescents that likely underly PWS caregiver burden. The stability and relationship between HQ-CT and ZBI support ZBI as an additional outcome measure in PWS clinical trials.
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Affiliation(s)
- Nathalie Kayadjanian
- Foundation for Prader-Willi Research, Walnut, California, United States of America
- PWS-Clinical Trial Consortium, Walnut, California, United States of America
- * E-mail:
| | - Caroline Vrana-Diaz
- Foundation for Prader-Willi Research, Walnut, California, United States of America
| | - Jessica Bohonowych
- Foundation for Prader-Willi Research, Walnut, California, United States of America
| | - Theresa V. Strong
- Foundation for Prader-Willi Research, Walnut, California, United States of America
- PWS-Clinical Trial Consortium, Walnut, California, United States of America
- Department of Genetics, University of Alabama, Birmingham, Alabama, United States of America
| | - Josée Morin
- Excelsus Statistics, Montreal, Quebec, Canada
| | | | - Lauren Schwartz
- Foundation for Prader-Willi Research, Walnut, California, United States of America
- PWS-Clinical Trial Consortium, Walnut, California, United States of America
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, United States of America
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12
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Lucijanić J, Baždarić K, Librenjak D, Lucijanić M, Hanževački M, Jureša V. A validation of the Croatian version of Zarit Burden Interview and clinical predictors of caregiver burden in informal caregivers of patients with dementia: a cross-sectional study. Croat Med J 2021. [PMID: 33410300 PMCID: PMC7821365 DOI: 10.3325/cmj.2020.61.527] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
AIM To validate the Croatian version of the Zarit Burden Interview (ZBI) and to investigate the predictors of perceived burden. METHODS This cross-sectional study involved 131 dyads of one informal caregiver family member and one patient with dementia visiting primary care practices (Health Care Center Zagreb-West; 10/2017-9/2018). Patient-related data were collected with the Mini-Mental-State-Examination, Barthel-index, and Neuropsychiatric-Inventory-Questionnaire (NPI-Q); caregiver-related data with the ZBI, and general information on caregivers and patients with a structured questionnaire. Principal-axis-factoring with varimax-rotation was used for factor analysis. RESULTS The caregivers' mean age was 62.1±13 years. They were mostly women (67.9%) and patients' children (51.1%). Four dimensions of ZBI corresponding to personal strain, frustration, embarrassment, and guilt were assessed and explained 56% variance of burden. Internal consistency of ZBI (α=0.87) and its dimensions (α1=0.88, α2=0.83, α3=0.72, α4=0.75) was good. Stronger cognitive and functional impairment of patients was associated only with personal strain, whereas more pronounced neuropsychiatric symptoms and the need for daily care were associated with more dimensions. Longer caregiver education suppressed embarrassment and promoted guilt. Guilt was higher in younger caregivers, caregivers of female patients, patients' children, and non-retired caregivers. In multivariate analysis significant predictors of higher overall burden were male sex of the patient, higher NPI-Q, the need for daily-care services, shorter duration of caregiving, non-spouse relationship, higher number of hours caring per-week, and anxious-depressive symptoms in a caregiver. CONCLUSION The Croatian version of ZBI is reliable and valid. Our data confirm that ZBI is a multidimensional construct. Caregivers may benefit from individually tailored interventions.
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Affiliation(s)
- Jelena Lucijanić
- Jelena Lucijanić, Health Care Center Zagreb-West, Prilaz baruna Filipovića 11, 10000, Zagreb, Croatia,
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13
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King R, Seeger T, Wang M, Li Pi Shan R, McGovern C, Knox J, Patel L, Fung T, Sajobi T, Debert C. Early Supported Discharge for Neurorehabilitation Following Acquired Brain Injury. Front Neurol 2021; 11:596526. [PMID: 33424748 PMCID: PMC7793829 DOI: 10.3389/fneur.2020.596526] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2020] [Accepted: 11/09/2020] [Indexed: 11/24/2022] Open
Abstract
Introduction: Early Supported Discharge (ESD) is a clinical flow management service offering interdisciplinary rehabilitation, wherein patients are provided supported in-home rehabilitation treatment; in comparison to conventional hospital-based rehabilitation model of service delivery. There has been little research into the functional outcomes for other types of acquired brain injury (ABI). Methods: In this prospective cohort study, ABI patients presenting at a level I trauma center in Calgary, Canada were placed in either an ESD program or conventional inpatient rehabilitation (IPR) program based on their medical history and presentation. A small number of patients completed both programs (ESD+IPR group). ESD therapies were designed to emulate IPR. Participants completed professionally-rated Mayo-Portland Adaptability Index-4 (MPAI), Quality of Life after Brain Injury (QOLIBRI), Generalized Anxiety Questionnaire-7 (GAD7), Montreal Cognitive Assessment (MoCA), and Patient Health Questionnaire-9 (PHQ9) surveys at 1, 3, and 6 months following initial assessment pre-rehabilitation. Caregivers completed the Zarit Burden Interview (ZBI) at the same time points. The Supervision Rating Scale (SRS) and Disability Rating Scale (DRS) were completed at admission to rehabilitation and all follow-ups. Generalized estimate equations models were used to describe the three groups over time, including age as a covariate. Results: Significant effects of time were reported in the MPAI participant sub-score in the ESD and IPR groups (χ(2)2 = 42.429, p < 0.000; χ(2)2 = 9.773, p = 0.008), showing significantly higher scores between 1 and 3 month timepoints for both groups. ZBI scores were significantly lower in the ESD group at 1 month compared to 3 and 6 months (χ(2)2 = 31.252, p < 0.001). The proportion of patients with medical complications during rehabilitation was 25.3% in ESD compared to 74.7% patients in IPR. Conclusions: Improvements in functional outcomes were evident in patients participating in ESD and IPR, with more medical complications reported in the IPR group. Caregiver burden lessened over time in the ESD group but not in the IPR group. Both ESD and ESD+IPR groups can be considered viable alternatives to traditional inpatient rehabilitation. A randomized control trial would be required to properly compare rehabilitation streams. Further investigation into affective and lifestyle elements of ABI recovery would also improve our understanding of targeted neurorehabilitation in this population.
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Affiliation(s)
- Regan King
- Calgary Brain Injury Program, Alberta Health Services, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Trevor Seeger
- Calgary Brain Injury Program, Alberta Health Services, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Meng Wang
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Rodney Li Pi Shan
- Calgary Brain Injury Program, Alberta Health Services, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Christine McGovern
- Calgary Brain Injury Program, Alberta Health Services, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Jason Knox
- Calgary Brain Injury Program, Alberta Health Services, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Lisa Patel
- Calgary Brain Injury Program, Alberta Health Services, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Tak Fung
- Department of Nursing, University of Calgary, Calgary, AB, Canada
| | - Tolulope Sajobi
- Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
| | - Chantel Debert
- Calgary Brain Injury Program, Alberta Health Services, Calgary, AB, Canada.,Department of Clinical Neurosciences, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
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14
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Troy C, Anna T, Perez C JJ, Liu J. Personal Determinants of Burden Among Indonesian Female Caregivers of Older Adults in Taiwan. J Appl Gerontol 2020; 41:217-226. [PMID: 33238777 DOI: 10.1177/0733464820972888] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
INTRODUCTION Families increasingly employ foreign domestic workers (FDWs) to care for older loved ones. Caregiver burden reflects FDWs' difficulty adapting to work demands. We test hypothesized associations between burden and six personal characteristics: children, marriage, education, Chinese proficiency, eldercare experience, and non-eldercare experience. METHOD In total, 299 Indonesian FDWs in Taiwan completed the Zarit Burden Interview. Exploratory factor analysis identified the dimensions of burden. Multiple and multinomial regressions related the variables to overall burden, burden dimensions, and burden severity. RESULTS Four dimensions were found: personal strain, role strain, dependency, and guilt. Children were negatively associated with burden, role strain, dependency, and guilt. Chinese proficiency was negatively associated with severity and guilt. Eldercare experience was positively associated with severity and personal strain. Marriage was non-monotonically related to severity. CONCLUSION Caregivers whose earnings benefit their children may be more likely to thrive in Taiwan. Language training may boost caregiver performance and host family satisfaction.
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15
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Rubin E, Klonoff P, Perumparaichallai RK. Does self-awareness influence caregiver burden? NeuroRehabilitation 2020; 46:511-518. [DOI: 10.3233/nre-203093] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Evan Rubin
- The Center for Transitional Neuro-Rehabilitation, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
- Bryn Mawr Rehab Psychology Associates, Main Line Health Care, Malvern, PA, USA
| | - Pamela Klonoff
- The Center for Transitional Neuro-Rehabilitation, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA
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Sodders MD, Killien EY, Stansbury LG, Vavilala MS, Moore M. Race/Ethnicity and Informal Caregiver Burden After Traumatic Brain Injury: A Scoping Study. Health Equity 2020; 4:304-315. [PMID: 32760875 PMCID: PMC7398439 DOI: 10.1089/heq.2020.0007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/12/2020] [Indexed: 01/07/2023] Open
Abstract
Background: Informal caregivers for persons with traumatic brain injury (TBI) face a range of unique issues, and racial/ethnic group differences in caregiver challenges are poorly understood. We undertook a scoping study of peer-reviewed literature to assess the quantity and quality of available research describing differences by race/ethnicity in informal caregiving roles and burden. Methods: Using Arksey and O'Malley's framework and guided by the Preferred Reporting Items of Systematic Reviews and Meta-analyses Extension for Scoping Reviews, we conducted electronic searches of PubMed, CINAHL, PsycARTICLES, PsycINFO, Social Work Abstracts, Embase, and Scopus to identify peer-reviewed studies that examined TBI informal caregiver burden and reported on the influences of race or ethnicity. Results: Among 4523 unique publications identified and screened, 11 studies included sufficient race/ethnicity data and were included in the analysis. Of these, six studies described civilian populations and five described military Veterans Affairs (VA). Included studies revealed that nonwhite caregivers and white caregivers use different approaches and coping strategies in their caregiving role. Some studies found differences in caregiver burden by race or ethnicity, others did not. Most were limited by a small sample size and overdependence on assessment tools not validated for the purposes or populations for which they were used. This was particularly true for race/ethnicity as a factor in TBI caregiver burden in VA groups, where essential characteristics moderate the association of race/ethnicity with socioeconomic factors. Conclusions: This scoping study highlights the paucity of information on race/ethnicity as a factor in TBI caregiver burden and roles, and suggests that innovative and alternative approaches to research are needed to explore needed changes in practice.
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Affiliation(s)
- Mark D Sodders
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.,Department of Child, Family, and Population Health Nursing, School of Nursing, University of Washington, Seattle, Washington, USA.,Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Elizabeth Y Killien
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.,Division of Pediatric Critical Care Medicine, Department of Pediatrics, University of Washington, Seattle, Washington, USA
| | - Lynn G Stansbury
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.,Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Monica S Vavilala
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.,Department of Anesthesiology and Pain Medicine, School of Medicine, University of Washington, Seattle, Washington, USA
| | - Megan Moore
- Harborview Injury Prevention and Research Center, University of Washington, Seattle, Washington, USA.,School of Social Work, University of Washington, Seattle, Washington, USA
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Pinyopornpanish K, Pinyopornpanish M, Wongpakaran N, Wongpakaran T, Soontornpun A, Kuntawong P. Investigating psychometric properties of the Thai version of the Zarit Burden Interview using rasch model and confirmatory factor analysis. BMC Res Notes 2020; 13:120. [PMID: 32122404 PMCID: PMC7050141 DOI: 10.1186/s13104-020-04967-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2019] [Accepted: 02/20/2020] [Indexed: 02/06/2023] Open
Abstract
Objective The Zarit Burden Interview (ZBI) has been widely used to assess caregiver burden. Few research papers have investigated the Thai version of the ZBI. The study aimed to examine the psychometric properties of the Thai version of both the full length (ZBI-22) and short versions (ZBI-12) using Rasch analysis and confirmatory factor analysis among a sample of Alzheimer’s disease caregivers. Results The ZBI-22 fitted the Rasch measurement model regarding unidimensionality but not for ZBI-12. Five items from ZBI-22, and 2 items from ZBI-12 were shown to be misfitting items. Half of ZBI items were shown to be disordered category or threshold, and were locally dependent. CFA revealed three-factor and four-factor fitted the data the best for ZBI-22 and ZBI-12, respectively. Reliability was good for both forms of the ZBI (α = 0.86–0.92). Significant correlations were found with caregiver’s perceived stress, anxiety/depression, pain and mobility but not with self-care and usual activity (p > 0.05), indicating convergent and discriminant validity. To conclude, the Thai version ZBI-22, but not ZBI-12, supported the reliability and unidimensional scale among Alzheimer’s disease caregivers. Some misfitting items of the ZBI undermined the unidimensionality of the scale, and need revision.
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Affiliation(s)
| | - Manee Pinyopornpanish
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, Thailand
| | - Nahathai Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, Thailand.
| | - Tinakon Wongpakaran
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, Thailand
| | - Atiwat Soontornpun
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - Pimolpun Kuntawong
- Geriatric Psychiatry Unit, Department of Psychiatry, Faculty of Medicine, Chiang Mai University, 110 Intawaroros Rd., T. Sriphum, A. Muang, Chiang Mai, Thailand
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Seebacher B, Mills RJ, Reindl M, Zamarian L, Kuisma R, Kircher S, Brenneis C, Ehling R, Deisenhammer F. German translation, cultural adaption and validation of the unidimensional self-efficacy scale for multiple sclerosis: a study protocol. BMJ Open 2019; 9:e029565. [PMID: 31434775 PMCID: PMC6707685 DOI: 10.1136/bmjopen-2019-029565] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Self-efficacy refers to individuals' confidence in their ability to perform relevant tasks to accomplish desired goals. This is independent of their actual abilities. In people with multiple sclerosis (MS), self-efficacy has been shown to powerfully influence motivation and health-related behaviour, such as adherence to prescribed treatment or physical activity. So far, a rigorously tested German language self-efficacy questionnaire for people with MS is missing. METHODS The purpose of this study is to translate the original Unidimensional Self-Efficacy Scale for Multiple Sclerosis (USE-MS) into German and to validate the German USE-MS (USE-MS-G). Based on Bandura's concept of self-efficacy and international guidelines for questionnaire development, the patient-led development of the pre-final German version will involve a forward-backward translation process, synthesis of translations, expert committee review and consensus with the original test developers. At two centres in Tyrol, Austria, content and face validity and cultural adaption for Austria will be established using face-to-face semistructured cognitive interviews of 30 people with MS (PwMS). A further 292 PwMS with minimal to severe disability will be tested at two timepoints to validate the USE-MS-G. RESULTS Mixed methods analyses will be applied. Interviews will be transcribed and analysed employing qualitative content analysis. External validity will be explored using Spearman's Rank correlation coefficients of the USE-MS-G with the 13-item Resilience Scale, General Self-Efficacy Scale, Multiple Sclerosis International Quality of Life questionnaire, Hospital Anxiety and Depression Scale and MS-specific Neurological Fatigue Index. Test-retest reliability, internal consistency and floor and ceiling effects will be evaluated. Internal validity will be examined using Rasch analysis. ETHICS AND DISSEMINATION Ethical approval was received from the Ethics Committee of the Medical University of Innsbruck, Austria (reference number EK1260/2018; 13.12.2018). Results from this study will be disseminated to the participants and MS Societies, and to clinicians and researchers through peer-reviewed publications and conferences. STUDY REGISTRATION ISRCTN Registry; trial ID ISRCTN14843579; prospectively registered on 02. 01. 2019; http://www.isrctn.com/ISRCTN14843579.
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Affiliation(s)
- Barbara Seebacher
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Roger J Mills
- Department of Neurology, Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Markus Reindl
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Laura Zamarian
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
| | - Raija Kuisma
- School of Health Sciences, University of Brighton, Eastbourne, UK
| | - Simone Kircher
- Clinical Department of Neurology, University Hospital of Innsbruck, Innsbruck, Austria
| | - Christian Brenneis
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
- Karl Landsteiner Institut für Interdisziplinäre Forschung am Reha Zentrum Münster, Münster, Austria
| | - Rainer Ehling
- Department of Neurology, Clinic for Rehabilitation Münster, Münster, Austria
- Karl Landsteiner Institut für Interdisziplinäre Forschung am Reha Zentrum Münster, Münster, Austria
| | - Florian Deisenhammer
- Clinical Department of Neurology, Medical University of Innsbruck, Innsbruck, Austria
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Scholten EWM, Hillebregt CF, Ketelaar M, Visser-Meily JMA, Post MWM. Measures used to assess impact of providing care among informal caregivers of persons with stroke, spinal cord injury, or amputation: a systematic review. Disabil Rehabil 2019; 43:746-772. [PMID: 31366259 DOI: 10.1080/09638288.2019.1641847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
PURPOSE (1) To identify measures used to evaluate the impact of caregiving among caregivers of persons with stroke, spinal cord injury, and amputation; and (2) to systematically evaluate their clinimetric properties reported in validation studies. MATERIALS AND METHODS Two separate systematic reviews (Embase, PsycINFO, CINAHL, Pubmed/Medline) were conducted. COSMIN guidelines were used to assess clinimetric properties and methodological quality of studies. RESULTS (1) 154 studies published between 2008 and May 2019 were included, in which 48 measures were used, mostly describing negative impact. Thirty measures were used only once and not further described. (2) In general, structural validity, internal consistency, and hypothesis testing were often investigated. Reliability, cross-cultural and criterion validity to a lesser extent, and scale development and content validity were rarely described. Tests of measurement error and responsiveness were exceptional. Most supporting evidence was found for the Zarit Burden Interview Short Form, Caregiver Burden Scale and Positive Aspects of Caregiving Questionnaire. CONCLUSIONS There is a wide variety of impact of caregiving measures. The present study provided a detailed overview of what is known about clinimetric characteristics of 18 different measures repeatedly used in research. The overview provides clinicians a guidance of appropriate measure selection. PROSPERO REGISTRATION CRD42018094796IMPLICATIONS FOR REHABILITATIONClinicians should be aware that information about measure development and clinimetric properties for most measures used to assess impact of informal caregiving is incomplete.Most supporting evidence was found for the Zarit Burden Interview Short Form, Caregiver Burden Scale and Positive Aspects of Caregiving Questionnaire.This overview of clinimetric properties provides clinicians guidance for selection of an appropriate measure.
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Affiliation(s)
- Eline W M Scholten
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Chantal F Hillebregt
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Marjolijn Ketelaar
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands
| | - Johanna M A Visser-Meily
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,Department of Rehabilitation, Physical Therapy Science & Sports, UMCU Utrecht Brain Center, University Medical Center, Utrecht, The Netherlands
| | - Marcel W M Post
- Center of Excellence for Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, The Netherlands.,University of Groningen, University Medical Center Groningen, Center for Rehabilitation, Department of Rehabilitation Medicine, Groningen, The Netherlands
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Queluz FNFR, Ferreira Campos CR, Santis LD, Isaac L, Barham EJ. Zarit Caregiver Burden Interview: Evidências de Validade para a População Brasileira de Cuidadores de Idosos. REVISTA COLOMBIANA DE PSICOLOGÍA 2019. [DOI: 10.15446/rcp.v28n1.69422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
A Zarit Caregiver Burden Interview (ZBI) avalia a sobrecarga de cuidadores de idosos. Porém, ainda carece de evidências de validade para o contexto brasileiro, com cuidadores de idades variadas. Neste estudo, foram verificadas evidências de validade do ZBI –interna e baseadas nas relações com qualidade de vida e depressão–. No Estudo 1, participaram 285 cuidadores de idosos com idades entre 18 e 87 anos, que responderam à ZBI. No Estudo 2, 205 dos cuidadores do Estudo 1 também responderam ao Inventário de Depressão de Beck e à Escala de Qualidade de Vida. No Estudo 1, foram testados três modelos por meio de uma análise fatorial confirmatória e o alfa de Cronbach. No Estudo 2, foram medidascorrelações de escores na ZBI com escores de depressão e qualidade de vida. O modelo de três fatores se mostrou o maisadequado, apresentando bons índices de consistência interna. Foram observadas correlações negativas entre a ZBI e qualidade de vida e positivas com depressão. Portanto, este estudo contribuiu para o processo de validação da ZBI no Brasil, com cuidadores de faixa etária ampla.
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Vatter S, McDonald KR, Stanmore E, Clare L, Leroi I. Multidimensional Care Burden in Parkinson-Related Dementia. J Geriatr Psychiatry Neurol 2018; 31:319-328. [PMID: 30244631 DOI: 10.1177/0891988718802104] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND OBJECTIVE Providing care to people with Parkinson-related dementia (PwPRD) may result in significant stress, strain, and burden for life partners. A common measurement of life partner burden is the Zarit Burden Interview (ZBI), which considers "burden" as a unitary concept; however, burden is highly complex and most likely comprises several dimensions. This study aimed to explore the factor structure of the ZBI in life partners of PwPRD and to examine the relationships among the emerging factors and the demographic and clinical features. METHODS Life partners of PwPRD participated in home-based quantitative assessments and self-completed postal questionnaires. The assessment battery included ZBI, measures of relationship satisfaction, mood, stress, resilience, health, quality of life, feelings related to care provision, and sociodemographic questions. Data on PwPRDs' motor and neuropsychiatric symptom severity were also elicited in home-based assessments. RESULTS An exploratory factor analysis (principal axis factoring) of ZBI, conducted with 127 life partners, revealed five burden dimensions: social and psychological constraints, personal strain, interference with personal life, concerns about future, and guilt. These burden factors were associated with lower relationship satisfaction, mental health, and resilience, and higher stress, anxiety, depression, resentment, negative strain, and PwPRD motor severity. In multiple linear regression analyses, where each factor score was the dependent variable, stress, negative strain, and resentment emerged as significant predictors of specific burden dimensions. CONCLUSIONS Burden is a complex and multidimensional construct. Interventions should address specific types of burden among life partners of PwPRD to support couples' relationships and maintain quality of life.
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Affiliation(s)
- Sabina Vatter
- 1 Faculty of Biology, Medicine and Health, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.,2 Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
| | - Kathryn R McDonald
- 1 Faculty of Biology, Medicine and Health, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Emma Stanmore
- 3 Faculty of Biology, Medicine and Health, Division of Nursing, Midwifery and Social Work, School of Health Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom
| | - Linda Clare
- 4 Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, United Kingdom
| | - Iracema Leroi
- 1 Faculty of Biology, Medicine and Health, Division of Neuroscience and Experimental Psychology, School of Biological Sciences, Manchester Academic Health Science Centre, University of Manchester, Manchester, United Kingdom.,2 Greater Manchester Mental Health NHS Foundation Trust, Manchester, United Kingdom
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Phelan SM, Bangerter LR, Friedemann-Sanchez G, Lackore KA, Morris MA, Van Houtven CH, Carlson KF, van Ryn M, Harden KJ, Griffin JM. The Impact of Stigma on Community Reintegration of Veterans With Traumatic Brain Injury and the Well-Being of Their Caregivers. Arch Phys Med Rehabil 2018; 99:2222-2229. [PMID: 29729228 DOI: 10.1016/j.apmr.2018.04.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2018] [Revised: 04/01/2018] [Accepted: 04/05/2018] [Indexed: 12/19/2022]
Abstract
OBJECTIVE To assess the association between perceived stigma and discrimination and caregiver strain, caregiver well-being, and patient community reintegration. DESIGN A cross-sectional survey study of 564 informal caregivers of U.S. military service veterans of wars in Iraq and Afghanistan who experienced traumatic brain injuries or polytrauma (TBI/PT). SETTING Care settings of community-dwelling former inpatients of U.S. Department of Veterans Affairs Polytrauma Rehabilitation Centers. PARTICIPANTS Caregivers of former inpatients (N=564), identified through next-of-kin records and subsequent nominations. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Caregiver strain, depression, anxiety, loneliness, and self-esteem; as well as care recipient community reintegration, a key aspect of TBI/PT rehabilitation. RESULTS Family stigma was associated with strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration. Caregiver stigma-by-association was associated with strain, depression, anxiety, loneliness, and lower self-esteem. Care recipient stigma was associated with caregiver strain, depression, anxiety, loneliness, lower self-esteem, and less community reintegration. CONCLUSIONS Perceived stigma may be a substantial source of stress for caregivers of U.S. military veterans with TBI/PT, and may contribute to poor outcomes for the health of caregivers and for the community reintegration of the veterans for whom they provide care.
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Affiliation(s)
- Sean M Phelan
- Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care Delivery, Mayo Clinic, College of Medicine, Rochester, Minnesota; Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota.
| | - Lauren R Bangerter
- Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care Delivery, Mayo Clinic, College of Medicine, Rochester, Minnesota
| | | | - Kandace A Lackore
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
| | - Megan A Morris
- Adult and Child Consortium for Health Outcomes Research and Delivery Science, Anschutz Medical Campus, University of Colorado Aurora, Colorado
| | - Courtney H Van Houtven
- Durham Veterans Affairs Health Care System, Durham, North Carolina; Department of Population Health Sciences, School of Medicine, Duke University, Durham, North Carolina
| | - Kathleen F Carlson
- Veterans Affairs Portland Health Care System, Portland, Oregon; Oregon Health & Science University, Portland, Oregon
| | - Michelle van Ryn
- Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota; Oregon Health & Science University, Portland, Oregon
| | - Kristin J Harden
- Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care Delivery, Mayo Clinic, College of Medicine, Rochester, Minnesota; Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
| | - Joan M Griffin
- Robert D. and Patricia E. Kern Mayo Clinic Center for the Science of Health Care Delivery, Mayo Clinic, College of Medicine, Rochester, Minnesota; Division of Health Care Policy and Research, Mayo Clinic, Rochester, Minnesota
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Al-Rawashdeh SY, Lennie TA, Chung ML. Psychometrics of the Zarit Burden Interview in Caregivers of Patients With Heart Failure. J Cardiovasc Nurs 2018; 31:E21-E28. [PMID: 27617563 PMCID: PMC5069100 DOI: 10.1097/jcn.0000000000000348] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
BACKGROUND Identification of family caregivers who are burdened by the caregiving experience is vital to prevention of poor outcomes associated with caregiving. The Zarit Burden Interview (ZBI), a well-known measure of caregiving burden in caregivers of patients with dementia, has been used without being validated in caregivers of patients with heart failure (HF). PURPOSE The purpose of this study is to examine the reliability and validity of the ZBI in caregivers of patients with HF. METHODS A total of 124 primary caregivers of patients with HF completed survey questionnaires. Caregiving burden was measured by the ZBI. Reliability was examined using Cronbach's α and item-total/item-item correlations. Convergent validity was examined using correlations with the Oberst Caregiving Burden Scale. Construct validity was demonstrated by exploratory factor analysis and known hypothesis testing (ie, the hypothesis of the association between caregiving burden and depressive symptoms). RESULTS Cronbach's α for the ZBI was .921. The ZBI had good item-total (r = 0.395-0.764) and item-item (mean r = 0.365) correlations. Significant correlations between the ZBI and the Oberst Caregiving Burden Scale (r = 0.466 for the caregiving time subscale and 0.583 for the caregiving task difficulty subscale; P < .001 for both) supported convergent validity. Four factors were identified (ie, consequences of caregiving, patient's dependence, exhaustion with caregiving and uncertainty, and guilt and fear for the patient's future) using factor analysis, which are consistent with previous studies. Caregivers with high burden scores had significantly higher depressive symptoms than did caregivers with lower burden scores (7.0 ± 6.8 vs 3.1 ± 4.3; P < .01). CONCLUSION The findings provide evidence that the ZBI is a reliable and valid measure for assessing burden in caregivers of patients with HF.
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Affiliation(s)
- Sami Y Al-Rawashdeh
- Sami Y. Al-Rawashdeh, PhD, RN Assistant Professor, Faculty of Nursing, Hashemite University, Zarqa, Jordan. Terry A. Lennie, PhD, RN, FAAN Professor, University of Kentucky College of Nursing, Lexington. Misook L. Chung, PhD, RN, FAHA, FAAN Professor, University of Kentucky College of Nursing, Lexington
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Li D, Hu N, Yu Y, Zhou A, Li F, Jia J. Trajectories of Multidimensional Caregiver Burden in Chinese Informal Caregivers for Dementia: Evidence from Exploratory and Confirmatory Factor Analysis of the Zarit Burden Interview. J Alzheimers Dis 2018; 59:1317-1325. [PMID: 28759966 DOI: 10.3233/jad-170172] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
BACKGROUND Despite its popularity, the latent structure of 22-item Zarit Burden Interview (ZBI) remains unclear. There has been no study exploring how caregiver multidimensional burden changed. OBJECTIVE The aim of the work was to validate the latent structure of ZBI and to investigate how multidimensional burden evolves with increasing global burden. METHODS We studied 1,132 dyads of dementia patients and their informal caregivers. The caregivers completed the ZBI and a questionnaire regarding caregiving. The total sample was randomly split into two equal subsamples. Exploratory factor analysis (EFA) was performed in the first subsample. In the second subsample, confirmatory factor analysis (CFA) was conducted to validate models generated from EFA. The mean of weighted factor score was calculated to assess the change of dimension burden against the increasing ZBI total score. RESULTS The result of EFA and CFA supported that a five-factor structure, including role strain, personal strain, incompetency, dependency, and guilt, had the best goodness-of-fit. The trajectories of multidimensional burden suggested that three different dimensions (guilt, role strain and personal strain) became the main subtype of burden in sequence as the ZBI total score increased from mild to moderate. Factor dependency contributed prominently to the total burden in severe stage. CONCLUSION The five-factor ZBI is a psychometrically robust measure for assessing multidimensional burden in Chinese caregivers. The changes of multidimensional burden have deepened our understanding of the psychological characteristics of caregiving beyond a single total score and may be useful for developing interventions to reduce caregiver burden.
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Affiliation(s)
- Dan Li
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
| | - Nan Hu
- National Center for Chronic and Non-communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Yueyi Yu
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
| | - Aihong Zhou
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
| | - Fangyu Li
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
| | - Jianping Jia
- Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.,Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.,Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, P.R. China.,Key Laboratory of Neurodegenerative Diseases, Ministry of Education, Beijing, P.R. China.,National Clinical Research Center for Geriatric Disorders, Beijing, P.R. China
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Kayadjanian N, Schwartz L, Farrar E, Comtois KA, Strong TV. High levels of caregiver burden in Prader-Willi syndrome. PLoS One 2018; 13:e0194655. [PMID: 29579119 PMCID: PMC5868812 DOI: 10.1371/journal.pone.0194655] [Citation(s) in RCA: 48] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/07/2018] [Indexed: 11/19/2022] Open
Abstract
Objectives Prader-Willi syndrome (PWS) is a rare genetic neurodevelopmental disorder that is characterized by hyperphagia, developmental delay, incomplete sexual development, mild-to-moderate intellectual disability, and a variety of challenging behavioral and psychiatric symptoms. The characteristics of PWS can be difficult for caregivers to cope with and are likely to cause significant and long- term caregiver burden. The current study examined burden in 142 caregivers of children and adults with PWS living in the US using the Zarit Burden Interview (ZBI). The study aimed to measure the level of burden in caregivers of individuals with PWS, to explore the impact of PWS on caregiver quality of life, and to assess ZBI as an indicator of that impact. Results Caregivers participating in this study were predominantly mothers, 30–59 years old, non-Hispanic Whites, married or in a relationship, with an annual household income slightly distributed towards higher income. Nearly 90% of the caregiver`s children with PWS lived at home. Caregivers experienced high caregiver burden with an average ZBI score of 44.4 ± 15.4. ZBI scores were highest for caregivers of teenage and young adult individuals with PWS (49.2 ± 14.6 and 49.2 ± 14.1, respectively), while those caring for older adults (>30) and the youngest age group had lower scores (38.6 ±10.5 and 34.8 ±12.5, respectively). Caregivers reported that caring for a person with PWS negatively impacted their romantic relationship, ability to work, sleep, and mood. Whereas we did not find strong correlations between family income or level of help the caregiver receives and ZBI scores, the results showed significant correlations and a linear relationship between ZBI scores and caregiver depressed mood, feelings of anxiety, negative romantic relationship impact, as well as sleep and work disruption. Conclusions Our study reveals that PWS incurs high caregiver burden and impacts many aspects of the lives of caregiver. We identified the ZBI as a good predictor of that impact. Our findings draw attention to the critical unmet need for support for caregivers of individuals with PWS.
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Affiliation(s)
- Nathalie Kayadjanian
- Foundation for Prader-Willi Research, Walnut, California, United States of America
- PWS-Clinical Trial Consortium, Walnut, California, United States of America
- * E-mail:
| | - Lauren Schwartz
- Foundation for Prader-Willi Research, Walnut, California, United States of America
- PWS-Clinical Trial Consortium, Walnut, California, United States of America
- Department of Rehabilitation Medicine, University of Washington, Seattle, Washington, United States of America
| | - Evan Farrar
- PWS-Clinical Trial Consortium, Walnut, California, United States of America
- Prader-Willi Syndrome Association (USA), Sarasota, Florida, United States of America
| | - Katherine Anne Comtois
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, Washington, United States of America
| | - Theresa V. Strong
- Foundation for Prader-Willi Research, Walnut, California, United States of America
- PWS-Clinical Trial Consortium, Walnut, California, United States of America
- Department of Genetics, University of Alabama, Birmingham, Alabama, United States of America
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Galvin M, Carney S, Corr B, Mays I, Pender N, Hardiman O. Needs of informal caregivers across the caregiving course in amyotrophic lateral sclerosis: a qualitative analysis. BMJ Open 2018; 8:e018721. [PMID: 29374665 PMCID: PMC5829772 DOI: 10.1136/bmjopen-2017-018721] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVES Amyotrophic lateral sclerosis (ALS), also known as motor neuron disease (MND), is a debilitating terminal condition. Informal caregivers are key figures in ALS care provision. The physical, psychological and emotional impact of providing care in the home requires appropriate assistance and support. The objective of this analysis is to explore the needs of informal ALS caregivers across the caregiving course. DESIGN In an open-ended question as part of a semistructured interview, caregivers were asked what would help them in their role. Interviews took place on three occasions at 4-month to 6-month intervals. Demographic, burden and quality of life data were collected, in addition to the open-ended responses. We carried out descriptive statistical analysis and thematic analysis of qualitative data. SETTING AND PARTICIPANTS Home interviews at baseline (n=81) and on two further occasions (n=56, n=41) with informal caregivers of people with ALS attending the National ALS/MND Clinic at Beaumont Hospital, Dublin, Ireland. RESULTS The majority of caregivers were family members. Hours of care provided and caregiver burden increased across the interview series. Thematic analysis identified what would help them in their role, and needs related to external support and services, psychological-emotional factors, patient-related behaviours, a cure and 'nothing'. Themes were interconnected and their prevalence varied across the interview time points. CONCLUSION This study has shown the consistency and adaptation in what caregivers identified as helpful in their role, across 12-18 months of a caregiving journey. Support needs are clearly defined, and change with time and the course of caregiving. Caregivers need support from family, friends and healthcare professionals in managing their tasks and the emotional demands of caregiving. Identifying the specific needs of informal caregivers should enable health professionals to provide tailored supportive interventions.
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Affiliation(s)
- Miriam Galvin
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
| | - Sile Carney
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Bernie Corr
- Department of Neurology, National Neuroscience Centre, Beaumont Hospital, Dublin, Ireland
| | - Iain Mays
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Niall Pender
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin, Ireland
- Department of Neurology, National Neuroscience Centre, Beaumont Hospital, Dublin, Ireland
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Mediational Model of Multiple Sclerosis Impairments, Family Needs, and Caregiver Mental Health in Guadalajara, Mexico. Behav Neurol 2018; 2018:8929735. [PMID: 29593840 PMCID: PMC5822770 DOI: 10.1155/2018/8929735] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2017] [Revised: 08/24/2017] [Accepted: 09/27/2017] [Indexed: 01/02/2023] Open
Abstract
Individuals with multiple sclerosis (MS), especially those living in Latin America, often require assistance from family caregivers throughout the duration of the disease. Previous research suggests that family caregivers may experience positive and negative outcomes from providing care to individuals with MS, but few studies have examined the unmet needs of individuals providing care to family members with MS and how these unmet needs may mediate the relationship between MS symptoms and caregiver mental health. The current study examined the relationships among MS impairments (functional, neurological, cognitive, behavioral, and emotional), unmet family needs (household, informational, financial, social support, and health), and caregiver mental health (satisfaction with life, anxiety, burden, and depression) in a sample of 81 MS caregivers from Guadalajara, Mexico. A structural equation model demonstrated the mediational effect of unmet family needs on the relationship between MS impairments and caregiver mental health. These findings suggest that intervention research on MS caregivers in Latin America may consider focusing on caregiver mental health problems by addressing unmet family needs and teaching caregivers ways to manage the impairments of the individual with MS.
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Landfeldt E, Mayhew A, Straub V, Bushby K, Lochmüller H, Lindgren P. Psychometric properties of the Zarit Caregiver Burden Interview administered to caregivers to patients with Duchenne muscular dystrophy: a Rasch analysis. Disabil Rehabil 2017; 41:966-973. [DOI: 10.1080/09638288.2017.1416501] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Erik Landfeldt
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Anna Mayhew
- John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, Centre for Life, Newcastle upon Tyne, UK
| | - Volker Straub
- John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, Centre for Life, Newcastle upon Tyne, UK
| | - Katharine Bushby
- John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, Centre for Life, Newcastle upon Tyne, UK
| | - Hanns Lochmüller
- John Walton Muscular Dystrophy Research Centre and MRC Centre for Neuromuscular Diseases, Institute of Genetic Medicine, Newcastle University, Centre for Life, Newcastle upon Tyne, UK
| | - Peter Lindgren
- Medical Management Centre, Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
- The Swedish Institute for Health Economics, Lund, Sweden
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29
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Oh J, Kim JA. Factor analysis of the Zarit Burden Interview in family caregivers of patients with amyotrophic lateral sclerosis. Amyotroph Lateral Scler Frontotemporal Degener 2017; 19:50-56. [DOI: 10.1080/21678421.2017.1385636] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Juyeon Oh
- Division of Nursing, Hanyang University, Seoul, South Korea and
- Cell Therapy Center for Intractable Disorders, Hanyang University Hospital, Seoul, South Korea
| | - Jung A. Kim
- Division of Nursing, Hanyang University, Seoul, South Korea and
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Tang B, Yu Y, Liu Z, Lin M, Chen Y, Zhao M, Xiao S. Factor analyses of the Chinese Zarit Burden Interview among caregivers of patients with schizophrenia in a rural Chinese community. BMJ Open 2017; 7:e015621. [PMID: 28965090 PMCID: PMC5640094 DOI: 10.1136/bmjopen-2016-015621] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVE This study aimed to evaluate the factor structure of the Chinese version of the 22-item Zarit Burden Interview (ZBI) among family caregivers of patients with schizophrenia in China. METHODS Using one-stage cluster-sampling design, 324 primary caregivers of patients with schizophrenia in Ningxiang County, Hunan Province, China, completed the Zarit Burden Interview face-to-face. Confirmatory factor analysis (CFA) was first performed based on existing models to check model fit. Owing to an unsatisfactory result of CFA, exploratory factor analysis (EFA) was then conducted to explore a new factor structure, and a subsequent CFA was run to examine its model fit. RESULTS The CFA results showed that none of the existing models fit the data reasonably well. The EFA results suggested five dimensions: negative emotion (10 items), interpersonal relationship (4 items), time demand (3 items), patient's dependence (2 items) and self-accusation and guilt (2 items). The following CFA confirmed the five-factor solution in this study, and the goodness-of-fit for this model fell within the acceptable range. The overall internal consistency (Cronbach's alpha) was 0.88, and the internal consistency coefficients of individual dimensions were 0.68 to 0.84. CONCLUSION This study supported a 22-item ZBI scale, with a five-factor structure when applied to Chinese caregivers of patients with schizophrenia.
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Affiliation(s)
- Bingwei Tang
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yu Yu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
- Hospital Evaluation Office, Xiangya Hospital Central South University, Changsha, China
| | - Ziwei Liu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Meijuan Lin
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yumei Chen
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Mei Zhao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shuiyuan Xiao
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
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Sinha P, Yohannan S, Thirumoorthy A, Sivakumar PT. Predictors of Desire to Institutionalization in Dementia Caregivers From a Developing Country. Am J Alzheimers Dis Other Demen 2017; 32:245-251. [PMID: 28605997 PMCID: PMC10852551 DOI: 10.1177/1533317517714888] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/03/2024]
Abstract
Older adults with dementia have higher rates of institutionalization than those without dementia. Desire to institutionalization (DTI) is an important factor influencing the actual institutionalization but is less well studied. This cross-sectional study examines the DTI with the scale of same name developed by Morycz, in 1985, in a sample of 50 caregivers of patients with dementia in a tertiary clinical care setting in a developing country. Caregiver burden associated with personal strain (by factor analyzed Zarit Burden Interview scale), and stress perceived out of caregiving (by Perceived Stress Scale) predicted higher DTI. Besides, those who were married had lower DTI scores. The factors which didn't affect DTI were total caregiver burden, family and social support, age of patient and caregiver, education of caregiver, severity and duration of dementia, and treatment duration. These results were different from those of developed country-based DTI studies and may indicate sociocultural differences.
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Affiliation(s)
- Preeti Sinha
- Department of Psychiatry, National Institute of Mental health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - Sherin Yohannan
- Department of Psychiatric Social Work, National Institute of Mental health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
| | - A. Thirumoorthy
- Department of Psychiatric Social Work, National Institute of Mental health and Neurosciences (NIMHANS), Bangalore, Karnataka, India
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Hagell P, Alvariza A, Westergren A, Årestedt K. Assessment of Burden Among Family Caregivers of People With Parkinson's Disease Using the Zarit Burden Interview. J Pain Symptom Manage 2017; 53:272-278. [PMID: 27810571 DOI: 10.1016/j.jpainsymman.2016.09.007] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Revised: 09/01/2016] [Accepted: 09/06/2016] [Indexed: 11/25/2022]
Abstract
CONTEXT Previous studies have supported the psychometric properties of the 22-Item Zarit Burden Interview (ZBI-22) scale among family caregivers of people with various disorders, including Parkinson's disease (PD). However, its short forms have not been psychometrically tested among PD family caregivers, and available psychometric analyses have not accounted for the ordinal nature of item-level data. OBJECTIVES To assess the psychometric properties of the ZBI-22 and its short forms among family caregivers of people with PD, while taking account for the ordinal nature of data. METHODS Cross-sectional postal survey ZBI-22 data from 66 family caregiver members (59% women; mean age 69.6 years) of a local Swedish PD society branch were analyzed according to classical test theory methods based on polychoric/polyserial correlations. RESULTS Missing item responses were ≤ 5%. Corrected item-total correlations were ≥ 0.42 and floor/ceiling effects were <20%, besides for the briefest (4- and 1-item) short forms (20% and 40% floor effects, respectively). Reliability was good for all scales (ordinal alpha 0.89-0.95). External construct validity was in general accordance with a priori expectations. Short forms demonstrated good criterion-related validity (rs 0.87-0.99) and discriminative ability (area under the curve, 0.91-0.98) relative to the full ZBI-22. CONCLUSION This study provides support for the reliability and validity of the ZBI-22 and its various short forms for use among PD family caregivers. In studies where caregiver burden is a central outcome, either ZBI-22 or ZBI-12 is suggested for use; other short forms can be used when caregiver burden is of less central focus or for clinical screening.
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Affiliation(s)
- Peter Hagell
- The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden.
| | - Anette Alvariza
- Department of Health Care Sciences and Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden; Capio Palliative Care Unit, Stockholm, Sweden
| | - Albert Westergren
- The PRO-CARE Group, School of Health and Society, Kristianstad University, Kristianstad, Sweden
| | - Kristofer Årestedt
- Department of Health Care Sciences and Palliative Research Centre, Ersta Sköndal University College, Stockholm, Sweden; Department of Health and Caring Science, Linnaeus University, Kalmar, Sweden; Kalmar County Hospital, Kalmar, Sweden
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Feast A, Orrell M, Russell I, Charlesworth G, Moniz-Cook E. The contribution of caregiver psychosocial factors to distress associated with behavioural and psychological symptoms in dementia. Int J Geriatr Psychiatry 2017; 32:76-85. [PMID: 26891463 DOI: 10.1002/gps.4447] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2015] [Revised: 01/06/2016] [Accepted: 01/20/2016] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The objective of the study is to examine caregiver factors as predictors of BPSD-related distress and their potential mechanisms. METHOD Informal caregivers of people with dementia (n = 157) recruited from 28 community mental health teams in six NHS Trusts across England completed questionnaires regarding psychosocial factors (relationship quality, competence, guilt, health-related quality of life in the caregiver and person with dementia, reactivity to behavioural and psychological symptoms in dementia [BPSD] and burden) and frequency of BPSD. Analyses of BPSD-related distress include hierarchical multiple regression, mediation, moderation and path analysis. RESULTS Caregiver psychosocial factors explained 56% of the variance in BPSD-related distress. After controlling for these factors, frequency of BPSD was not a significant predictor of BPSD-related distress. Caregiver reactivity to BPSD, burden, competence and relationship quality directly influenced BPSD-related distress. Guilt influenced distress indirectly via competence, burden and reactivity to BPSD. The final model accounted for 41% of the variance in BPSD-related distress and achieved a good fit to the data (χ2 = 23.920, df = 19, p = 0.199). CONCLUSIONS Caregiver psychosocial factors including sense of competence, guilt, burden and reactivity to BPSD contribute to BPSD-related distress. Tailored interventions for managing behaviour problems in family settings could focus on these factors associated with BPSD-related distress to minimise distress in families. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- Alexandra Feast
- Division of Psychiatry, University College London, London, UK
| | - Martin Orrell
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Ian Russell
- Swansea University Medical School, Swansea University, Swansea, UK
| | - Georgina Charlesworth
- Research Department of Clinical, Educational, and Health Psychology, University College London, London, UK
| | - Esme Moniz-Cook
- Faculty of Health and Social Care, University of Hull, Hull, UK
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Galvin M, Corr B, Madden C, Mays I, McQuillan R, Timonen V, Staines A, Hardiman O. Caregiving in ALS - a mixed methods approach to the study of Burden. BMC Palliat Care 2016; 15:81. [PMID: 27596749 PMCID: PMC5011853 DOI: 10.1186/s12904-016-0153-0] [Citation(s) in RCA: 60] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2016] [Accepted: 08/26/2016] [Indexed: 12/13/2022] Open
Abstract
Background Caregiver burden affects the physical, psychological and emotional well-being of the caregiver. The purpose of this analysis was to describe an informal caregiver cohort (n = 81), their subjective assessment of burden and difficulties experienced as a result of providing care to people with Amyotrophic Lateral Sclerosis (ALS). Methods Using mixed methods of data collection and analysis, we undertook a comprehensive assessment of burden and difficulties associated with informal caregiving in ALS. As part of a semi-structured interview a series of standardised measures were used to assess quality of life, psychological distress and subjective burden, and in an open-ended question caregivers were asked to identify difficult aspects of their caregiving experience. Results The quantitative data show that psychological distress, hours of care provided and lower quality of life, were significant predictors of caregiver burden. From the qualitative data, the caregiving difficulties were thematised around managing the practicalities of the ALS condition, the emotional and psychosocial impact; limitation and restriction, and impact on relationships. Conclusions The collection and analysis of quantitative and qualitative data better explores the complexity of caregiver burden in ALS. Understanding the components of burden and the difficulties experienced as a result of caring for someone with ALS allows for better supporting the caregiver, and assessing the impact of burden on the care recipient. Electronic supplementary material The online version of this article (doi:10.1186/s12904-016-0153-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Miriam Galvin
- School of Nursing and Human Sciences, Dublin City University, Dublin 9, Ireland. .,Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.
| | - Bernie Corr
- Department of Neurology, National Neuroscience Centre, Beaumont Hospital, Dublin 9, Ireland
| | - Caoifa Madden
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Iain Mays
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland
| | - Regina McQuillan
- Beaumont Hospital, Dublin 9, Ireland.,St Francis Hospice, Raheny, Dublin 5, Ireland
| | - Virpi Timonen
- School of Social Work and Social Policy, Trinity College Dublin, Dublin 2, Ireland
| | - Anthony Staines
- School of Nursing and Human Sciences, Dublin City University, Dublin 9, Ireland
| | - Orla Hardiman
- Academic Unit of Neurology, Trinity Biomedical Sciences Institute, Trinity College Dublin, Dublin 2, Ireland.,Department of Neurology, National Neuroscience Centre, Beaumont Hospital, Dublin 9, Ireland
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Lin CY, Wang JD, Pai MC, Ku LJE. Measuring burden in dementia caregivers: Confirmatory factor analysis for short forms of the Zarit Burden Interview. Arch Gerontol Geriatr 2016; 68:8-13. [PMID: 27580015 DOI: 10.1016/j.archger.2016.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/08/2016] [Accepted: 08/08/2016] [Indexed: 10/21/2022]
Abstract
INTRODUCTION To examine the psychometric properties of different short versions of the Zarit Burden Interview (ZBI), and to find an efficient and valid short version for clinical use among dementia caregivers. MATERIALS AND METHODS A total of 270 Taiwanese dementia caregivers filled out the full form of the ZBI, which contains 22 items. Using the 22-item ZBI, we used confirmatory factor analysis (CFA) to calculate the fit indices of all proposed short versions with various items to determine useful short versions. Additional associations between each useful short version and informal care hours, as well as subjective financial situations, were examined to understand their concurrent validity. RESULTS Based on the CFA results, three short versions of the ZBI, performed excellently (4-item version: comparative fit index [CFI]=1.000, Tucker-Lewis index [TLI]=1.035, standardized root mean square residual [SRMR]=0.019, and root mean square error of approximation [RMSEA]=0.000; 8-item version: CFI=0.970, TLI=0.958, SRMR=0.045, and RMSEA=0.065; 12-item version: CFI=0.959, TLI=0.950, SRMR=0.053, and RMSEA=0.075). In addition, the 12-item ZBI, as compared with other versions, had a higher correlation with the number of informal care hours. The 12-item ZBI was also highly correlated with the original 22-item ZBI (r=0.952). CONCLUSIONS We found the 12-item ZBI to be a promising measure for healthcare providers to assess the burden of dementia caregivers quickly and efficiently.
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Affiliation(s)
- Chung-Ying Lin
- Department of Rehabilitation Sciences, Faculty of Health and Social Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
| | - Jung-Der Wang
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Department of Occupational and Environmental Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University,Tainan, Taiwan
| | - Ming-Chyi Pai
- Division of Behavioral Neurology, Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan; Alzheimer's Disease Research Center, National Cheng Kung University Hospital, Tainan, Taiwan
| | - Li-Jung Elizabeth Ku
- Department of Public Health, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Development and Psychometric Validation of the EDE-QS, a 12 Item Short Form of the Eating Disorder Examination Questionnaire (EDE-Q). PLoS One 2016; 11:e0152744. [PMID: 27138364 PMCID: PMC4854480 DOI: 10.1371/journal.pone.0152744] [Citation(s) in RCA: 171] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2015] [Accepted: 03/18/2016] [Indexed: 11/20/2022] Open
Abstract
Objective The aim of this study was to develop and validate a short form of the Eating Disorder Examination Questionnaire (EDE-Q) for routine, including session by session, outcome assessment. Method The current, 28-item version (6.0) of the EDE-Q was completed by 489 individuals aged 18–72 with various eating disorders recruited from three UK specialist eating disorder services. Rasch analysis was carried out on factors identified by means of principal component analysis, which in combination with expert ratings informed the development of an EDE-Q short form. The shortened questionnaire’s reliability, validity and sensitivity was assessed based on online data collected from students of a UK university and volunteers with a history of eating disorders recruited from a national eating disorders charity aged 18–74 (N = 559). Results A 12-item short form, the Eating Disorder Examination Questionnaire Short (EDE-QS) was derived. The new measure showed high internal consistency (Cronbach’s α = .913) and temporal stability (ICC = .93; p < .001). It was highly correlated with the original EDE-Q (r = .91 for people without ED; r = .82 for people with ED) and other measures of eating disorder and comorbid psychopathology. It was sufficiently sensitive to distinguish between people with and without eating disorders. Discussion The EDE-QS is a brief, reliable and valid measure of eating disorder symptom severity that performs similarly to the EDE-Q and that lends itself for the use of sessional outcome monitoring in treatment and research.
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Stevens LF, Pickett TC, Wilder Schaaf KP, Taylor BC, Gravely A, Van Houtven CH, Friedemann-Sánchez G, Griffin JM. The Relationship between Training and Mental Health among Caregivers of Individuals with Polytrauma. Behav Neurol 2015; 2015:185941. [PMID: 26770015 PMCID: PMC4685074 DOI: 10.1155/2015/185941] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2015] [Revised: 10/23/2015] [Accepted: 10/27/2015] [Indexed: 11/23/2022] Open
Abstract
This was a hypothesis-generating exploration of relationships between caregiver training during TBI/polytrauma rehabilitation and caregiver mental health. In this cross-sectional study, 507 informal caregivers to US service members with TBI who received inpatient rehabilitation care in a Veterans Affairs' Polytrauma Rehabilitation Center from 2001 to 2009 completed a retrospective, self-report survey. Embedded in the survey were measures of caregiver mental health, including the National Institutes of Health's Patient Reported Outcome Measurement Information System (PROMIS) Anxiety and Depression Short Forms, the Rosenberg Self-Esteem scale, and the Zarit Burden Short Form. Though no groups endorsed clinical levels, mental health symptoms varied by caregiver training category (Trained, Not Trained, and Did Not Need Training). Caregivers who did not receive training on how to navigate healthcare systems endorsed higher depression and burden and lower self-esteem than those who did. Caregivers who did not receive training in supporting their care recipients' emotions endorsed higher anxiety, depression, and burden and lower self-esteem than those who did. Analyses also suggested a different association between training and mental health based on caregivers' relationship to the care recipient and the intensity of care recipient needs. Potential hypotheses for testing in future studies raised by these findings are discussed.
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Affiliation(s)
- Lillian Flores Stevens
- Hunter Holmes McGuire VAMC, Psychology Section (116B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA
- Departments of Psychology, Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Treven C. Pickett
- Hunter Holmes McGuire VAMC, Psychology Section (116B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA
- Departments of Psychology, Psychiatry, Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Kathryn P. Wilder Schaaf
- Hunter Holmes McGuire VAMC, Psychology Section (116B), 1201 Broad Rock Boulevard, Richmond, VA 23249, USA
- Departments of Psychology, Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond, VA, USA
| | - Brent C. Taylor
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, 1 Veterans Drive (152/Building 9), Minneapolis, MN 55417, USA
| | - Amy Gravely
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, 1 Veterans Drive (152/Building 9), Minneapolis, MN 55417, USA
| | - Courtney Harold Van Houtven
- Center for Health Services Research in Primary Care, Durham VA Medical Center, 508 Fulton Street, Durham, NC 27705, USA
| | - Greta Friedemann-Sánchez
- Humphrey School of Public Affairs, University of Minnesota, 267 Humphrey Center, 301 19th Avenue S., Minneapolis, MN 55455, USA
| | - Joan M. Griffin
- Center for Chronic Disease Outcomes Research, Minneapolis VA Health Care System, 1 Veterans Drive (152/Building 9), Minneapolis, MN 55417, USA
- Mayo Clinic, Department of Health Sciences Research, Division of Health Care Policy and Research, Kern Center for the Science of Health Care Delivery, 200 First Street SW, Rochester, MN 55905, USA
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Harding R, Gao W, Jackson D, Pearson C, Murray J, Higginson IJ. Comparative Analysis of Informal Caregiver Burden in Advanced Cancer, Dementia, and Acquired Brain Injury. J Pain Symptom Manage 2015; 50:445-52. [PMID: 25912274 DOI: 10.1016/j.jpainsymman.2015.04.005] [Citation(s) in RCA: 57] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2014] [Revised: 04/01/2015] [Accepted: 04/16/2015] [Indexed: 10/23/2022]
Abstract
CONTEXT Measurement and improvement of informal caregiver burden are central aims of policy and intervention. Burden itself is a complex construct, and total burden can differ by patient diagnosis, although how diagnosis affects different aspects of caregiver subjective burden is unclear. OBJECTIVES To compare the subjective burden of caregivers across three diagnostic groups using the 22-item Zarit Burden Inventory. METHODS We performed a secondary analysis of pooled cross-sectional data from four U.K. studies of informal caregivers of patients with advanced cancer (n = 105), dementia (n = 131), and acquired brain injury (ABI) (n = 215). Zarit Burden Inventory totals, subscales (personal and role strain), and individual mean scores were compared between diagnostic groups using the general linear model, adjusting for caregiver characteristics. RESULTS Caregiver age (mean years [SD]: cancer 66.1 [12.0]; dementia 61.9 [13.4]; and ABI 53.8 [10.9]) differed significantly across diagnostic groups (P < 0.001); 81.9%, 36.6%, and 59.1% of caregivers were spouse/partners, respectively (P < 0.001). Total burden was highest in ABI caregivers and lowest in cancer (mean total score [SD]: cancer 23.3 [13.4]; dementia 27.9 [16.4]; and ABI 39.1 [17.3]) (P < 0.001). Subscale scores showed similar patterns (mean personal and role subscale scores [SD]: cancer 11.8 [6.9], 5.8 [4.8]; dementia 14.4 [8.8], 7.3 [5.7]; and ABI 18.7 [9.1], 11.8 [6.0]) (P < 0.001 for both subscales). Most (17 of 22) individual item scores differed by diagnosis group (P < 0.05), except concepts of duty, responsibility, and perception of financial situation. CONCLUSION Our data show that total, subscale, and most individual elements of caregiver subjective burden differ between cancer, dementia, and ABI caregivers. This should be considered when designing future intervention strategies to reduce caregiver burden in these groups.
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Affiliation(s)
- Richard Harding
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom.
| | - Wei Gao
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom
| | - Diana Jackson
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom
| | - Clare Pearson
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom
| | - Joanna Murray
- Health Service & Population Research, Institute of Psychiatry, King's College London, London, United Kingdom
| | - Irene J Higginson
- Department of Palliative Care, Policy and Rehabilitation, Cicely Saunders Institute, King's College London, London, United Kingdom
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Construct Validity of the Chinese Version of the Activities of Daily Living Rating Scale III in Patients with Schizophrenia. PLoS One 2015; 10:e0130702. [PMID: 26121246 PMCID: PMC4488143 DOI: 10.1371/journal.pone.0130702] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Accepted: 05/23/2015] [Indexed: 12/05/2022] Open
Abstract
Background The Chinese version of the Activities of Daily Living Rating Scale III (ADLRS-III), which has 10 domains, is commonly used for assessing activities of daily living (ADL) in patients with schizophrenia. However, construct validity (i.e., unidimensionality) for each domain of the ADLRS-III is unknown, limiting the explanations of the test results. Purpose This main purpose of this study was to examine unidimensionality of each domain in the ADLRS-III. We also examined internal consistency and ceiling/floor effects in patients with schizophrenia. Methods From occupational therapy records, we obtained 304 self-report data of the ADLRS-III. Confirmatory factor analysis (CFA) was conducted to examine the 10 one-factor structures. If a domain showed an insufficient model fit, exploratory factor analysis (EFA) was performed to investigate the factor structure and choose one factor representing the original construct. Internal consistency was examined using Cronbach’s alpha (α). Ceiling and floor effects were determined by the percentage of patients with the maximum and minimum scores in each domain, respectively. Results CFA analyses showed that 4 domains (i.e., leisure, picture recognition, literacy ability, communication tools use) had sufficient model fits. These 4 domains had acceptable internal consistency (α = 0.79-0.87) and no ceiling/floor effects, except the leisure domain which had a ceiling effect. The other 6 domains showed insufficient model fits. The EFA results showed that these 6 domains were two-factor structures. Conclusion The results supported unidimensional constructs of the leisure, picture recognition, literacy ability, and communication tool uses domains. The sum scores of these 4 domains can be used to represent their respective domain-specific functions. Regarding the 6 domains with insufficient model fits, we have explained the two factors of each domain and chosen one factor to represent its original construct. Future users may use the items from the chosen factors to assess domain-specific functions in patients with schizophrenia.
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Ashford S, Siegert RJ, Alexandrescu R. Rasch measurement: the Arm Activity measure (ArmA) passive function sub-scale. Disabil Rehabil 2015; 38:384-90. [PMID: 25918961 DOI: 10.3109/09638288.2015.1041613] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
PURPOSE To evaluate the conformity of the Arm Activity measure (ArmA) passive function sub-scale to the Rasch model. METHODS A consecutive cohort of patients (n = 92) undergoing rehabilitation, including upper limb rehabilitation and spasticity management, at two specialist rehabilitation units were included. Rasch analysis was used to examine scaling and conformity to the model. Responses were analysed using Rasch unidimensional measurement models (RUMM 2030). The following aspects were considered: overall model and individual item fit statistics and fit residuals, internal reliability, item response threshold ordering, item bias, local dependency and unidimensionality. RESULTS ArmA contains both active and passive function sub-scales, but in this analysis only the passive function sub-scale was considered. Four of the seven items in the ArmA passive function sub-scale initially had disordered thresholds. These items were rescored to four response options, which resulted in ordered thresholds for all items. Once the items with disordered thresholds had been rescored, item bias was not identified for age, global disability level or diagnosis, but with a small difference in difficulty between males and females for one item of the scale. Local dependency was not observed and the unidimensionality of the sub-scale was supported and good fit to the Rasch model was identified. The person separation index (PSI) was 0.95 indicating that the scale is able to reliably differentiate at least two groups of patients. CONCLUSIONS The ArmA passive function sub-scale was shown in this evaluation to conform to the Rasch model once disordered thresholds had been addressed. Using the logit scores produced by the Rasch model it was possible to convert this back to the original scale range. Implications for Rehabilitation The ArmA passive function sub-scale was shown, in this evaluation, to conform to the Rasch model once disordered thresholds had been addressed and therefore to be a clinically applicable and potentially useful hierarchical measure. Using Rasch logit scores it has be possible to convert back to the original ordinal scale range and provide an indication of real change to enable evaluation of clinical outcome of importance to patients and clinicians.
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Affiliation(s)
- Stephen Ashford
- a Regional Rehabilitation Unit , Northwick Park Hospital , Middlesex , UK .,b Department of Palliative Care, Policy and Rehabilitation , King's College London, School of Medicine , London , UK , and
| | - Richard J Siegert
- c Department of Psychology, Faculty of Health and Environmental Sciences , AUT University , Auckland , New Zealand
| | - Roxana Alexandrescu
- b Department of Palliative Care, Policy and Rehabilitation , King's College London, School of Medicine , London , UK , and
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Abendroth M. Development and Initial Validation of a Parkinson’s Disease Caregiver Strain Risk Screen. J Nurs Meas 2015; 23:4-21. [DOI: 10.1891/1061-3749.23.1.4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Background and Purpose: Family caregivers face potential strain in caring for persons with Parkinson’s disease because of the unpredictability of symptom presentation. The Caregiver Strain Risk Screen (CSRS) was developed and tested for initial validation. Methods: Instrument item development was guided by focus-group and interview data and a theoretical conceptualization of caregiver strain risk in caregivers of persons with Parkinson’s disease. Caregivers of persons with Parkinson’s disease (N = 217) provided data. Results: Principal components analysis supported a 28-item instrument with 4 factors: self-preservation, nursing home consideration, coping through spirituality, and coping through formal support. Conclusion: The 28-item CSRS demonstrated acceptable validity and reliability in measuring the construct. Research using a new sample is underway to further psychometrically test and validate the CSRS through confirmatory factor analysis.
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Siegert RJ, Jackson DM, Playford ED, Fleminger S, Turner-Stokes L. A longitudinal, multicentre, cohort study of community rehabilitation service delivery in long-term neurological conditions. BMJ Open 2014; 4:e004231. [PMID: 24583762 PMCID: PMC3939653 DOI: 10.1136/bmjopen-2013-004231] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Revised: 01/10/2014] [Accepted: 01/24/2014] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES Part A: To pilot the use of a register to identify and monitor patients with complex needs arising from long-term neurological conditions. Part B: To determine the extent to which patients' needs for health and social services are met following discharge to the community after inpatient rehabilitation; to identify which factors predict unmet needs and to explore the relationship between service provision and outcomes at 12 months. DESIGN A multicentre, prospective, cohort study surveying participants at 1, 6 and 12 months using postal/online questionnaires and telephone interview. SETTING Consecutive discharges to the community from all nine tertiary, specialist, inpatient neurorehabilitation services in London over 18 months in 2010-2011. PARTICIPANTS Of 576 admissions 428 patients were recruited at discharge: 256 responded at 4 weeks, 212 at 6 months and 190 at 12 months. MEASURES Neurological Impairment Scale, The Needs and Provision Complexity Scale, The Northwick Park Dependency Scale, Community Integration Questionnaire, Zarit Burden Inventory. RESULTS n=322 (75%) expressed willingness to be registered, but in practice less than half responded to questionnaires at 6 and 12 months (49% and 44%, respectively), despite extensive efforts to contact them, with no significant differences between responders and non-responders. Significant unmet needs were identified within the first year following discharge, particularly in rehabilitation, social work support and provision of specialist equipment. Dependency for basic care and motor and cognitive impairment predicted services received, together accounting for 40% of the variance. Contra to expectation, patients whose rehabilitation needs were met were more dependent and less well integrated at 12 months post discharge than those with unmet needs. CONCLUSIONS Registration is acceptable to most patients, but questionnaires/telephone interviews may not be the most efficient way to reach them. When community resources are limited, service provision tends to be focused on the most dependent patients. REGISTRATION The study was registered with the NIHR Comprehensive Local Research Network: ID number 7503.
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Affiliation(s)
- Richard J Siegert
- School of Public Health and Psychosocial Studies and School of Rehabilitation and Occupational Studies, AUT University, Auckland, New Zealand
| | - Diana M Jackson
- Department of Palliative Care, Policy and Rehabilitation, School of Medicine, King's College London, London, UK
| | | | | | - Lynne Turner-Stokes
- Department of Palliative Care, Policy and Rehabilitation, School of Medicine, King's College London, London, UK
- Regional Rehabilitation Unit, Northwick Park Hospital, London, UK
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Branger C, O’Connell ME, Morgan DG. Factor Analysis of the 12-Item Zarit Burden Interview in Caregivers of Persons Diagnosed With Dementia. J Appl Gerontol 2014; 35:489-507. [PMID: 24652929 DOI: 10.1177/0733464813520222] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2013] [Accepted: 12/15/2013] [Indexed: 11/15/2022] Open
Abstract
The Zarit Burden Interview (ZBI) is commonly used to measure dementia caregiver burden, but its factor structure is unclear. A two-factor structure for the 12-item ZBI, “personal strain” and “role strain,” has been shown, but recent data suggest that an additional factor of “guilt” is embedded in the “role strain” items. The 12-item ZBI administered to 194 informal rural and urban caregivers of persons diagnosed with dementia was analyzed using exploratory factor analysis. A two-factor structure, with item loadings consistent with previously conceptualized constructs of “personal strain” and “role strain,” was found. Moreover, this factor structure was invariant to caregiver subgroups. When the predictive value of these factors was explored, only “personal strain” was important in predicting caregiver psychological distress, measured with the Brief Symptom Inventory. However, “role strain,” which included the hypothesized “guilt” items, did not appear to be an important predictor of caregiver distress.
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Cristancho-Lacroix V, Kerhervé H, de Rotrou J, Rouquette A, Legouverneur G, Rigaud AS. Evaluating the efficacy of a web-based program (diapason) for informal caregivers of patients with Alzheimer's disease: protocol for a randomized clinical trial. JMIR Res Protoc 2013; 2:e55. [PMID: 24317497 PMCID: PMC3869082 DOI: 10.2196/resprot.2978] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2013] [Accepted: 10/26/2013] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Informal caregivers (CGs) of patients with Alzheimer's disease are at risk of suffering from psychological and physical weakening. Several psychoeducational interventions have been designed to prevent stress and burden of caregivers. In France, despite health authorities' recommendations, to our knowledge there is no rigorously assessed Web-based psychoeducational program to date. OBJECTIVE The objective of our study was to assess the efficacy of a French Web-based psychoeducational program (called Diapason) with an unblinded randomized clinical trial. METHODS In this protocol, 80 informal caregivers of patients followed at Broca Hospital are recruited offline and randomized in the experimental condition (EC) or the control condition (CC). The volunteers in EC have to visit a closed online user group at least once a week and validate one new session of this fully automated Web program, during 12 weeks. Each week a new thematic is added to the website. The participants in the CC receive usual care, and have access to the Diapason program after their participation (6 months). Face-to-face evaluations for both groups are planned every 3 months (M0-M3 and M6). The main objective of this program is to provide CGs with information on the disease process, how to prevent psychological strain (using anticipation and relaxation techniques), and offering a virtual space (forum) to discuss with other caregivers. The primary outcome of this study is the self-perceived stress, while self-efficacy, burden, depression, and self-perceived health status are defined as secondary outcomes. Other variables that might have an impact on the program efficacy are collected. RESULTS This protocol was accepted for funding. The enrollment began in October 2011, and participants currently recruited will finish their evaluations in January 2014. The results are expected for June 2014. CONCLUSIONS Findings might provide empirical evidence on: (1) the feasibility of an Internet-based program in the French context, (2) the effectiveness of a Web-based program for informal caregivers, and (3) the identification of caregivers who will benefit from this type of intervention. TRIAL REGISTRATION Clinicaltrials.gov NCT01430286; http://clinicaltrials.gov/ct2/show/NCT01430286 (Archived by WebCite at http://www.webcitation/6KxHaRspL).
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Magee WL, Siegert RJ, Daveson BA, Lenton-Smith G, Taylor SM. Music Therapy Assessment Tool for Awareness in Disorders of Consciousness (MATADOC): Standardisation of the principal subscale to assess awareness in patients with disorders of consciousness. Neuropsychol Rehabil 2013; 24:101-24. [DOI: 10.1080/09602011.2013.844174] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Characteristics of care-givers and care recipients influencing the impact of paid care services on family care-giver burdens. AGEING & SOCIETY 2013. [DOI: 10.1017/s0144686x13000081] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
ABSTRACTIn the last few decades, a number of researchers have attempted to identify the effects of paid care services on alleviating the sense of burden of family care-givers, especially care-givers to people with dementia. However, few researchers have considered the possibility that paid care services alleviate the sense of burden only among those care-givers who possess specific characteristics. Without considering this point, the impact of paid care services would be averaged over an entire sample, and one might overlook the effects on these specific care-givers. With this background, this study examines the relationship between family care-givers' sense of burden and the amount of paid care services in Japan and identifies groups of care-givers among whom these services are significantly associated with a lesser sense of burden. The sense of burden of 339 family care-givers to older care recipients with dementia was measured using a modified version of the Caregiver Burden Inventory. In order to examine their association with the amount of paid care services received, logistic regression analysis was individually applied to groups of care-givers who exhibit specific characteristics. The results suggested that paid care services alleviated two out of five components of burden, provided the groups to which the analyses are applied are appropriately defined. In particular, two subsets of the entire sample, comprising young care-givers aged 49 or below, and including male care-givers, indicated that their overall sense of social and emotional burden were alleviated by the use of paid care services. The practical implications for policy makers are discussed.
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Ballesteros J, Santos B, González-Fraile E, Muñoz-Hermoso P, Domínguez-Panchón AI, Martín-Carrasco M. Unidimensional 12-item Zarit Caregiver Burden Interview for the assessment of dementia caregivers' burden obtained by item response theory. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2012; 15:1141-1147. [PMID: 23244818 DOI: 10.1016/j.jval.2012.07.005] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2011] [Revised: 07/09/2012] [Accepted: 07/12/2012] [Indexed: 06/01/2023]
Abstract
OBJECTIVES To develop a one-dimensional version of the 22-item Zarit Caregiver Burden Interview (ZBI) by applying item response theory approaches. METHODS The answers to the 22-item ZBI of 241 caregivers participating in a clinical trial were analyzed 1) with a Mokken nonparametric item response theory analysis to ascertain the dimensional structure underlying the scale and obtain a one-dimensional reduced version, 2) with the Samejima's graded response model to assess the item characteristics of the reduced version, and 3) with confirmatory factor analysis to confirm the unidimensionality of the reduced ZBI version and assess the item loadings to the burden latent variable. RESULTS Mokken analysis resulted in a major one-dimensional scale comprising 12 items directly related with burden. All items showed scalability indices over 0.30. The scalability for the overall scale was 0.44 defining a medium scale according to Mokken's criteria. An unconstrained Samejima's graded response model showed appropriate fit, and most items of the reduced 12-item ZBI presented pertinent difficulty and discrimination parameters. The results of the 12-item ZBI confirmatory factor analysis fitted to a one-dimensional latent structure for burden (comparative fit index=0.975; root-mean-square error of approximation=0.067; weighted root mean square residual=0.677). All factor lodgings were above 0.40 with items 9 (strained by the relative) and 22 (overall feeling of burden) presenting the highest loadings. CONCLUSIONS The reduced 12-item ZBI fits a one-dimensional latent variable of burden. Further psychometric studies, focusing on its equivalence for different populations, sensitivity to change, and minimal important difference are warranted.
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Affiliation(s)
- Javier Ballesteros
- Department of Neuroscience - Psychiatry, Medical School, University of the Basque Country, UPV/EHU, Leioa, Spain.
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Torres AR, Hoff NT, Padovani CR, Ramos-Cerqueira ATDA. Dimensional analysis of burden in family caregivers of patients with obsessive-compulsive disorder. Psychiatry Clin Neurosci 2012; 66:432-41. [PMID: 22834662 DOI: 10.1111/j.1440-1819.2012.02365.x] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
AIMS Obsessive-compulsive disorder (OCD) also generates emotional burden in the patient's family members, but no study has evaluated the specific dimensions of burden. The objectives were to evaluate the dimensions of the Zarit Burden Interview (ZBI) and possible correlates. METHODS This was a cross-sectional study involving 47 patients and 47 caregivers, using a sociodemographic questionnaire; the ZBI; the Self Reporting Questionnaire; the Family Accommodation Scale; and the Yale-Brown Obsessive-Compulsive Scale. The ZBI factor analysis was conducted using Varimax Rotation. RESULTS Six factors were identified, explaining 74.2% of the total variance: factor 1, interference in the caregiver's personal life (36.6% of the variance); factor 2, perception of patient's dependence (10.8%); factor 3, feelings of irritation or intolerance (9.2%); factor 4, guilt (7.2%); factor 5, insecurity (5.6%); and factor 6, embarrassment (4.8%). The six ZBI factors were associated with greater OCD severity and with greater accommodation to the patient's symptoms, and factors 1, 2, 5 and 6 with caregiver's psychological morbidity. Caregiver's sex (female) was associated with factors 5 and 6, relationship with the patient (being a parent or son/daughter) with factor 5, higher educational level with factor 6, living with the patient with factor 3, worse self-evaluation of health with factors 1, 5 and 6, and occupational status (not working) with factors 1, 2, 5 and 6. CONCLUSION The dimensions of burden identified indicate the most affected aspects of a caregiver's life and could guide the planning of more specific interventions. Thus, the caregiver could participate more effectively in the OCD patient's treatment, with a lower impact on his/her life.
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Affiliation(s)
- Albina Rodrigues Torres
- Department of Neurology, Psychology and Psychiatry, Botucatu Medical School Botucatu Medical School, Institute of Biosciences, Univ Estadual Paulista, Botucatu, SP, Brazil.
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Özer N, Yurttaş A, Akyıl RÇ. Psychometric Evaluation of the Turkish Version of the Zarit Burden Interview in Family Caregivers of Inpatients in Medical and Surgical Clinics. J Transcult Nurs 2012; 23:65-71. [DOI: 10.1177/1043659611423830] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The aim of this study was to adapt the Zarit Burden Interview (ZBI) to family caregivers of inpatients in medical and surgical clinics to assess the validity and reliability of the Turkish version. The study design was descriptive and methodological. A total of 223 family caregivers providing care to patients for at least 1 week in clinics were selected through convenience sampling. Data were collected using the Turkish translation of the ZBI. The psychometric testing of the adapted instrument was carried out to establish internal consistency, interitem correlation, and construct validity. The content validity procedure resulted in a final scale comprising 18 items. Cronbach’s alpha was .82. Factor analysis yielded one factor. The Turkish version of the ZBI adapted to the clinics can be used as a one-factor tool.
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Van Durme T, Macq J, Jeanmart C, Gobert M. Tools for measuring the impact of informal caregiving of the elderly: a literature review. Int J Nurs Stud 2011; 49:490-504. [PMID: 22078211 DOI: 10.1016/j.ijnurstu.2011.10.011] [Citation(s) in RCA: 89] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2010] [Revised: 10/09/2011] [Accepted: 10/17/2011] [Indexed: 10/15/2022]
Abstract
OBJECTIVES (1) Describe available tools to assess the impact of informal caregiving of home-dwelling elderly, (2) identify an acceptable and appropriate tool for a study aiming at the evaluation of the impact of innovative projects for care and support of care for elderly at home, on their main informal caregiver and (3) find a definition of 'main informal caregiver'. STUDY DESIGN Literature review by searches of the following electronic databases: MEDLINE, CINAHL, EMBASE, using firstly keywords and exclusion criteria, then citations and reference search. RESULTS This review has identified 105 scales assessing the impact of informal caregiving of the elderly. Those scales were described in terms of characteristics of the care receiver population, content and psychometric properties. Most retrieved scales are intended to measure the impact of caregiving on caregivers' health of elderly with dementia (n=49), overall elderly (n=21), cancer patients (n=7), chronically ill patients (n=7), psychiatric patients (n=7) and stroke patients (n=3). Dimensions of the impact of caregiving were classified into its positive (n=34), negative (n=55) or neither positive nor negative (n=16) consequences on the informal caregiver's health. Internal consistency varied from 0.48 to 0.99 and in half of the cases (n=52), construct validity was reported. Scales comprised 1-200 questions. The Zarit Burden Interview (ZBI-12) was selected for the study and an operational definition of the concept of "main informal caregiver" was constructed. CONCLUSION This review identified a large number of scales that can be used to assess the impact of caregiving, viewed through different dimensions. The Zarit Burden Interview can be a useful tool for researchers and clinicians due to its user-friendliness, extensively validation and international use, making comparisons between groups possible. Despite the fact that only the original version of each scale was selected, this inventory should be a useful tool for intervention studies and even clinicians work.
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Affiliation(s)
- Thérèse Van Durme
- Institut de Recherche Santé et Société, Université Catholique de Louvain, Brussels, Belgium.
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