Hostname: page-component-76fb5796d-45l2p Total loading time: 0 Render date: 2024-04-26T01:39:33.695Z Has data issue: false hasContentIssue false
  • English
  • Français

Factors emerging from the “Zarit Burden Interview” and predictive variables in a UK sample of caregivers for people with dementia

Published online by Cambridge University Press:  22 March 2018

Kerry Johanna Smith ,
Catriona George  and
Nuno Ferreira
Kerry Johanna Smith*
Affiliation:
Department of Psychological Services and Research, NHS Dumfries & Galloway, Dumfries, Scotland
Catriona George
Affiliation:
Department of Paediatric Psychology and Liaison, Royal Hospital for Sick Children, NHS Lothian, Edinburgh, Scotland
Nuno Ferreira
Affiliation:
Department of Clinical and Health Psychology, School of Health in Social Science, The University of Edinburgh, Edinburgh, Scotland Department of Social Sciences, School of Humanities and Social Sciences, The University of Nicosia, Nicosia, Cyprus
*
Correspondence should be addressed to: Dr. Kerry Johanna Smith, Department of Psychological Services and Research, NHS Dumfries & Galloway, Crichton Hall, Dumfries DG1 4TG, Scotland. Phone: +744-7828061074. Email: kerrysmith9@nhs.net.
Get access Rights & Permissions [Opens in a new window]

Abstract

Background:

Caring for persons with dementia (PWD) can create “caregiver burden,” which is associated with negative outcomes for caregivers and PWD. The ZBI (Zarit Burden Interview) is a widely used unitary measure of caregiver burden. However, recent research has found caregiver burden to be multi-dimensional. The purpose of this study was to explore the factor structure of the ZBI within a sample of UK caregivers. A secondary aim was to identify variables that predicted burden dimensions found.

Methods:

A total of 110 unpaid community caregivers of PWD completed the ZBI. They also completed the EACQ (Experiential Avoidance in Caregiving Questionnaire), DEX (Dysexecutive Questionnaire), PACS (Positive Aspects of Caregiving Scale), and a demographic questionnaire. ZBI data were analyzed via exploratory factor analysis (principal axis factoring). Relationships between burden factors and other variables were studied using Pearson correlations and multiple regression.

Results:

Analysis identified three burden factors, namely direct impact of caregiving, uncertainty around the future, and frustration/embarrassment. A direct impact of caregiving and frustration/embarrassment has been found previously. Uncertainty over the future is a new factor, which was predicted by adult-child caregiver role, highlighting that spouses and adult children are likely to have different burden experiences. Additionally, uncertainty over the future and frustration/embarrassment were inversely predicted by PACS, suggesting that being mindful of positive aspects of caregiving may function as a protective factor for burden.

Conclusions:

This study found caregiver burden to be multi-dimensional and uncovered a novel factor in uncertainty over the future, which warrants further exploration. Burden factors were associated with a range of modifiable variables that could be targeted within health and social care interventions to improve outcomes for caregivers and PWD.

Keywords

dementiaAlzheimer's diseasecarersfactor analysiscaregiver burdencaregiver stressZarit Burden Interviewdementia caregivers
Type
Original Research Article
Information
International Psychogeriatrics , Volume 30 , Special Issue 11: Social Aspects of Dementia and Dementia Practice , November 2018 , pp. 1671 - 1678
Copyright
Copyright © International Psychogeriatric Association 2018 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Footnotes

Nuno Ferreira’s name has been corrected. A corrigendum notice detailing this change was also published (DOI: 10.1017/S1041610218002363).

References

Alzheimer's Society (UK) (2018). Available at: https://www.alzheimers.org.uk/site/scripts/documents_info.php?documentID=341; last accessed 05 February 2018.Google Scholar
Ankri, J., Andrieu, S., Beaufils, B., Grand, A. and Henrard, J. C. (2005). Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians. International Journal of Geriatric Psychiatry, 20, 254–260, doi:10.1002/gps.1275.Google Scholar
Bédard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A. and O'Donnell, M. (2001). The Zarit Burden Interview a new short version and screening version. The Gerontologist, 41, 652–657, doi:10.1093/geront/41.5.652.Google Scholar
Bennett, P., Ong, P. and Ponsford, J. (2005). Measuring executive dysfunction in an acute rehabilitation setting: using the dysexecutive questionnaire (DEX). Journal of the International Neuropsychological Society, 11, 376–385.Google Scholar
Brodaty, H., McGilchrist, C., Harris, L. and Peters, K. E. (1993). Time until institutionalization and death in patients with dementia: role of caregiver training and risk factors. Archives of Neurology, 50, 643–650, doi:10.1001/archneur.1993.00540060073021.Google Scholar
Campbell, P. et al. (2008). Determinants of burden in those who care for someone with dementia. International Journal of Geriatric Psychiatry, 23, 1078–1085, doi:10.1002/gps.2071.Google Scholar
Cheng, S. T., Kwok, T. and Lam, L. C. (2014). Dimensionality of burden in Alzheimer caregivers: confirmatory factor analysis and correlates of the Zarit Burden Interview. International Psychogeriatrics, 26, 1455–1463, doi:10.1017/S104161021400101X.Google Scholar
Cohen, C. A., Colantonio, A. and Vernich, L. (2002). Positive aspects of caregiving: rounding out the caregiver experience. International Journal of Geriatric Psychiatry, 17, 184–188, doi:10.1002/gps.561.Google Scholar
Conde-Sala, J. L., Garre-Olmo, J., Turró-Garriga, O., Vilalta-Franch, J. and López-Pousa, S. (2010). Differential features of burden between spouse and adult-child caregivers of patients with Alzheimer's disease: an exploratory comparative design. International Journal of Nursing Studies, 47, 1262–1273, doi:10.1016/j.ijnurstu.2010.03.001.Google Scholar
Flynn-Longmire, C. V. F. and Knight, B. G. (2011). Confirmatory factor analysis of a brief version of the Zarit Burden Interview in Black and White dementia caregivers. The Gerontologist, 51, 453–462, doi:10.1093/geront/gnr011.Google Scholar
George, L. K. and Gwyther, L. P. (1986). Caregiver weil-being: a multidimensional examination of family caregivers of demented adults. The Gerontologist, 26, 253–259.Google Scholar
Gilhooly, K. J. et al. (2016). A meta-review of stress, coping and interventions in dementia and dementia caregiving. BMC Geriatrics, 16, 1–8, doi:10.1186/s12877-016-0280-8.Google Scholar
Hayes, S. C., Wilson, K. G., Gifford, E. V., Follette, V. M. and Strosahl, K. (1996). Experiential avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment. Journal of Consulting and Clinical Psychology, 64, 1152–1168, doi:10.1037/0022-006X.64.6.1152.Google Scholar
Hébert, R., Bravo, G. and Préville, M. (2000). Reliability, validity and reference values of the Zarit Burden Interview for assessing informal caregivers of community-dwelling older persons with dementia. Canadian Journal on Aging, 19, 494–507, doi:10.1017/S0714980800012484.Google Scholar
Knight, B. G., Fox, L. S. and Chou, C. P. (2000). Factor structure of the burden interview. Journal of Clinical Geropsychology, 6, 249–258, doi:10.1023/A:1009530711710.Google Scholar
Losada, A. et al. (2015). Cognitive-behavioral therapy (CBT) versus acceptance and commitment therapy (ACT) for dementia family caregivers with significant depressive symptoms: results of a randomized clinical trial. Journal of Consulting and Clinical Psychology, 83, 760–772, doi:10.1037/ccp0000028.Google Scholar
Losada, A., Márquez-González, M., Romero-Moreno, R. and López, J. (2014). Development and validation of the Experiential Avoidance in Caregiving Questionnaire (EACQ). Aging & Mental Health, 18, 897–904, doi:10.1080/13607863.2014.896868.Google Scholar
O'Rourke, N. and Tuokko, H. A. (2003). Psychometric properties of an abridged version of the Zarit Burden Interview within a representative Canadian caregiver sample. The Gerontologist, 43, 121–127, doi:10.1093/geront/43.1.121.Google Scholar
Riedel, O., Klotsche, J. and Wittchen, H. U. (2016). Overlooking informal dementia caregivers' burden. Research in Gerontological Nursing, 4, 167–174, doi:10.3928/19404921-20160531-02.Google Scholar
Sánchez-Izquierdo, M., Prieto-Ursúa, M. and Caperos, J. M. (2015). Positive aspects of family caregiving of dependent elderly. Educational Gerontology, 41, 745–756, doi:10.1080/03601277.2015.1033227.Google Scholar
Schulz, R. and Beach, S. R. (1999). Caregiving as a risk factor for mortality: the caregiver health effects study. JAMA, 282, 2215–2219, doi:10.1001/jama.282.23.2215.Google Scholar
Sousa, M. F., Santos, R. L., Turró-Garriga, O., Dias, R., Dourado, M. C. and Conde-Sala, J. L. (2016). Factors associated with caregiver burden: comparative study between Brazilian and Spanish caregivers of patients with Alzheimer's disease (AD). International Psychogeriatrics, 28, 1–12, doi:10.1017/S1041610216000508.Google Scholar
Springate, B. A. and Tremont, G. (2014). Dimensions of caregiver burden in dementia: impact of demographic, mood, and care recipient variables. The American Journal of Geriatric Psychiatry, 22, 294–300, doi:10.1016/j.jagp.2012.09.006.Google Scholar
Tarlow, B. J., Wisniewski, S. R., Belle, S. H., Rubert, M., Ory, M. G. and Gallagher-Thompson, D. (2004). Positive aspects of caregiving contributions of the REACH project to the development of new measures for Alzheimer's caregiving. Research on Aging, 26, 429–453, doi:10.1177/0164027504264493.Google Scholar
Wilson, B. A., Evans, J. J., Emslie, H., Alderman, N. and Burgess, P. (1998). The development of an ecologically valid test for assessing patients with a dysexecutive syndrome. Neuropsychological Rehabilitation, 8, 213–228, doi:10.1080/713755570.Google Scholar
Zarit, S. H., Reever, K. E. and Bach-Peterson, J. (1980). Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist, 20, 649–655.Google Scholar
Zarit, S. H. and Zarit, J. M. (1987). The Memory and Behavior Problems Checklist (1987R) and the Burden Interview. Technical Report. Pennsylvania State University, USA.Google Scholar