Abstract
ObjectiveThe 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.ResultsThe 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.
Highlights
Caregiver burden is a state where the physical and psychological well-being, family relations or financial status of the caregiver could be threatened by providing the necessary care to another [1]
For the distribution of the Zarit Burden Interview (ZBI)-items, some had unacceptable kurtosis (> ±3), which contributed to the high frequency of zero categories on these respective items (Additional file 1: Table S1)
Correlation analysis showed that ZBI-22 had a coefficient of 0.855 (p < 0.01) with ZBI-12 for the uncorrected correlation, and 0.784 (p < 0.01)
Summary
The quality of life index score was quite high on average, while perceived stress and depressive symptoms were low (Table 1). Spouse Parents Offspring Relatives Nonrelated (hired caregiver) Length of caregiving, median, IQR, min–max (years) Number of hours per day Number of days per week Having physical illness Having mental problems Clinical data ZBI-22 ZBI-12 EQ-5D Mobility Self-care Usual activities Pain/discomfort Anxiety/depression PSS PHQ-9. Correlation analysis showed that ZBI-22 had a coefficient of 0.855 (p < 0.01) with ZBI-12 for the uncorrected correlation, and 0.784 (p < 0.01). Both ZBI-22 and ZBI21 significantly related to PHQ-9, PSS, the EQ-5D index score, subscale mobility, pain and anxiety/depression, but not to self-care and usual activity indicating convergent and discriminant validity (Table 2).
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