The Latina Caregiver Burden Scale: Assessing the Factor Structure for Rapid Clinical Assessment

Abstract

The study of caregiver burden is important for those faced with chronic illnesses such as AIDS as caregivers are the first line of care provision, sustaining care recipients in the home. Because perception of burden may vary across caregiver cultural groups, accurate measurement of burden is crucial to offer culturally sensitive services for those providing in-home care. The purpose of this study was to test the factor structure of a rapid assessment instrument, the Latina Caregiver Burden Scale, in a sample of 154 newly immigrated Latina caregivers primarily of Mexican descent. Face-to-face interviews were conducted in Spanish and English by bilingual, bicultural interviewers. The findings suggest that aspects of caregiver burden for these low-income women are tied to factor structures associated with depression and guilt mentality, socioeconomic stress, and stigma linked with HIV/AIDS. Social workers have greater likelihood of accurate cultural assessment of caregiver burden in similar groups when using such research-supported measures. KEY WORDS: assessment scale; burden; caregiver ; Latina / Latino ; women ********** Although burdens associated with extended caregiving for an ill relative have been well documented with valid and reliable measures in white groups, these same burdens have been little studied in ethnic minority samples (Awad & Voruganti, 2008; Land & Hudson, 2004). Such measures are needed as social workers in the health arena may find caregiver perceptions of burdens, and the emotional response to different aspects of the caregiving role, to be extremely valuable in comprising ongoing service plans. Moreover, caregivers' perceptions of burden may vary across cultural and ethnic groups; thus, accurate assessment of burden is crucial if social workers are to provide culturally sensitive services to relieve caregiver stress. BACKGROUND With the rapid rise of immigration, especially in California, recent attention has turned to family caregiving in Latino cultures, where family values are strong and women constitute the backbone of caregiving (de Figueiredo & Turato, 2001; Madianos et al., 2004; Magana, 2006; Oliveros, 2008). Especially among newly emigrated Latinos, caregiving tasks fall to Latinas because of strong cultural role expectations and limited services for care outside the home (Oliveros, 2008). Nonetheless, adequate culturally sensitive measures of caregiver burden are lacking (Janevic & Connel, 2001; Neff, Amodei, Valescu, & Pomeroy, 2003; Shurgot & Knight, 2004). The present study tested the factor structure of a rapid assessment instrument measuring burden in a sample of 154 newly immigrated Latina caregivers, a population underserved in both practice and research. Burden and Caregiving in Latino Cultures Studies reveal that Latina female caregivers dedicate an enormous portion of their lives to the caregiving role and provide substantial assistance to ill, orphaned, and elderly relatives (Choppelas & Wilson, 2006; Shurgot & Knight, 2004; Wight, Aneshensel, & LeBlanc, 2003). For a variety of reasons, these tasks may be more burdensome for some Latino groups, such as caregivers who are poorer, recently emigrated, undocumented women of Mexican and Central American origin who have traveled North across the border in search of a better life in California. To meet the needs of a relative with a complex chronic illness, such as HIV or Alzheimer's disease, caregivers are often required to have knowledge of multiple services to promote disease management (Oliveros, 2008). Caregivers must understand the illness, facilitate the required services, and likewise become familiar with the service systems and individuals involved in the care of the patient (Choppelas & Wilson, 2006; Magana, Ramirez Garcia, Hernandez, & Cortez, 2007; Oliveros, 2008). Concomitantly, many female caregivers of Mexican and Central American origin often cope with the burdens of acculturation, lack of documentation and accompanying fear of deportation, and resulting isolation (County of Los Angeles, Department of Public Health, HIV Epidemiology Program, 2009) and may not be knowledgeable about health care services (Flaskerud & Nyamanthi, 1990; Land & Hudson, 1997, 2004). …