Validation of the Zarit Burden Interview for Chinese Canadian Caregivers

Abstract

The factor structure of a Chinese version of the Zarit Burden Interview was assessed with a random sample of Chinese caregivers in Canada. The results indicated that the latent constructs identified in earlier studies on caregivers did not fit well when tested with Chinese caregivers. Exploratory factor analysis reported a five-factor solution, which accounted for 32.45% of the variance in eigenvalues. Maximum-likelihood confirmatory factor analysis was conducted to assess the generalizability of this five-factor model and a better fit to the observed data was reported. The findings showed that Chinese caregivers had different experiences in providing care. The concept of burden was more than practical challenges and strain; it also included negative feelings such as embarrassment, anger, and uncertainty due to the loss of control over the future of the caring process. KEY WORDS: caregiving burden; family caregivers; Zarit Burden Interview ********** The need for caregiving of elderly family members increases as the aging population continues to grow. An informal caring system is sustained by family caregivers who provide basic care in health, social, emotional, and financial domains, particularly for those who are frail or suffer from chronic illnesses. However, informal caring can also be burdensome. Family caregivers spend less time with their family and friends because of caregiving responsibilities (Neal, Chapman, & Ingersoll-Dayton, 1988) and have increased rates of depression (Baumgarten et al., 1994; Canadian Study of Health and Aging Working Group, 1994; Chappell & Penning, 1996; Livingston, Manela, & Katona, 1996). The time required for caring for a frail older family member often amounts to a full-time job (Schulz et al., 2003), and employed family caregivers take more time off than their noncaregiving coworkers, are more often interrupted because of family matters, and work fewer hours than desired (Birenbaum & Clarke-Steffen, 1992; Covinsky et al., 1994; Schulz et al.; Stommel, Given, & Given, 1993). Caregiving employees have also reported adverse health effects, such as difficulty sleeping, frequent headaches, and weight gain or loss (Wagner, 1987). Clearly, social workers working with the elderly population must also provide support to family caregivers. Measuring the needs and the burden of family caregivers requires a valid assessment tool. The Zarit Burden Interview (ZBI) is a widely used 22-item assessment tool for measuring caregiver's perceived burden of providing family care (Zarit, Orr, & Zarit, 1985). It asks family caregivers about areas that may cause stress and strain such as physical, psychological, economic, and relational problems. Items are answered on a five-point scale ranging from 0 = never to 4 = always. Scores are added to give total score ranges from zero to 88, with higher scores implying greater perceived caregiver burden (Rankin, Haut, Keefover, & Franzen, 1994). Zarit and Zarit (1987) originally proposed severe burden at scores in the 61 to 88 range, moderate to severe burden at 41 to 60, mild to moderate burden at 21 to 40, and little or no burden at less than 21. The psychometric properties of the ZBI include an acceptable inter-item reliability and convergent validity, indicated by a Cronbach's alpha of .79 and a correlation coefficient of .71, between caregiver's global evaluation and ZBI scores (Scott, Roberto, Hutton, & Slack, 1985). A test-retest reliability of .71 and internal consistency (Cronbach's alpha = .91) also have been reported (Gallagher et al., 1985). Spearman's rho correlations include .32 with activities of daily riving (Poulshock & Deimling, 1984), .32 with social life restrictions (Thompson, Futterman, Gallagher-Thompson, Rose, & Lovett, 1993), .41 with the Brief Symptoms Inventory (Derogatis, Lipman, Covi, Richels, & Uhlenhutg, 1970), .71 with the global index of burden, and -. …