Dutch Objective Burden Inventory Research Articles

The Subjective Component of the Dutch Objective Burden Inventory: A Psychometric Analysis.

The reliability and validity of the subjective component of the Dutch Objective Burden Inventory (DOBI) are unknown. The validity and reliability of the subjective component of the DOBI were examined in caregivers of individuals with heart failure, using the original 38- and a 24-item version. In an online cross-sectional investigation, confirmatory factor analysis was used to examine factorial validity. In examining convergent validity, corrected item-dimension correlations assessed item performance and associations between subjective subscale scores and the Bakas Caregiving Outcomes Scale. Cronbach's α examined internal consistency. The original 4-factor solution was retained and both the original and shorter versions of the subjective component of the DOBI supported adequate construct validity and internal consistency. Both the 38- and 24-item forms of the subjective DOBI supported construct validity and reliability. Further studies examining the usefulness of both versions are needed in carers of individuals with more severe HF.

Psychometric Examination of the Dutch Objective Burden Inventory in Heart Failure Caregivers.

Psychometric properties of the 38-item version of the Dutch Objective Burden Inventory (DOBI) have been evaluated primarily in older female caregivers, with no published studies that vary by a different gender and age distribution. The aim of this study was to test the construct validity and reliability of the DOBI in caregivers of individuals with heart failure from the United States and other countries. This secondary analysis from a cross-sectional study used an online survey. Factorial validity was tested with confirmatory factor analysis, item performance was examined with ordinal item response analysis, and convergent validity was tested correlating DOBI subscale scores with Bakas Caregiving Outcomes Scale scores. Internal consistency reliability was assessed with Cronbach α. Item response analysis removed 14 items. Confirmatory factor analysis retained the original 4-factor solution. Original and reduced instruments demonstrated good internal consistency. Validity was supported by meaningful associations with the Bakas Caregiving Outcomes Scale. Both the original 38-item DOBI and the reduced 24-item DOBI had support for their construct validity and internal consistency. The 24-item DOBI may be a useful alternative to the 38-item version, because it maintains psychometric properties of the original instrument while decreasing data collection burden. However, more research is needed to assess whether the shorter version is useful in assessing objective caregiving burden.

Correlation between quality of life of cardiac patients and caregiver burden.

Caregivers experience high strain related to care giving. There is increasing interest in examining the caregiver burden of cardiac patients and studying the characteristics of caregivers. To explore the correlation between quality of life cardiac patients and caregiver's burden. A cross-sectional design using a convenience sample of caregivers and patients with cardiac conditions. Sociodemographic sheet, Dutch Objective Burden Inventory (DOBI), and Quality of Life (QLI-Cardiac 4). Linear regression was used to explore the predictors. 200 caregivers and 200 patients with cardiac diseases completed the study. The overall mean scores of both DOBI and QLI-4 indicated moderate results 1.51(SD 0.4), 19.8 (SD 4.7) respectively. Predictors of caregiver burden were young, less educated caregivers and high QoL of cardiac patients. Caregivers should receive more support and training from healthcare providers to develop their coping and resilience skills in a way that decreases their care burden and improves their quality of care and self-confidence.

Influence of filial piety values on care-giving burden among caregivers of patients with chronic heart failure

Objective To investigate the status of filial piety values and care-giving burden of caregivers of patients with chronic heart failure (CHF) and to explore the influence of filial piety values on care-giving burden. Methods By purposive sampling method, 190 CHF patients and their caregivers were selected from three hospitals in Nanjing, Kunshan and Suzhou from April 2017 to April 2018. Patients' General Information Questionnaire, caregivers' General Information Questionnaire, Chinese version of Filial Values Index (FVI) , and Dutch Objective Burden Inventory (DOBI) for chronic heart failure patients' caregivers were used in the study. Results The total scores of FVI and DOBI of caregivers of CHF patients were (94.88±11.29) and (7.01±11.25) . Patient's course of disease, caregiver's gender, whether to live with patients, attitude to patients' disease and filial piety were the influencing factors of care burden (P<0.05) . Conclusions It is suggested that more attention should be paid to the burden of caregivers of patients with chronic heart failure and interventions should be taken to improve their filial piety values so as to reduce their burden of care. Key words: Chronic heart failure; Caregiver; Filial piety; Burden; Influencing factor

Mediating effect of filialpiety values on the relationship between anxiety and caregiving burden among caregivers of patients with chronic heart failure

Objective To understand the filialpiety values, anxiety and caregiving burden of caregivers of patients with chronic heart failure and to analyze the mediating effect of filialpiety values on the relationship between anxiety and caregiving burden. Methods During April 2017 to April 2018, 191children caregivers of patients with chronic heart failure from 3 secondary and tertiary medical institutions in Suzhou, Nanjing and Kunshan were selected to complete Visual Analogue Scale for Anxiety, Chinese Filial Values Index scale (FVI) and Dutch Objective Burden Inventory (DOBI). Results The total score of caregivers' anxiety, filialpiety values and caregiving burden were 3(0, 6), 96(84, 107) and 1(0, 9) respectively. Correlation analysis showed that the caregivers' anxiety was positively correlated with the caregiving burden (r=0.328, P<0.01), while filialpiety values were negatively correlated with caregiving burden (r=-0.537, P<0.01). Mediating-effect analysis showed that anxiety had a negative effect on filialpiety values (a=-0.61, P=0.02), and had a positive effect on caregiving burden (c=0.64, P=0.01). The filialpiety values had a negative effect on caregiving burden (b=-0.43, P<0.01). Filialpiety values played a partial mediating role between anxiety and caregiving burden (c' = 0.26, P<0.05). Conclusions Medical staff should establish targeted interventions to improve caregivers′ filialpiety values, thereby reducing their caregiving burden. Key words: Chronic heart failure; Caregiver; Filialpiety; Anxiety; Burden

Psychosocial Factors Related to Adverse Outcomes in Caregivers of Heart Failure Patients: A Structural Equation Modeling Analysis

Background HF caregivers often experience caregiving burden, impacting their physical and psychological well-being. Social support and social problem-solving, as coping resources, may influence the effect of caregiving burden on self-care, depressive symptoms, and quality of life. Yet, studies examining these coping resources on HF caregiver outcomes are lacking. Purpose To investigate whether social support and social problem-solving mediate the relationships among caregiving burden, self-care, depressive symptoms, and quality of life in HF caregivers. Methods Using a descriptive, cross-sectional, correlational design, HF caregivers (n=530) completed online surveys, including the Dutch Objective Burden Inventory, the Interpersonal Support Evaluation List-12, the Social Problem-Solving Inventory Revised-Short, the Center for Epidemiological Studies - Depression scale, the Denyes Self-care Practice Instrument, and the Bakas Caregiving Outcomes Scale. Path analytic methods were used to examine a hypothesized mediating role of social support and social problem solving in the relationships between caregiving burden and caregiver self-care, depressive symptoms, and quality of life. The analysis proceeded in two phases: 1) a model-development phase with ∼62% of the sample (n=329) used to make data-based decisions on measurement indicators and structure of the path model; and 2) a confirmatory phase with ∼38% of the sample (n=201) used to provide unbiased inference on the model structure resulting from the initial phase. Results Participants were 41.39 (± 10.38) years old, Caucasian (78.3%), men (50.9%) caring for their spouse with HF (44.9%). Perceived caregiver burden was a predictor of caregiver social support (standardized effect B= -.4), self-care (Total B= -.39), depressive symptoms (Total B= .45), and quality of life (Total B= -.33). Higher level of caregiver burden was associated with less social support, worse self-care, more depression and decreased quality of life. Social support mediated the relationship between caregiving burden and depression (56% of Total effect), but did not appear to relevantly mediate the relationship between caregiving burden and self-care (11% of Total effect) or quality of life (0% of Total effect). When considered simultaneously with social support, social problem-solving was not a relevant mediator between caregiving burden and outcomes. Conclusions Caregiving burden negatively impacts caregiver outcomes. Social support appears more beneficial in mediating the effects of caregiving burden on depression, but has little mediational effect on caregiver self-care or quality of life.

The Dutch Objective Burden Inventory: Initial Validity and Reliability in a Japanese Population of Caregivers for Heart Failure Patients

The Dutch Objective Burden Inventory: Initial Validity and Reliability in a Japanese Population of Caregivers for Heart Failure Patients

Caregiving demands and caregivers’ psychological outcomes: the mediating role of perceived injustice

Objectives: This study hypothesized that higher caregiving demands are related to higher perceived injustice. Furthermore, this study investigated the mediating role of perceived injustice in the link between caregiving demands and caregivers’ psychological well-being. Design: A cross-sectional design. Setting: The Pain Centre of the university medical centre. Subjects: Participants were 184 family caregivers of patients with chronic musculoskeletal pain. Main measures: Participants completed questionnaires that assessed caregiving demands (i.e. The Dutch Objective Burden Inventory), perceived injustice (i.e. The Injustice Experience Questionnaire), how much they considered different sources responsible for the injustice they experienced (i.e. A newly developed inventory), perceived burden (i.e. The Zarit Burden Interview), distress (i.e. The Depression, Anxiety, and Stress Scale), and anger (i.e. The Hostility subscale of the Symptom Checklist-90-Revised). Results: The findings showed that caregiving demands are significantly related to perceived injustice in family caregivers (r = .44; P < .001). Only a small group of family caregivers considered the patient or themselves responsible, but more than half of the caregivers considered healthcare providers at least somewhat responsible for the unjust situation. Finally, perceived injustice mediated the association between caregiving demands and burden (b = .11, CI: .04-.23) and distress (b = .05, CI: .006-.12), but not anger (b = .008, CI: -.01-.06). Conclusion: The findings suggest that perceived injustice plays an important role in the well-being of family caregivers and caregivers’ well-being may be improved by changing their perceptions about their caregiving tasks and their condition.

Psychometric Properties of Turkish Version of the Dutch Objective Burden Inventory

The purpose of this study was to assess the psychometric properties of the Dutch Objective Burden Inventory (DOBI) for the Turkish society. This is a descriptive, methodological study. The sample was composed of 230 heart failure patients' caregivers. The DOBI was translated using translation and back-translation. The translated Turkish version was submitted to eight experts who analyzed it for its content validity. Scores from the experts were evaluated using the Kendall W analysis, and no statistically significant difference was found among the scores (Kendall W=.13, p=.338). In the confirmatory factor analysis, factor loading was found to be between 0.75 and 1.00 for all subscales. Thus, the DOBI demonstrated acceptable internal consistency (the components displayed α scores from .96 to .99), good test-retest reliability (no statistically significant differences were found, p>.050). The Turkish version of the DOBI scale is a valid and reliable tool for the Turkish population. It can be used in nursing practices and research.

The relation between motivational support of partners and self-care behavior in patients with chronic heart failure

Purpose: Social support, mostly provided by partners of Heart Failure patients, is known to be associated with positive health outcome in HF patients. Behavioral models suggest that social support has an impact through the influence of health behaviors. Partners of HF patients provide motivational support by encouraging patients to comply with their HF treatment regimen. In this study we hypothesized that motivational support of partners would be positively associated with self-care in HF patients. Method: Using a cross-sectional design, self-care in HF patients was measured with the European Hear Failure Self-care Behavior scale containing of 12 items measuring different aspects of self-care (EHFScB-12). Support of partners was measured with the Dutch Objective Burden Inventory (DOBI) measuring the amount of different kinds of support as reported by partners. The DOBI contains 38 items in total, in this study the subscale motivational support was used. The study population consisted of HF patients (and their partners) that participated in the Dutch COACH trial on the effects of education and counseling. Patients and partners were asked to complete a questionnaire while at home, 12 months after the index hospitalization. Results: In total 394 HF patients (44% NYHA III-IV, 24% female, mean age 67 (sd 11) and their 394 partners (76% female, mean age 67 (sd 12)) completed the questionnaire. The total score on self-care behavior in HF patients was 23 (range 12-60, sd 5.7). Partners provided motivational support with a mean score of 1.4 (range 1-3, sd 0.4). The amount of motivational support provided by partners was not associated with the level of self-care in the HF patients (Spearman's rho 0.08, p=0.12). Furthermore, no significant single item correlations between e.g. motivating my partner to adhere to prescriptions and I eat a low salt diet were found. Conclusion: Partners of HF patients report their efforts in trying to support patients to comply with their HF treatment regimen. However, this support does not seem to affect patient's self-care behavior. Further research is necessary to gain insight in effective support strategies in patients and families coping with HF.

Coping with dementia. An example of a combined psychosocial intervention

Introduction.– To date, little research has been devoted to the effectiveness of combined psychosocial interventions in dementia. Therefore, the aim of the present pilot study was to examine to which extent participation in a combined intervention programme for the patient–(informal) caregiver dyad had a beneficial effect on the quality of life of the person with dementia and on the subjective burden of the caregiver(s). Text.– The patients included in this study (n = 16) were elderly men and women (M = 73.56; SD = 6.46) diagnosed with early dementia and with an MMSE score of 17 or higher (M = 23.25; SD = 3.21; range = 17–28). The spouse acted as primary caregiver for the majority of the participants. The first preliminary descriptive statistics demonstrate a significantly improved quality of life (WHO-Qol-8) experienced by persons with dementia after measurement, as indicated by a negative mean difference score (M = –0.17; SD = 0.37) compared to the pre-measurement before the onset of the programme. The results of the follow-up measurement after two months (M = –0.05; SD = 0.33) reveal a minor regression compared to the post-measurement results. As far as the caregiver group is concerned, our results suggest an increase in personal and practical patient care (Dutch Objective Burden Inventory), which is in contrast with the general trend of a decreased subjective burden (Zarit caregiver burden scale). The finding that a relative increase in emotional support is observed in virtually all family groups leads us to hypothesize that both the quality of life and the coping skills of caregivers are improved by creating a more open communication. Disclosure.– No significant relationships.

The Dutch Objective Burden Inventory: Validity and Reliability in a Canadian Population of Caregivers for People with Heart Failure

Evidence suggests that caregivers of people with heart failure (HF) often experience caregiver burden and emotional distress. However, these studies measured the caregiving experience using generic tools since a disease-specific tool was not available. Recently, the Dutch Objective Burden Inventory (DOBI) was developed as a disease-specific tool measuring objective caregiver burden in a Dutch HF population of caregivers. Using a cross-sectional design, caregivers of HF patients attending an outpatient HF clinic completed the DOBI, the Hosptial Anxiety and Depression Scale (HADS) and the Caregiver Reaction Assessment (CRA). Caregivers (n=47) were mainly female (72%) and spouses (72%) of the HF patients with a mean age of 63.1 (±10.4) years. Patients were older (mean age 72.7; ±10.6), 64% male and had advanced HF. Feasibility for the objective portion of the DOBI was excellent with <10% missing values. The subjective component of the DOBI was incomplete and could not be used in the analyses. Seven items had minimal variability. Significant relationships emerged between the DOBI, CRA and HADS revealing construct validity for all subscales of the DOBI. Cronbach's alpha was >.80 for all DOBI subscales. The DOBI is the only disease-specific tool that measures burden for caregivers of HF patients. The objective portion of the DOBI showed evidence of adequate internal consistency and construct validity in a Canadian population of caregivers of HF patients attending a HF Clinic. Further testing is needed to determine floor and ceiling effects for DOBI items and responsiveness of this tool.

The Dutch Objective Burden Inventory – Validity and Reliability Testing in Canada

The Dutch Objective Burden Inventory – Validity and Reliability Testing in Canada

FP7 The Dutch Objective Burden Inventory: Validity and Realiability in a Canadian Population of Caregivers for People with Heart Failure

FP7 The Dutch Objective Burden Inventory: Validity and Realiability in a Canadian Population of Caregivers for People with Heart Failure

The Objective Burden in Partners of Heart Failure Patients; Development and Initial Validation of the Dutch Objective Burden Inventory

Measures on objective caregiver burden in partners of Heart Failure patients are hardly available and never include HF specific aspects. The main objective of our study was to develop an inventory that assesses the objective caregiver burden of partners of HF patients, including the full range of potential care giving demands. To develop the inventory, six domains of caregiving demands were identified. Items for the domains were generated from the literature, expert opinion and existing scales. The original 50-items self-report inventory was administered to 321 partners of HF patients. Demographic data of HF partners were collected by questionnaire. Clinical data of the HF patients were collected by chart review. Component analysis led to exclusion of 12 original items and to a meaningful four-factor solution with a total explained variance of 43%. The components reflected four different kinds of care giving tasks; personal care, emotional, motivational and practical (treatment related) support. They demonstrated good internal consistency and initial validity was supported by a pattern of meaningful associations with external variables. The Objective Burden Inventory is a promising inventory to assess objective care giving tasks performed by HF partners, including emotional and motivational support. It provides information on the caregiver situation that may help to develop effective interventions.