Mean Zarit Burden Interview Score Research Articles

Factors associated with the burden of family caregivers of patients with mental disorders: a cross-sectional study

BackgroundCaregivers are responsible for the home care of family members with mental-health disorders often experience changes in their life that can generate stress and burden. The aim of this study was to identify factors associated with the burden of caregivers of family members with mental disorders.MethodsThis cross-sectional study was conducted with a non-probability sample of family caregivers, whose patients attended a community services program, the Psychosocial Care Centers, in three cities in the southwest region of Goiás State, Central Brazil. Data collection took place from June 2014 to June 2015. The participants were 281 caregivers who completed a sociodemographic questionnaire and the Zarit Burden Interview (ZBI). Bivariate analyses (t test, analysis of variance, and Pearson correlation) were performed, and variables with values of p < 0.10 and gender were included in a multiple-linear regression model. Values of p < 0.05 were considered significant.ResultsThe caregivers were mostly female and parents of the patients, were married, with low education, and of low income. The mean ZBI score was 27.66. The factors independently associated with caregivers’ burden were depression, being over 60 years of age, receiving no help with caregiving, recent patient crisis, contact days, and having other family members needing care.ConclusionsThis study identified factors that deserve the attention of community services and can guide programs, such as family psycho-education groups, which may help to minimize or prevent the effects of burden on family caregivers responsible for patients’ home care.

Burden for caregivers of children with attention-deficit/hyperactivity disorder in Oman

IntroductionNurturing children with neurodevelopmental disorders such as ADHD is associated with psychological burden to the caregivers. Oman has a pyramidal population structure with the bulk of the population are in the pediatric age group. Previous studies have indicated that ADHD is common in Oman.ObjectivesTo measure level of burden of care among caregivers of children with ADHD and the relationship between the degree of burden, subtypes of ADHD and socio-demographic factors.MethodsA cross sectional study conducted in a tertiary hospital in Oman. Arabic-version of the Zarit Burden Interview (ZBI) was used to evaluate the level of burden among the caregivers. The severity and subtypes of ADHD were quantified using Vanderbilt ADHD Parent/Teacher Rating Scale. Socio-demographic background and clinical data were gathered from medical records.ResultsThe study included caregivers of 100 children with ADHD. The mean ZBI score was significantly high for the parents of children with ADHD. As for the relationship with socio-demographic background, mothers of children with ADHD reported a higher mean ZBI score compared to fathers. Factors such as income, number of siblings, and severity/subtypes of ADHD played significant roles.ConclusionTo our knowledge, this is the first study of Arab/Islamic population exploring the burden of care for children with ADHD. Some of the risk factors appear to have direct effects. If this study will withstand further scrutiny, concerted effort is needed in emerging economies such as Oman to address the issue of burden among the caregivers of children with ADHD.Disclosure of interestThe authors have not supplied their declaration of competing interest.

The burden perceived by informal caregivers of the elderly in Saudi Arabia.

OBJECTIVES:The objective of this study was to discover the characteristics of informal caregivers of elderly patients; to determine the socioeconomic, psychological, and physical consequences facing informal caregivers; and to measure their burdens and needs.MATERIALS AND METHODS:This study was a cross-sectional survey of informal caregivers of elderly patients. Participants were recruited from different hospitals and primary care clinics in Riyadh, Saudi Arabia. For an intended sample size of 384 caregivers, a multistage sampling was used. A self-administered questionnaire was used to collect data. Data analysis included student's t-test and ANOVA to test for statistical significance.RESULTS:The study included 315 caregivers of elderly patients. Over half of the elderly patients were female (55.9%) and over 70 years old (65.7%); about 31% had chronic diseases or disabilities, which represented the majority of health problems reported by the elderly population. Most of the caregivers were family members (87.9%), young (43.8%), female (52.7%), unemployed (54.6%), and unmarried (58.1%). Most caregivers suffered from musculoskeletal problems (78.1%). The mean Zarit Burden Interview score was 31.3, which indicated a moderate burden. More than half of caregivers requested blood pressure (55.6%) and blood sugar measuring devices (53%). Three quarters (74.9%) of the caregivers wanted educational training to cope with emergencies. Most caregivers expressed a need for frequent healthcare for themselves (58.4%) and a home health visit service (72.9%) to support them in the care of their elderly.CONCLUSIONS AND RECOMMENDATIONS:Mobilization of resources in locations where these carers of the elderly live are greatly needed. In addition, health authorities should provide devices and essential training to manage the common problems and emergencies that informal caregivers have to deal with. Moreover, caregivers need follow-up supervision by a home visit team. Further studies are required to guide the implementation of the above advice.

P3.02a-033 The Humanistic Burden Associated with Caring for Advanced NSCLC Patients in Europe - A Real World Survey of Caregivers: Topic: Miscellaneous

While the financial aspects of the burden on caregivers for patients with advanced Non-Small Cell Lung Cancer (aNSCLC) have been estimated, limited published information exists on the humanistic burden incurred by these caregivers. Data were taken from a multi-center, cross-sectional study of aNSCLC patients and their caregivers conducted in France, Germany and Italy. The study consisted of three components: medical chart review, patient questionnaire and caregiver questionnaire. Overall, 683 consulting patients and 277 accompanying informal caregivers were recruited via treating physicians. The impact on health related quality of life was measured using the EuroQoL-5D (EQ-5D-3L) while caregiver burden was quantified using the Zarit Burden Interview (ZBI), which consists of 22 items, each rated 0-4. ZBI scores were grouped into: little/no burden (0-20), mild/moderate (21-40), moderate/severe (41-60) and severe burden (61-88). Scores of 24+ were assumed to identify caregivers at risk of depression. Analysis, conducted on 277 matched patient and caregiver forms, was stratified by country and by patients’ line of therapy. Statistical significance was assessed using Mann-Whitney U tests. Caregivers’ mean (SD) age was 55.2 (13.0) years; 78.6% were female and 62.3% were the patient’s partner/spouse. Patients’ mean (SD) age was 66.2 (9.7); 73.6% were male and 91.0% had Stage IV NSCLC. Over two-thirds (70.4%) of patients were receiving 1st line advanced therapy, while 29.6% were receiving later lines of therapy. The mean (SD) EQ-5D-3L index for caregivers was 0.87 (0.19). Differences in EQ-5D-3L were observed between carers of 1st line patients and later line patients (0.89 v 0.83 p=0.003). The mean ZBI score for caregivers was 32.1 (15.6); A quarter (24.0%) of caregivers had little/no burden, 44.6% mild/moderate, 28.8% moderate/severe and 2.6% severe burden; 69.7% of caregivers were identified as at risk of depression. Differences in ZBI were observed between carers of 1st line patients and later line patients (30.9 v 34.9 p=0.099). Comparing these results with other published ZBI data, the burden suffered by aNSCLC patient caregivers appears to be higher than other conditions studied in Europe, namely, Parkinson’s disease (25.8) another study conducted across advanced cancer (18.5). Caregivers for aNSCLC patients suffer significant humanistic burden in addition to the overall burden faced by patients and is likely to result in additional costs. When assessing the impact of a treatment, the potential to improve the impact on caregivers should also be included.

Quality of life, family burden and associated factors in relatives with obsessive–compulsive disorder

ObjectiveThe aim of this study is to assess the quality of life (QoL), family burden and psychiatric disorders in first-degree relatives of patients with obsessive–compulsive disorder (OCD) and to compare them with healthy controls and their relatives. MethodsForty patients with OCD and 47 of their first-degree relatives as well as 40 healthy subjects and 45 of their first-degree relatives were recruited in this study. OCD and comorbid anxiety or mood disorders were determined by means of the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders. Comorbid Axis II disorders were diagnosed with the Structured Clinical Interview for Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition Personality Disorders. Type and severity of obsessive–compulsive symptoms were assessed with the Yale–Brown Obsessive–Compulsive Scale, and the disability of patients with OCD was evaluated with the WHO DAS II. Family burden and QoL in the relatives were evaluated with the Zarit Burden Interview (ZBI) protocol and the World Health Organization Quality of Life Assessment—Brief, respectively. ResultsThe mean ZBI score of family members of OCD patients was higher than the control relatives. Linear regression analysis indicated that the independent factors associated with ZBI were duration of OCD, comorbid major depressive disorder and poorer insight. Compared with those of control relatives, the QoL of relatives of patients with OCD was significantly lower in all domains. While the diagnosis of major depressive disorder in relatives of OCD patients was significantly higher than the control relatives, the diagnosis of any anxiety disorder did not differ. ConclusionsOur study provides evidence that OCD not only affects the lives of patients but also their family members.

Partner Burden in Irritable Bowel Syndrome

Studies have described the burden experienced by caregivers and next of kin to patients with diseases such as cancer. However, the burden of functional gastrointestinal disorders on partners of patients has not been determined. We aimed to quantify the degree of burden to partners of patients with irritable bowel syndrome (IBS), to describe the factors that affect the burden perceived, and to identify the areas of relationship that are affected. We surveyed 152 patients diagnosed with IBS at a tertiary gastrointestinal clinic, on the basis of Rome III criteria, and their partners. Their partners completed questionnaires including the Zarit Burden Interview (ZBI), Relationship Satisfaction Scale, and questions on sexual relationships. Patients with IBS were rated for disease severity by using the Functional Bowel Disease Severity Index. We compared findings with those from 39 partners of healthy individuals (controls). There were no significant demographic differences between the partners of patients with IBS and controls; demographics had no effect on burden. Burden was significantly higher among partners of IBS patients (mean ZBI score, 22.1) than controls (mean ZBI score, 11.5) (P = .0002). The degree of burden was directly related to IBS severity (P < .0001). There were inverse relationships between partners' rating of burden (ZBI) and relationship quality (R = -0.60; P < .001) and sexual satisfaction (R = -0.56; P < .0001). There was no difference in the Relationship Satisfaction Scale scores (4.25 vs 4.19; P = .78) or sexual relationship (6.47 vs 6.21; P = .64) between partners of IBS patients and controls, respectively. Partners of patients with IBS have a significant burden (on the basis of ZBI score), compared with partners of healthy individuals. Perceived burden increases with IBS severity and poorer sexual and relationship satisfaction.

Emotional burden in caregivers of patients with obsessive-compulsive disorder

The objective of this study was to evaluate the emotional burden, psychological morbidity, and level of family accommodation in caregivers of obsessive-compulsive disorder (OCD) patients, according to sociodemographic and clinical factors. Fifty Brazilian DSM-IV OCD patients and their caregivers were evaluated using the Family Accommodation Scale, the Zarit Burden Interview (ZBI), the Self-Report Questionnaire (caregivers), the Yale-Brown Obsessive-Compulsive Scale, and the Beck Depression Inventory (patients). Most caregivers (80%) were aged between 30 and 59 years and lived with the patient (88%). Forty-two percent presented a common mental disorder and their mean ZBI score was 28.9. Family accommodation was moderate in 26% and severe or very severe in 24%. Caregivers' levels of psychological morbidity, accommodation, and emotional burden were associated with each other and with the severity of patient obsessive-compulsive and depressive symptoms. The results suggest that caregivers of OCD patients have important levels of burden and psychological morbidity and should receive orientation and support to minimize this emotional impact.

The Metric Properties of Zarit Caregiver Burden Scale

To evaluate the Chinese version of the Zarit Burden Interview (ZBI) as an instrument for measuring strain in Chinese caregivers of elderly people with dementia. The objective of the present study was to carry out a metric analysis of a Chinese version of ZBI using a cross-sectional study. Patients and their caregivers completed a variety of questionnaires, including the Mini-Mental State Examination (MMSE), the Neuropsychiatric Inventory (NPI), the Geriatric Depression Scale (GDS), and the Hamilton Anxiety Scale (HAMA). Cronbach alpha coefficient was used to assess inter-item consistency, and a split half correlation coefficient was used to determine the internal consistency of the ZBI. Correlations between the ZBI and GDS, and the ZBI and HAMA were assessed for convergent validity. Correlations of the ZBI and MMSE, the ZBI and NPI were also calculated to evaluate the possible correlation of caregiver burden with the severity of cognitive impairment and neuropsychiatric symptoms. There were 42 patients with dementia in the study. The intraclass correlation coefficient was 0.89 and the split half correlation coefficient was 0.87. The mean ZBI score was 24.40+/-14.68. Item-total (corrected) correlation showed significant coefficients (rs>0.33, P<0.05) for most items. There was a significant correlation between the ZBI and GDS (rs=0.57, P<0.001), and between the ZBI and HAMA (rs=0.44, P=0.003). Furthermore, there was a significant positive correlation between the ZBI and NPI, the ZBI and the agitation score, the ZBI and the apathy score, and the ZBI and MMSE. The Chinese version of ZBI meets some of the basic reliability and validity standards required for health status measures. Further studies could lead to a better understanding of the difficulties experienced by caregivers of patients suffering from dementia in China.

Emotional burden and psychological morbidity in caregivers of patients with obsessive-compulsive disorder

Introduction:The objective of this study was to evaluate the emotional burden, psychological morbidity and level of family accommodation in caregivers of obsessive-compulsive disorder (OCD) patients, according to sociodemographic and clinical factors.Method:Fifty Brazilian DSM-IV OCD patients and their caregivers were evaluated using the Family Accommodation Scale, the Zarit Burden Interview (ZBI), the Self Report Questionnaire (caregivers), the Yale-Brown Obsessive-Compulsive Scale and the Beck Depression Inventory (patients).Results:Most caregivers (80%) were aged between 30 and 59 years-old and lived with the patient (88%). Forty-two percent presented a common mental disorder and their mean ZBI score was 28.9. Family accommodation was moderate in 26% and severe or very severe in 24%. Caregivers' levels of psychological morbidity, accommodation and emotional burden were associated with each other and with the severity of patient obsessive-compulsive and depressive symptoms.Conclusion:The results suggest that caregivers of OCD patients have important levels of burden and psychological morbidity and should receive orientation and support to minimize this emotional impact.

Falls of the elderly are associated with burden of caregivers in the community

Little attention has been paid to the impact on caregivers who provide care to a family member who has falls. The purpose of the current study was to determine whether falls of care recipients are associated with caregivers' burden. A cross-sectional study of 1874 community-dwelling care recipients and 1478 caregivers was conducted. We examined the characteristics of care recipients and caregivers, including demographic characteristics, depressive mood as assessed by the Geriatric Depression Scale (GDS-15), the basic activities of daily living (bADL), fall history in the past 6 months, and physician-diagnosed chronic diseases to determine whether there was an association with caregivers' burden as assessed by the Zarit Burden Interview (ZBI). A total of 567 care recipients (30.3%) had a history of falls in the past 6 months. The mean ZBI score of caregivers with falls was significantly higher than that of caregivers without falls. There were negative correlations between the ZBI score and recipient bADL score and positive correlations between the ZBI score and GDS-15 scores of the recipient and caregiver, the level of severity of dementia, and the Charlson comorbidity index. Male recipient, fall history, behavioral disturbance, and dementia had significantly higher ZBI scores than those of controls. The stepwise multiple regression analyses found that the GDS-15 score of caregivers and recipients, level of severity of dementia, bADL score, and fall history were independently associated with the ZBI score. Among the community-dwelling frail elderly, falls are associated with caregiver burden even when controlling for various possible confounding factors.

The PINK1 phenotype can be indistinguishable from idiopathic Parkinson disease

Mutations in the PINK1 gene cause autosomal recessive parkinsonism characterized by early onset and a variable phenotypic presentation. A patient homozygous for the Ala168Pro mutation has been fully characterized clinically. Apart from onset at age 39 years and the excellent and sustained response to levodopa, all clinical and laboratory features, including SPECT and assessment of autonomic function, were indistinguishable from typical idiopathic Parkinson disease.