Zarit Burden Interview Scale Research Articles

Burden, Anxiety, and Depression Among Caregivers of Parkinson's Disease Patients.

Parkinson's disease (PD) is a disabling neurodegenerative movement disorder. Most PD patients are looked after by caregivers who are close to them regardless of their relationship. Caregivers may experience a notable impact on their mental health as they dedicate a significant amount of time to the patient while observing the progression of the disease. The aim of this study was to evaluate the level of burden, depression, anxiety, and stress among caregivers of PD patients. We conducted a cross-sectional analysis between July and September 2023 among caregivers of PD patients following in the Movement Disorders Clinic at King Khalid University Hospital in Riyadh, Saudi Arabia, and through the Saudi Parkinson's Society. The data collection was done anonymously through an electronic self-administered questionnaire. Caregiver burden was assessed by using the validated Arabic version of the Zarit Burden Interview (ZBI) scale, and the Depression Anxiety Stress Scale (DASS) was used to assess the presence and level of anxiety and depression. There were 118 caregivers (53.39% female, 33.9% aged between 35- 45 years, and 73.73% were sons/daughters) caring for 118 patients (57.63%, male, 38.98% aged between 66- 76). The ZBI score was highest among sibling caregivers. Moreover, burden scores were higher among those who provided care more frequently than others. Our study revealed that PD caregivers face a high risk of care burden, especially those who are siblings and spend longer periods in patient care. Additionally, female caregivers reported higher rates of depression, anxiety, and stress.

Burden levels and predictive factors among caregivers of hemodialysis patients: a cross-sectional study in Oman.

Caring for individuals with chronic kidney disease (CKD) is a highly demanding task that can adversely affect the physical and psychological well-being of caregivers. This study aimed to investigate the burden experienced by caregivers of patients undergoing hemodialysis (HD) in Oman and explore the factors associated with this burden, including demographic and medical characteristics. A descriptive cross-sectional was employed. Caregiver burden was assessed, and demographic and medical variables were examined among caregivers of HD patients. A total of 326 unpaid family caregivers completed the Zarit Burden Interview scale, demographics and some medical variables. Linear multiple regression analyses were conducted to identify factors linked to caregiver burden. Of the caregivers, 62.9% reported a minimal burden, 21.8% experienced mild-to-moderate burden, 8.6% faced moderate-to-severe burden, and 6.7% encountered a severe burden. The final multiple regression model demonstrated statistical significance compared to the constant (F = 8.68, p < 0.001), with eight predictors explaining 18% of the variance, and caregivers' satisfaction with health emerged as the only significant predictor. A substantial portion of caregivers reported minimal burden. These findings suggest the need for further in-depth investigations into factors contributing to this favourable outcome. Furthermore, caregivers' satisfaction with health was the only significant predictor of their burden. Healthcare providers need to give special attention to this point and conduct periodic assessments of the primary caregivers' health. Implementing improvements in the healthcare system based on these findings could enhance the overall caregiving experience for HD patients and their caregivers.

Effect of Psychoeducation on Reducing Burden Among Primary Caregivers of People with Schizophrenia

Schizophrenia is a serious psychological illness that needs long-term treatment. Family members, especially those who care for a patient at home, experience the burden of providing long-term care. Psychoeducational intervention may enhance the caregiver’s outcomes. The major goal of the study was to explore the effect of psychoeducation on reducing the burden among primary carers of people with schizophrenia. In this study, thirty-two participants (32 caregivers) were purposefully selected based on the National Institute of Mental Health (NIMH). A personal information form and the Bangla version of the Zarit Burden Interview scale were administered. Total participants were divided by simple randomization into two groups (i.e., experimental and control groups). Following the baseline evaluation by questionnaire, the experimental group of 16 caregivers received two sessions of psychoeducation, but the control group of the same number of caregivers did not. The effectiveness of psychoeducation was evaluated using a pretest-posttest control group design. Findings suggested that psychoeducation decreased the level of burden, and after the intervention, the mean score of the experimental group was lower than that of the control group. These findings found that the psychoeducation intervention had a positive outcome in reducing the burden on caregivers of patients who deal with schizophrenia. Jagannath University Journal of Life and Earth Sciences, 9(1): 81–94, 2023 (June)

Association between quality of life and burden of cancer caregivers: An example in a low and middle income country

ObjectiveLimited knowledge on burden and quality of life (QoL) among cancer caregivers is available in low and middle income countries. This study aims to investigate the QoL, levels of burden, and their associations among Vietnamese cancer caregivers. MethodsThis study was conducted across three hospitals in Vietnam. 348 caregivers were recruited from January to June 2021. Data were collected by using socio-demographic questionnaires, the Zarit Burden Interview scale, and Caregiver Qol Cancer. The association between QoL and burden was analyzed by using multivariate linear regression. ResultsOlder age (p = 0.03), employed (p = 0.01), and care more than 40 h (p = 0.007) were associated with a higher burden, respectively. QoL of financial concern had the lowest score (mean = 48.03, SD = 28.87), compared to the other subscale. Caregivers who had pre-existing health conditions, unstable work, spent more than 40 h per week, and took care dependent cancer patients were associated with a lower overall QoL score. Comparing to caregivers of no burden, those of mild burden had a lower QoL score by 10.70; while those of mild severe burden had the worse QoL (lower by 23.80 scores). ConclusionsPerceptional burden among caregivers is associated with QoL. Further policies are recommended to protect cancer caregivers, to alleviate the caregiving burden, and thus to improve the overall QoL.

Care for the caregiver: an exploration of caregiver burden of children with chronic medical conditions at a tertiary care hospital in Karachi, Pakistan – a mixed-methods study

ObjectivesCaregiver burden often goes unrecognised and can substantially affect caregivers’ physical, psychological and financial well-being, thereby impacting quality of care. This study investigates burden among caregivers of children with chronic...

PSYCHOSOCIAL BURDEN OF PARENTS HAVING CHILDREN WITH HAEMOPHILIA IN NEPAL

Background: Parenting a child with haemophilia, a hereditary bleeding disorder, causes more stress than parenting a normal child. The main aim of this study was to find out the psychosocial burden faced by parents having children with haemophilia in Nepal. Methods: In this cross-sectional study, 76 parents having children with haemophilia were recruited from Nepal Haemophilia Society using a non-probability purposive sampling technique. The Zarit Burden Interview scale was used. Chi-square test and odds ratio at 95% confidence interval were used to assess an association between parents’ psychosocial burden with the parents and child-related variables using SPSS version 16. Results: A moderate level of psychosocial burden was prevalent among 60.5% of the parents. There was a significant association between parents’ psychosocial burden with parents’ education (p = 0.037), income (p = 0.03), type of Haemophilia among children (p = 0.03) and type of treatment received by children (p = 0.01). Further, the odds ratio predicted that psychosocial burden was 3.0 times higher (95% CI = 1.1 – 8.3, p = 0.04) among those parents with insufficient income and 4.2 times higher (95% CI = 1.3 – 13.4, p = 0.02) for the parents whose children were under factor VIII and associated treatment. Conclusions: Psychosocial burden, particularly of moderate intensity was higher in parents having children with haemophilia. Those parents with low education level, with less income and whose children are diagnosed with Haemophilia A and under factor VIII and associated treatment should be more considered in reducing their psychosocial burden.

Burden of Care Among Caregivers of Mentally Ill Patient at Tertiary Level Hospital

Abstract&#x0D; Introduction&#x0D; Caregivers of people with mental illnesses are a key support system. The caregivers suffer significant burden as a result of the care giving role. The level of burden of caregivers among people with mental illness is considered to be a negative impact on the care provided by the family to their patient.&#x0D; Methods&#x0D; A descriptive cross sectional research design was used. A total of 96 care givers were selected using purposive sampling technique. The purpose of the study was to assess the burden of care of mentally ill patient among care givers in a selected hospital. The Zarit Burden Interview Scale was use to assess burden care. All the collected data were analyzed by using descriptive statistical method such as frequency, mean, percentage, standard deviation and chi square test to find out the association with level of burden of care and selected demographic variables.&#x0D; Results&#x0D; Nearly one third (31.3%) of caregivers had moderate level of burden and 9.4% of them had severe burden of care. There was significant association between the level of burden of care with sex of the caregivers and their educational level.&#x0D; Conclusion&#x0D; Caregivers had moderate level of burden of care while caring their mentally ill patient. In order to reduce their burden of care, self-help and psycho-educational programs will be effective. This action addresses to improve their perceived knowledge on mental illness and develop coping skills to deal with their patient’s behavior.&#x0D; Key Words: Burden; Caregivers; Mentally ill patient.

Sociodemographic Association of Caregivers Burden with Schizophrenia Disorder

Objective: The aim of this study is to find out a relationship between life satisfaction and caregiver burden among patients who are suffering from psychiatric illness.&#x0D; Materials and methods: The sample size of this study was 170 psychiatric patients. Primarily consent was received from the higher authorities of the psychiatric hospitals and rehabilitation centers in Karachi. Zarit Burden Interview Scale (ZBIS) and Satisfaction with Life Scale (SWLS) were used. Psychiatric patients were divided into schizophrenia disorder (n = 85) and bipolar disorder (n = 85). Data were analyzed by statistics software (SPSS, version, 20.0). The sample was constituted with male 75 (44.1%) and females were 95 (55.9%). The average age range of caregivers was between 19 and 60 years with M = 44.74 and SD = 12.05 years.&#x0D; Results : The results indicated that caregiver burden was a significant predictor of satisfaction with life in patients with schizophrenia disorder [R2, .554; F (1.84) = 36.711, p&lt;.000]. A significant difference was also observed between male and females caregivers of psychiatric patients on the variable of caregiver burden and satisfaction with life scale (i.e. t=-3.129; p=.&lt;002; t=3.528; p=.&lt;.001).&#x0D; Conclusion: It is concluded that caregiver burden significantly affects the level of mental health of the caregivers of patients with psychiatric disorders.&#x0D; Bangladesh Journal of Medical Science Vol. 23 No. 01 January’24 Page : 89-94

Caregiving burden and associated factors among family caregivers of individuals with schizophrenia in Bangladesh: A cross-sectional study.

Schizophrenia is a severe mental disorder affecting millions worldwide. Family caregivers play a vital role in patient treatment and recovery, but their responsibilities can be physically and emotionally exhausting. There is limited research on caregiver burden in Bangladesh, prompting this study to identify factors associated with the burden among caregivers of schizophrenic patients. This cross-sectional study collected data from 175 caregivers from January to December 2020 in Dhaka, Bangladesh. A semi-structured questionnaire and a validated Bangla version of the Zarit Burden Interview (ZBI) scale were used to assess the burden of primary caregivers and associated factors in caring for patients with schizophrenia. Participants' mean age was 34.02 ± 10.45 years, with 26.9% in the 34-41 age group. 49.1% were housewives, with most earning 5000 to 15000 taka monthly. Spouses accounted for 28.6% of caregivers. Most patients had an illness duration of less than five years (66.3%). Mean ZBI score was 49.49 ± 12.06, indicating moderate to severe burden. Factors significantly associated with caregiver burden included age, gender, occupation, income, marital status, house condition, relationship with patients, illness stage, and duration. This study highlights the burden experienced by caregivers of schizophrenic patients in Bangladesh and identifies factors associated with the burden. It recommends community interventions and psychosocial provisions to address this issue and inform targeted interventions to reduce caregiver burden. These findings provide insights for a comprehensive plan to manage such cases in the future.

Perceived Burden of Care among Parents of Children with Sickle Cell Disease.

Children affected with Sickle Cell Disease mostly depend on their parents for assistance which creates physical, emotional, social, and financial burdens among the parents. The objective of this study was to find out the level of perceived burden of care among parents of children with sickle cell disease in a hospital. A descriptive cross-sectional research design was used with a quantitative approach. The data were collected using a structured interview schedule using the Zarit Burden Interview scale among 152 parents attending the social service unit of Bheri Hospital, Nepalgunj. A nonprobability purposive sampling technique was used. Data were analyzed using Statistical Package for Social Science (SPSS), version 20. The Chi-square test was used to measure the association between the level of burden of care and selected variables. One hundred and fifty-two parents were included in the study, among which more than half (58.6%) were fathers. More than half (52.0%) of parents perceived mild to moderate burden with a Mean±SD score of level of burden is 1.26±0.44. A significant statistical association was found between the level of burden of care and the relationship to the child (p=0.002), and the type of family (p=0.04). The study showed that the majority of the parents' perceived a mild to moderate burden.

Self Perceptions of Stress in Caregiving Moderate Associations of Within and Between Caregivers’ Physical Health Symptoms

AbstractBackgroundThe success of dementia care requires the full support from the caregivers with the goal of delaying the disease’s progress. Studies over decades have reinforced that the knowledge, attitude, and skills of caregivers are crucial parameters of the success of in‐community care for dementia. Nevertheless, studies have identified that many caregivers, across different culture and ethicity, are not well prepared emotionally or practically to be the caregivers and this will result in stress, particularly when their stress are ignored by medical professionals during this long journey of care.MethodThis is a mixed‐method research to examine how self‐perceptions of aging (SPA) moderated within‐ and between‐caregivers Self‐perceived stress (SPS) associations with physiological health symptoms (PHS) and daily physical health symptoms (DPHS). SPA was measured by the Philadelphia Geriatric Centre Morale scale. SPS was measured by Zarit Burden Interview Scale and Revised Memory and Behaviour Problem Checklist. DPHS was measured daily through an adapted symptom checklist.ResultA pilot study of 20 caregivers reported significantly more physical health symptoms compared to individuals with lower perceived stress on average (p &lt; .05). SPA significantly moderated associations between both within‐ and between‐persons perceived stress (SPS) and physiological health symptoms (PHS) (ps &lt; .05).ConclusionMore positive SPA significantly dampened the impact of perceived stress, suggesting the importance of SPA as an individual characteristic within stress processes. Future work should examine how daily changes in SPA may exacerbate or mitigate the impacts of daily stress processes and health outcomes.

The Pain Characteristics and Caregiver Burden in Patients With Cancer-related Pain and their Associated Factors: A Cross-sectional Study

Introduction: Pain is the most common symptom among patients with cancer; the pain also affects their caregivers. Objective: This study aimed to explore the pain characteristics and caregiver burden in patients with cancer-related pain and their associated factors. Materials and Methods: This cross-sectional study was conducted on 240 patients and their caregivers (120 patients and 120 caregivers), who were chosen using the convenience sampling method. They completed face-to-face surveys, including information about sociodemographic and disease characteristics, the brief pain inventory, the pain beliefs questionnaire, and the Zarit burden interview scale. The descriptive statistics, frequency distributions, and multiple linear regression model were used to analyze the obtained data according to the two-tailed P&lt;0.05. Results: The mean age of the patients was 58.79±13.46 years, and 50.8% were females. The mean age of the caregivers was 47.84±13.24 years, and 83.3% were females. The linear regression analyses showed demographic and clinical factors of patients were associated with pain severity (R2=0.326, P&lt;0.001). In addition, these factors were associated with all sub-dimension of pain interference and pain beliefs (P&lt;0.001). Furthermore, the linear regression model showed that patients' pain severity, pain interference and pain beliefs were predictive factors of caregiver burden (R2=0.266, P&lt;0.001). Conclusion: These results will help health professionals understand the pain characteristics of patients and caregiver burden to improve cancer-related pain and caregiver burden.

Caregiver Burden in Substance Use Disorders Patients

Background: Substance Use Disorders (SUDs) impose significant challenges not only on individuals grappling with addiction but also on the caregivers who provide support and care. The caregiving role is associated with multifaceted burdens that require understanding and targeted interventions. Recognizing the diverse dimensions of caregiver burden is crucial for offering effective support. Objective: The study aimed to find out the caregiver burden in substance use disorder patients, examining severity and socio-demographic correlations, contributing insights into effective support strategies. Methodology: The cross-sectional observational study took place at Sylhet MAG Osmani Medical College's Psychiatry Department and a private psychiatric and drug rehabilitation center in Sylhet from September 1, 2018, to August 31, 2020. The research focused on substance use disorder patients and their caregivers, involving 50 eligible patients selected through inclusion and exclusions criteria. Diagnoses followed DSM IV criteria. Socio-demographics were gathered via semi-structured questionnaires. Caregiver burden was assessed using the Bengali Zarit Burden Interview (ZBI) scale through approximately hour-long interviews, with 1-2 daily. Ethical procedures encompassed informed consent and confidentiality assurance. Result: The study included 50 male participants. Patients mean age was 31.92 (±8.21) and caregivers mean age was 41.68 (±12.89). Mainly, caregivers were mothers (40%) and wives (34%). Caregivers experiencing moderate to severe burden were 58%, mild to moderate burden were 26%, and severe burden were 16%. Mean ZBI score was 48.22±13.55. Higher burden correlated with illiteracy, low family income, excessive drug spending, prolonged substance use, and multiple drug usage. Alcohol users faced more burden than other substance users. Female caregivers, younger age, and housewives experienced heightened burden. No burden links were found with marital status, habitat, religion, family type, or drug administration method. Conclusion: This study concluded that Substance use heightens caregiver burden, notably among female, young, and housewife caregivers. Addressing these trends is vital for effective care of substance use

Burden of Care of Family Caregivers for People Diagnosed with Serious Mental Disorders in a Rural Health District in Kwa-Zulu-Natal, South Africa.

An estimated 6% of the world population has serious mental illness, with one in four families having a member with some form of psychiatric disorder, who is mostly cared for by their relatives within a family setting. Although care-giving in a home setting is reported to be associated with significant mental distress, the burden of such distress is rarely measured. The purpose of this study was to quantify the burden of care among family caregivers of relatives with serious mental disorders, as well as to explore possible associations between the caregiver burden of care and a range of caregiver and Mental Health Care User (MHCU) variables in a rural district in Kwa-Zulu Natal, South Africa. The Zarit Burden Interview (ZBI) scale was used to collect data from 357 caregivers, and STATA 14 was used to analyze data. The ages of the sample ranged from 18 to 65 years, with a mean of 50.29, and the majority (86%) were female and unemployed (83%). The ZBI scores ranged from 8 to 85, with a mean of 41.59. The majority (91%) were found to be affected by family caregiver burden, which ranged from mild to severe. Using the Pearson Chi-square test of association (p = 0.05), variables that were significantly associated with the burden of care were clinically related (caregiver self-reported depression, MHCU diagnosis, recent relapse of the MHCU), socio-economic (caregiver family monthly income, MHCU disability grant status and MHCU employment status) and socio-demographic (MHCU gender and MHCU level of education). The prevalence of the burden of care is high and severe, and the scarcity of resources in families and communities contributes to the high burden of care in these rural communities.

Investigating the Needs of Caregivers of Patients Suffering from Chronic Diseases: A Mixed-Method Study.

The objective of this study was to investigate the needs of carers of patients suffering from chronic diseases. The present study is a mixed approach, quantitative and qualitative. The study population consisted of 560 caregivers of patients with chronic diseases. The data collection was done with an improvised needs survey questionnaire, which included 57 questions. The questionnaire surveyed carers 'financial needs, social needs, psychological needs, and patients' education needs. The Cronbach-a index of the Patient Needs Survey was 0.956 and that of caregivers was 0.965. Carers' burden of care was assessed with The Zarit Burden Interview scale. The statistical analysis of the data was done with the statistical program IBM SPSS for Windows version 26.0. The main diseases of the patients were chronic renal failure (22.6%), multiple sclerosis (19%), cancer (19%), diabetes mellitus (7.1%), dementia (6%), and chronic obstructive pulmonary disease (6%). The majority of patients (82.1%) had health problems for more than 24 months. Caregivers provided 12.5 ± 8.3 h of daycare and cared for patients for more than 24 months (73.2%). Caregivers seek information from health professionals (4.41 ± 1.2), need more information (4.11 ± 1.4), feel stressed about the role of caregiver (3.91 ± 1.3), time available for vacation is limited (3.89 ± 1.4), time available for entertainment is limited (3.80 ± 1.3) and they feel intimidated with the role of carer (3.76 ± 1.3). The caregivers' charge was 42.4 ± 19.6. Most caregivers reported moderate to severe burdens. Caregivers experience a lack of clear and comprehensible information about the treatment that caring patients receive, as well as a lack of ongoing care from health professionals.

Effects of Yin Yoga on Burden and Self-Compassion in Caregivers of Persons With Dementia: A Pilot Study.

Informal caregivers of persons with dementia face tremendous challenges in balancing their own needs and those of the care recipient. The aim of the current pilot study was to test the feasibility and acceptability of a Yin yoga intervention on caregiver burden and self-compassion. This study used a convenience sample (N = 5) with one group pre-survey/post-survey design. Participants were asked to complete a 60-minute Yin yoga intervention via Zoom three times per week for 8 weeks. Pre- and post-intervention comparisons were performed on caregiver burden (Zarit Burden Interview Scale) and self-compassion (Neff Self-Compassion Scale). Results indicated that the intervention was feasible and acceptable with slight modifications, including (a) leveraging social networks to increase the scope of recruitment efforts nationally and increase the size and diversity of the sample, (b) adding an activity log to better understand adherence, and (c) offering more live yoga sessions. [Journal of Gerontological Nursing, 49(6), 22-27.].

Risk factors for agitation in home-cared older adults with dementia: evidence from 640 elders in East China.

Agitation is common among older adults with dementia, negatively affecting their quality of life and their caregivers'. Since home care remains the dominant approach for older adults, this study investigates the risk factors for agitation in older adults with dementia in China. We perform a cross-sectional study of home-cared older adults with dementia in Ningbo, China, using 2020 data. We use a self-made questionnaire to investigate the risks of agitated behavior and its related factors. We perform descriptive, univariate, and regression analyses. We address 640 older Chinese adults; 42.8% of the sample exhibits one or more agitated behaviors. We find that basic health issues, such as activities of daily living (ADL), family support issues, such as Zarit Burden Interview (ZBI) scale and Family APGAR Questionnaire (APGAR), and behavioral awareness issues, such as fall and scald, significantly influence the occurrence of agitation behaviors (p < 0.05). Older adults with severe ADL disorder (b = 6.835, β = 0.196, p < 0.001), ZBI score of 67.00-88.0 (b = 10.212, β = 0.248, p = 0.005), severe APGAR disorder (b = 3.699, β = 0.100, p = 0.012) and a history of fall (b = 9.311, β = 0.199, P = <0.001) or scald (b = 9.288, β = 0.125, p = 0.002) are more likely to exhibit agitated behaviors. Agitated behavior in home-cared older adults with dementia are diverse and related to mental state, family support, and behavioral awareness issues. Caregivers, often family members, should be attentive to the needs of dementia patients and take active and effective measures to improve their quality of life. They should be aware of the causes and triggers of agitated behavior and take steps to reduce its occurrence.

CARE GIVER BURDEN IN PATIENTS OF SCHIZOPHRENIA AND BIPOLAR DISORDER IN A RURAL AREA OF SOUTHERN KARNATAKA

Background: It can be a difcult task to provide care to the patients living with psychiatric health issues, especially with chronic diseases such as schizophrenia and bipolar disorder where the patient loses touch with reality. Hence, our study aims to assess the perception of burden that caregivers endure while giving care to the patients of schizophrenia and bipolar disorder and to compare the difference in burden between these two conditions. The study also evaluated the factors affecting the caregivers' burden. Materials and Methods: This was a cross-sectional interviewbased study conducted at the psychiatry department of a tertiary care hospital in Sullia, Dakshina Kannada, Karnataka among caregivers of schizophrenia and bipolar disorder. Each caregiver was given the Zarit-Burden Interview scale in a language they understand and asked to rate each statement from 0 to 4 where ratings were based on likert scale and the nal scores were interpreted. Data of the burden score were expressed as mean and standard deviation and compared using unpaired t-test. Pearson's correlation coefcient was used for correlation between burden score and variables such as age, years of education, and duration of illness. The analysis was done using SPSS 21.0 version. Results: A total of 100 caregivers reported the interview scale completely, of which 50 caregivers belonged to schizophrenia group and 50 were related to bipolar disorder. Average of burden score was 64.89 ± 15.7 and 59.11 ± 17.8 (maximum score: 88) in schizophrenia and bipolar group, respectively, and difference between the group was statistically signicant. In both the groups, it was found that, with increase in the age of patients, caregiver's burden signicantly increased. Conclusion: Caregivers of schizophrenia and bipolar disorder patients feel a considerable burden of care with more burden felt by the caregivers of schizophrenia. The more vulnerable to burden are females, elderly, low-income groups, and patients in whom longer duration of care is required. The caregivers should receive an adequate support for maintaining their own mental health via adequate psycho education, counselling and psychiatric intervention if necessary.

Relationship of Psychological Flexibility and Mindfulness to Caregiver Burden, and Depressive and Anxiety Symptoms in Caregivers of People with Dementia

Caregivers of People with dementia (PwD) commonly experience burdens and other mental health issues, e.g., depression and anxiety. At present, there are limited studies that examine the relationships between caregiver psychological factors and caregiver burden, and depressive and anxiety symptoms. Therefore, this study's objectives were to examine the relationships between psychological flexibility and mindfulness in caregivers of PwD, and to determine the predictors of these three outcomes. This was a cross-sectional study conducted in the geriatric psychiatry clinic of Kuala Lumpur Hospital, Malaysia, and the sample (n = 82) was recruited via a universal sampling method over three months. The participants completed a questionnaire that consisted of the sociodemographics of the PwD and caregivers, illness characteristics of the PwD, Acceptance and Action Questionnaire-II (AAQ-II), Mindful Attention Awareness Scale (MAAS), Zarit Burden Interview Scale (ZBI), Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7). The results show that despite significant relationships between psychological flexibility and mindfulness and lower levels of caregiver burden, and depressive and anxiety symptoms (p < 0.01), only psychological inflexibility (p < 0.01) remained as a significant predictor of the three outcomes. Therefore, in conclusion, intervention programs that target the awareness of the caregiver's psychological inflexibility should be implemented to alleviate these adverse outcomes in dementia caregivers.

Burden in caregivers of children with congenital Zika syndrome in Pernambuco, Brazil: analysis and application of the Zarit burden interview scale.

This study aimed to analyze the burden on caregivers of children with congenital Zika syndrome associated with viral infections in the state of Pernambuco, Brazil using the Zarit Burden interview scale. A quantitative study was conducted at the Oswaldo Cruz University Hospital, Recife City, State of Pernambuco, Brazil. By convenience sampling, 56 mothers, two grandmothers, and two caregivers were enrolled, all are female. Data were collected from July 2019 to January 2020. In the analysis, the percentage frequencies were calculated. The normality was identified using the Kolmogorov-Smirnov test, and participant profiles were compared using Student's t-test and analysis of variance. In descriptive statistics, quantitative variables are described by the median and interquartile range and categorical variables by proportions using the Chi-square test. In the comparative analysis, all factors evaluated were significant, except for the "gestational period in which the disease occurred" (p<0.111). The significance of differences in all activities was evaluated. In the mean comparison test, only the factor "has a job" was significant (p<0.043). When comparing the average of caregivers' responses to the categories of the Zarit burden interview scale, the highest level of burden was regarding the feeling that the child is dependent on the caregiver (3.62 points). Caregiver burden was classified as absence, light, moderate, and high. The consequences of contracting the Zika virus in the first trimester of pregnancy, lack of paid work, financial scarcity, full-time dedication to the child, and lack of time for themselves increase the burden on caregivers. Thus, caregivers have mild burden.