Zarit Caregiver Burden Scale Research Articles

Prevalence of mild behavioral impairment in mild cognitive impairment and subjective cognitive decline, and its association with caregiver burden.

Mild behavioral impairment (MBI) describes later life acquired, sustained neuropsychiatric symptoms (NPS) in cognitively normal individuals or those with mild cognitive impairment (MCI), as an at-risk state for incident cognitive decline and dementia. We developed an operational definition of MBI and tested whether the presence of MBI was related to caregiver burden in patients with subjective cognitive decline (SCD) or MCI assessed at a memory clinic. MBI was assessed in 282 consecutive memory clinic patients with SCD (n = 119) or MCI (n = 163) in accordance with the International Society to Advance Alzheimer's Research and Treatment - Alzheimer's Association (ISTAART-AA) research diagnostic criteria. We operationalized a definition of MBI using the Neuropsychiatric Inventory Questionnaire (NPI-Q). Caregiver burden was assessed using the Zarit caregiver burden scale. Generalized linear regression was used to model the effect of MBI domains on caregiver burden. While MBI was more prevalent in MCI (85.3%) than in SCD (76.5%), this difference was not statistically significant (p = 0.06). Prevalence estimates across MBI domains were affective dysregulation (77.8%); impulse control (64.4%); decreased motivation (51.7%); social inappropriateness (27.8%); and abnormal perception or thought content (8.7%). Affective dysregulation (p = 0.03) and decreased motivation (p=0.01) were more prevalent in MCI than SCD patients. Caregiver burden was 3.35 times higher when MBI was present after controlling for age, education, sex, and MCI (p < 0.0001). MBI was common in memory clinic patients without dementia and was associated with greater caregiver burden. These data show that MBI is a common and clinically relevant syndrome.

Estrés, Sobrecarga Y Ansiedad En Cuidadoras Primarias De Niños Que Padecen Leucemia En Hidalgo

Leukemia is the type of cancer that occurs more in children and teenagers. The chronic-degenerative nature of the disease makes that the minors need someone responsible for their care known as informal primary caregiver. Generally, the primary caregiver role, who attends all the patient needs, it’s acquired by the father or mother of the minor. The demands of that labor can bring negative physiological and psychosocial consequences. Objective: to determine the relationship and the difference by sex and disease phase of the minor in the levels of stress, burden and anxiety of primary caregivers of boys and girls with leukemia in Hidalgo. Method: through a non-probability sampling of volunteers subjects were selected N = 50 female primary caregivers. To measure the variables they were used the following instruments: Perceived Stress Scale, Zarit Caregiver Burden Scale and Beck Anxiety Inventory. Results: showed positive and statistically significant correlations between anxiety-burden and stress-anxiety. It also found that the caregivers of boys have higher levels of anxiety than caregivers of girls and caregivers of patients in active phase of the disease have higher burden compared with caregivers of patients in remission phase. Conclusion: there are some high levels of stress, burden and anxiety in caregivers. There exists correlation between anxiety-stress and burdenanxiety. The caregivers of boys have more anxiety. The caregivers of children in active phase of the disease present more burden.

The relationship between psychiatric symptoms and burden of caregivers in senile dementia patients

Objective To investigate the occurrence and severity of behavioral and psychological symptoms of dementia(BPSD)in elderly dementia patients, and to explore the relationship of the degree of dementia and the severity of BPSD with the burden of caregivers in pension agency. Methods Using a convenient sampling method, the Clinical Dementia Rating(CDR)scale, neuropsychiatric scale(NPI)and Zarit caregiver burden scale(ZBI)were used to evaluate 145 patients with Alzheimer's disease and caregiver burden in Hangzhou. Results The incidence rate of BPSD was 51.8%(72 cases), with a higher incidence rate of delusions of 22.3%(31 cases), a higher severity of sleep disorder/nocturnal behavior〔NPI symptom score(5.95±4.60)points〕. The symptom making a greatest burden on the caregivers was delusion〔ZBI score(32.81±17.66)points〕. There were positively correlations of the burden of caregivers with the degree of dementia and the severity of BPSD(r=0.434, 0.710, all P<0.01)in patients with senile dementia. Conclusions The incidence rate of BPSD in dementia patients is higher, and the occurrence of BPSD is associated with the severity of mini-mental state examination(MMSE)and dementia, which increases the burden of caregivers.More attention should be paid to BPSD in patients with senile dementia.And the social support system serving patients with senile dementia and their caregivers should be further improved. Key words: Dementia; Behavioral symptoms; Mental disorders

Manisa'da bir toplum sağlığı merkezi bölgesinde evde sağlık hizmeti alan kişilere bakım verenlerin yükünün değerlendirilmesi

Objective: The aim of this study is to evaluate the caregivers' burden and relevant factors who look after patients that receive home health service. Method: This cross-sectional study is conducted caregivers who look after home health service patients in years 2014-2016 in Manisa Şehzadeler. The study consists of 234 individuals. The participation rate is 83.5%. A questionnaire which consists of sociodemographic factors, questions about the illness and Zarit Caregiver Burden Scale that evaluates caregivers' stress is applied to participants. Results: 67.7% of caregivers have mild/ moderate/ severe burden, 87.4% of them are women, 67.1% of them are first degree relatives and 89.8 % of them are members of lower social class. Having the caregiver in the lower social class, having the patient's daughter-in-law, extended family structure and patient's bad health perception are the reasons that increase the caregiver's burden. Conclusion: 67.7% of caregivers have mild/ moderate/ severe burden. Caregivers need to be supperted economically, socially and psychologically. It is also suggested that paid caregivers who cares patients at home should be promoted and additional studies should be carried out.

Emotional and instrumental support influencing male caregivers for people with dementia living at home.

Object: To clarify the emotional and instrumental support influencing male caregivers for people with dementia living at home.Patients/Materials and Methods: The subjects were 298 male caregivers. Nursing care burden was assessed using the Zarit Caregiver Burden Scale. Ability to cope with care problems was assessed using the Nursing Care Problems Coping Scale for Male Caregivers for People with Dementia Living at Home (NCSM). Emotional support was assessed using the Emotional Support Network Scale. Instrumental support was assessed using the question “Do you have someone to help when you have a problem with nursing care?”.Results: There was a significant correlation (P < 0.04) between the point (index) of NCSM and Zarit Caregiver Burden Scale. A positive significant correlation was found in three coping styles. A negative significant correlation was found in one coping style, and no significant correlation in one coping style. The ‘Solve the problem’ coping style was linked to support from both within and beyond the family. Both ‘Emotional avoidance’ and ‘Cognitive transformation’ coping styles were linked to support from within the family, and “Request assistance” style only to external support. There were no correlations between the source of support and the “Careful supervision and waiting” coping style.Conclusion: Emotional and instrumental support for male caregivers was more than three times more likely to be obtained from within the family than outside it. With families becoming smaller, it is becoming more important for communities and society in general to provide emotional and instrumental support for male caregivers. Male caregivers need support from someone with whom they feel comfortable. It is particularly necessary to consider how to support male caregivers who use the “Emotional avoidance” coping style.

Levels of Care Burden and Self-efficacy for Informal Caregiver of Patients With Cancer.

This descriptive study was conducted to determine the levels of self-efficacy and caregiver burden experienced by caregivers for patients with cancer. The study was conducted at the oncology clinic of a hospital in Erzurum city, Turkey. The study sample consisted of 101 caregivers of patients hospitalized with a diagnosis of cancer. The Self-Efficacy Scale Turkish version and the Zarit Caregiver Burden Scale, which is a sociodemographic questionnaire, were used for data collection. The level for the burden of care for caregivers to patients with cancer was moderate, and the level of self-efficacy was moderate. A statistically significant, positive relationship was found between the scores for the Care Burden Scale and the Completing Behavior Subscale (r = 0.213; P < .05). A statistically significant, negative relationship was observed between the mean scores of the Care Burden Scale with Self-Efficacy Scale's total score (r = -0.104; P < .05), Sustaining Behavior Subscale (r = -0.324; P < .01), and Initiating Behavior Subscale (r = -0.199; P ≤ .05). Therefore, initiatives focused on self-efficacy levels should be developed to increase the abilities of caregivers for patients with cancer.

Northern Manhattan Hispanic Caregiver Intervention Effectiveness Study: protocol of a pragmatic randomised trial comparing the effectiveness of two established interventions for informal caregivers of persons with dementia

IntroductionThe prevalence of dementia is increasing without a known cure, resulting in an increasing number of informal caregivers. Caring for a person with dementia results in increased stress and depressive...

Effects of multiple training modalities in patients with Alzheimer's disease: a pilot study.

ObjectiveThis pilot study investigated the effects of multiple training modalities on cognition, neuropsychiatric symptoms, caregivers’ burden, and quality of life in patients with Alzheimer’s disease (AD).Patients and methodsThis intervention study was conducted in 24 patients with AD aged ≥65 years with a Clinical Dementia Rating (CDR) score of 0.5–1. The patients were assigned to receive multiple training modalities (1 hour for each training: Tai Chi, calligraphy, and drawing) over a 6-week period in either the experimental group (n=14) or the comparison group (n=10). A series of neuropsychological tests – namely the Traditional Chinese version Mini-Mental Status Examination, Cognitive Assessment Screening Instrument (CASI), Neuropsychiatric Inventory and the Neuropsychiatric Inventory Caregiver Distress Scale, and the Clinical Dementia Rating Sum of Boxes scale – were conducted at the baseline and after the intervention. The World Health Organization Quality of Life-BREF (WHOQOL-BREF) and Zarit Caregiver Burden Scale were used to assess the quality of life and caregivers’ burden, respectively. Independent sample t-test and paired sample t-test were used to analyze the data.ResultsAfter the intervention, the experimental group reported higher scores in the orientation domain of CASI (P=0.007) and in the psychiatry domain of WHOQOL-BREF (P=0.042) compared with the comparison group. Caregivers’ distress was significantly decreased in the experimental group (P=0.035) but not in the comparison group (P=0.430).ConclusionThe multiple training modalities improved scores in the orientation domain of CASI and psychiatry domain of WHOQOL-BREF in patients with AD. Moreover, the intervention reduced caregivers’ distress.

Pilot testing of the “First You Should Get Stronger” program among caregivers of older adults with dementia

ObjectiveIn this study, randomized controlled interventional study pattern was used to examine the effects of the “First You Should Get Stronger” program on the caregiving burden and healthy life style behavior of caregivers of dementia patients. Methods“Zarit Caregiver Burden Scale” and “Healthy Life Style Behavior Scale” were used. The study was completed with 40 caregivers in total with 20 in the intervention group and 20 in the control group. A statistically significant difference was determined between the “Zarit Caregiving Burden Scale” and “Healthy Life Style Behavior Scale” score averages of the intervention group that participated in the “First You Should Get Stronger” program in comparison with those of the control group. ResultsIt is important for the healths of caregivers to include similar programs for the caregivers of dementia patients in continuous and regular applications. DiscussionThe results highlight the importance of the “First You Should Get Stronger” program significantly decreased the caregiving burden and significantly developed the healthy lifestyle behaviors of caregivers in the intervention group. Since dementia is a difficult neurological syndrome with patients cared at home, it generally wears out the caregivers significantly. It is suggested that the nurses and healthcare professionals working with dementia patients are evaluated separately and that they carry out caregiving applications within the scope of the “First You Should Get Stronger” program.

A pilot study of a new method of cognitive stimulation using abacus arithmetic in healthy and cognitively impaired elderly subjects

BackgroundThis study explores the applicability of a cognitive stimulation method based on abacus arithmetic in elderly people with and without cognitive impairment. MethodsThis observational and prospective pilot study was performed in 2 hospitals. The study assessed the applicability of a programme of arithmetic training developed for use in the elderly population. The primary endpoint was an evaluation of the stimulation programme, in terms of usability, satisfaction, and participation in healthy elderly controls and elderly patients with mild cognitive impairment or Alzheimer disease. Secondary endpoints were family satisfaction, caregiver burden, and the behaviour and cognition of patients. ResultsUsability, satisfaction, and degree of participation were high. The Mini-Mental State Examination showed significant changes (23.1±4.8 before the intervention vs 24.9±4.2 afterwards, P=.002); there were no changes on the Trail Making Test parts A and B, Yesavage Geriatric Depression scale, and Zarit caregiver burden scale. ConclusionsThe study suggests that cognitive stimulation with abacus arithmetic may be used in elderly people with and without cognitive impairment. Further studies will be needed to evaluate the efficacy of this kind of programmes.

Identifying Sociodemographic Characteristics Associated With Burden Among Caregivers of the Urban Homebound: The Importance of Racial and Relationship Differences.

Limited research has explored whether the burden associated with caring for homebound patients varies across racial groups or by relationship status. We examined these variations for this vulnerable population. Patients self-identified informal caregivers and caregiver burden/depression were assessed using the Zarit Caregiver Burden Scale and the Center for Epidemiologic Studies–Depression scale (CES-D). Forty-nine informal caregivers completed the interview. Mean age was 58 (SD = 14), 78% were female, 37% Black, 35% Hispanic, and 46% had completed high school. Over 60% of caregivers had moderate or severe caregiver burden and 30% had significant depression. White caregivers had greater burden than Black and Hispanic caregivers (p = .02). Mean caregiver burden was higher among spouse/partner caregivers, versus those who identified as children or other family or friends (p = .004). Additional research is needed to better understand the experience of racial and ethnic minorities and spouses in providing informal care to homebound adults.

The Burden for Caring Patients on Maintenance Hemodialysis is Influenced by Social and Demographic Factors

Caregiving by family members is an invaluable and essential support for chronic ill patients. However, physical and psychological stress associated with long-term caregiving may also affect the well-being and life quality of caregivers. Herein we assessed the burden for caring patients on maintenance hemodialysis by primary family caregivers. 151 patients and their 151 primary family caregivers were recruited. Patients were on hemodialysis for an average of 3.56 years. Self-perceived Zarit Caregiver Burden Scale and WHO-5 well-being index were measured in caregivers. Caregiving related physical and emotional distress was present in 115 out of 151 caregivers. Social and demographic factors including age, educational levels, caring hours and relationship with patients were correlated with the severity of burden. Additionally, caring for patients with diabetes, multiple comorbidities, lower income and higher medical expense increased the burden for caregivers. In conclusion, our study demonstrated that caregiver burden was commonly present in family caregivers of patients on maintenance hemodialysis. Several social and demographic factors in caregivers and patients contributed to caregiver burden.

Cost Related to Dementia in the Young and the Impact of Etiological Subtype on Cost.

Young onset dementia (YOD) presents in individuals who are economically productive and socially active. While the cost related to dementia in the elderly has been widely studied, the cost related to YOD is largely unknown. To study the economic burden of community dwelling YOD in relation to late onset dementia (LOD) and cost of YOD based on etiology. In this prospective cross-sectional study of 255 patients attending a tertiary neurology center, data on economic burden, clinical features, and caregiver burden were collected using structured financial questionnaire, standard cognitive and neuropsychiatric measures, and Zarit caregiver burden scale. Cost components were grouped into those relating to direct medical costs, direct non-medical costs, and those related to indirect costs. Cost was also categorized based on etiology of YOD. The mean age at symptom onset in the YOD and LOD cohort was 57.0 (SD 5.1) and 75.0 (SD 5.9) years, respectively. The median annual cost for patients with YOD was almost twice that of LOD (USD 15,815 versus USD 8,396). Indirect cost contributed heavily to cost related to YOD. Even when grouped by dementia etiology, YOD patients with Alzheimer's disease, frontotemporal dementia (FTD), and vascular dementia had higher cost compared to their elderly counterparts. Young onset FTD had the highest cost. 43.2% of YOD reported loss of employment due to dementia, which was significantly higher than that in LOD (2.4%). Patients with YOD have a high economic burden. Young patients with FTD have the highest cost followed by vascular dementia and Alzheimer's disease.

A cross-sectional evaluation of home health service in patients with chronic neurologic diseases in a province of Turkey.

In this study, we aimed to compare patients' characteristics, comorbid risk factors, medical supplies, and caregivers' demographics between stroke patients and patients with other chronic neurological diseases receiving home health services. In our study, between November 2013 and March 2014, chronic neurological disease (CND) patients having home health services were enrolled in the study. During patient visits, patients were assessed by the questionnaire comprising the modified Rankin scale (mRS), Barthel index, Zarit caregiver burden scale, and mini nutritional assessment (MNA). Stroke patients were classified as Group I, and the other neurologic diseases as Group II. A total of 202 patients including stroke patients (n = 112), dementia (n = 64), Parkinson's disease (n = 17), motor neuron disease (n = 4), brain cancer (n = 2), cerebral palsy (n = 1), multiple sclerosis (n = 1), and head trauma (n = 1) answered the questionnaire. The mean age of Group I (61K:51E) was 76.6 ± 9.1 years; the Group II (28M:62F) was 80.9 ± 12.3 years. The mean age of Group I was significantly lower than Group II (p = 0.005) and the number of male patients in Group I was significantly higher (p = 0.001). The educational status between the two groups was not significantly different in terms of duration of illness and addiction. There was no difference between the two groups in terms of Zarit caregiver burden scale, Barthel index, and mRS. The presence of malnutrition (MNA < 17) was significantly lower in Group I (p = 0.007). There was no difference between stroke patients and other CND patients group in terms of caregiver burden and psychosocial status except for malnutrition. Being careful on nutritional support and providing appropriate nutritional support in other CND patients are expected to increase the life quality.

Şizofreni hastalarının bakımıyla ilgilenenlerde yük ve ilişkili özellikler

Burden and burden-related features in caregivers of schizophrenia patients Objective: Burden, social support and coping methods in caregivers of patients and the relationship between these variables were cross-sectionally evaluated in this study. Method: Demographic form, Zarit Caregiver Burden Scale, Multidimensional Scale of Perceived Social Support and Ways of Coping Inventory were administered to the caregivers. The correlation of specified load levels with respect to the disease and characteristics of the caregivers were investigated. Results: The mean burden score of caregivers participated in the study was 60.45 points. By gender, burden in female caregivers was higher than men. The burden of employed caregivers was higher than unemployed. Statistically significant negative correlation between monthly income and burden was found. Helplessness and fatalistic attitudes were statistically correlated with burden. Conclusion: Caregivers who are not able to use effective coping styles have heavier burdens. Caregivers using nonfunctional coping styles, should be helped to change their attitudes.

Estudio piloto de un nuevo método de estimulación aritmética empleando el ábaco en ancianos sanos y con trastorno cognitivo

BackgroundThis study explores the applicability of a cognitive stimulation method based on abacus arithmetic in elderly people with and without cognitive impairment. MethodsThis observational and prospective pilot study was performed in 2 hospitals. The study assessed the applicability of a programme of arithmetic training developed for use in the elderly population. The primary endpoint was an evaluation of the stimulation programme, in terms of usability, satisfaction, and participation, in healthy elderly controls and elderly patients with mild cognitive impairment or Alzheimer disease. Secondary endpoints were family satisfaction, caregiver burden, and the behaviour and cognition of patients. ResultsUsability, satisfaction, and degree of participation were high. The Mini-Mental State Examination showed significant changes (23.1±4.8 before the intervention vs 24.9±4.2 afterwards, P=.002); there were no changes on the Trail Making Test parts A and B, Yesavage Geriatric Depression scale, and Zarit caregiver burden scale. ConclusionsThe study suggests that cognitive stimulation with abacus arithmetic may be used in elderly people with and without cognitive impairment. Further studies will be needed to evaluate the efficacy of this kind of programmes.

The Social Functionality of Schizophrenic Patients and the Burden Experienced by Their Caregivers

This descriptive study was carried out to determine the social functionality levels of the schizophrenic patients, the burden experienced by their caregivers. The universe comprised of 130 caregivers selected from the hospitals and Schizophrenic Patients and Relatives Solidarity Society in Ankara. For data collection 'Patient and Caregiver Identification Form”, 'Zarit Caregiver Burden Scale” and 'Schizophrenic Patients Functional Recovery Scale” were used. For the normality assumption in data evaluation, the Shapiro-Wilks test, for the significance difference between two means, and one way variance analysis, and for correlation Pearson Correlation Coefficient Test were used. The study results revealed that caregivers’ burden level was medium relatives (55.80±15.90), and the patients’ social functionality was also medium (49.96±16.34), and there was a negative medium level correlation between the social functionality average points of the patients and the average burden points of the caregiver patient relatives. It was determined that there was statistically important difference between points according to age, education and employment status of the patients, job of working patients, regular drug use and medical visits, caregiver age, civil status, relation with the patient, employment and income level, number of family members, time spent with the patient, knowledge about disease, society membership and regular attendance to family education sessions. Education and employment of patients, regular drug use and medical visits, substance addicttion and substance type caused statistically important difference between social functionalty levels of patients. Thus, psychiatric nurses one suggested to plan necessary psychosocial skill training to improve social functionality levels of patients.

Characteristics and mental health of Hispanic dementia caregivers in New York City.

Dementia prevalence and related caregiving burden are increasing, particularly among Hispanics. We studied the characteristics and mental health of Hispanic caregivers in New York City. We recruited 139 Hispanic family caregivers. We collected data on sociodemographic characteristics and predictors of caregiver burden, measured with the Zarit Caregiver Burden Scale, and depressive symptoms, measured with the Geriatric Depression Scale. The mean age was 59.3 ± 10.4 years. The majority of caregivers were daughters and earned less than US$30 000 a year. In multivariate analyses with linear regression, lower satisfaction with social networks was associated with higher caregiver burden and a greater number of depressive symptoms. Higher dementia severity was associated with higher caregiver burden, while higher caregiver comorbidities were associated with higher depressive symptoms. Caregiver comorbidities and satisfaction with social support may be targets for intervention that could improve caregiver burden and depressive symptoms among Hispanic caregivers.

Development of a nursing care problems coping scale for male caregivers for people with dementia living at home.

Objective: The number of male caregivers has increased, but male caregivers face several problems that reduce their quality of life and psychological condition. This study focused on the coping problems of men who care for people with dementia at home. It aimed to develop a coping scale for male caregivers so that they can continue caring for people with dementia at home and improve their own quality of life. The study also aimed to verify the reliability and validity of the scale.Patients/Material and Methods: The subjects were 759 men who care for people with dementia at home. The Care Problems Coping Scale consists of 21 questions based on elements of questions extracted from a pilot study. Additionally, subjects completed three self-administered questionnaires: the Japanese version of the Zarit Caregiver Burden Scale, the Depressive Symptoms and the Self-esteem Emotional Scale, and Rosenberg Self-Esteem Scale.Results: There were 274 valid responses (36.1% response rate). Regarding the answer distribution, each average value of the 21 items ranged from 1.56 to 2.68. The median answer distribution of the 21 items was 39 (SD = 6.6). Five items had a ceiling effect, and two items had a floor effect. The scale stability was about 50%, and Cronbach’s α was 0.49. There were significant correlations between the Care Problems Coping Scale and total scores of the Japanese version of the Zarit Caregiver Burden Scale, the Depressive Symptoms and Self-esteem Emotional Scale, and the Rosenberg Self-Esteem Scale.Conclusion: The answers provided on the Care Problems Coping Scale questionnaire indicated that male caregivers experience care problems. In terms of validity, there were significant correlations between the external questionnaires and 19 of the 21 items in this scale. This scale can therefore be used to measure problems with coping for male caregivers who care for people with dementia at home.

Factor‐associated caregiver burden in medically complex patients with special health‐care needs

Many medically complex patients with special health-care needs (PSHCN) receive home-based medical support, placing a major burden on their caregivers. We characterized the caregiving factors involved in PSHCN and their relationship with caregiver burden. The PSHCN and their families were recruited from children's hospitals and rehabilitation centers. A medical information handbook was distributed to the families on enrollment, followed by a self-report questionnaire 1 year later. Data on the type of caregiving involved, family circumstances, and caregiver burden were collected. The Zarit caregiver burden scale (ZS) was used to evaluate caregiver burden. Logistic regression (proportional odds model) was used to determine associations between each variable and caregiver burden in each of two PSHCN age groups: <15 years old (younger group) and ≥ 15 years (older group). Sixty-eight PSHCN and their families were included in the analysis. The mean age of the PSHCN was 15.4 ± 11.8 years. On multivariate analysis there was a significant positive correlation between ZS score and older siblings (odds ratio [OR], 3.65), but no significant correlation between caregiver burden and type of care involved in the younger group. In the older group, a positive correlation was observed between caregiver burden and home mechanical ventilation with tracheostomy (OR, 15.16), but a negative correlation with younger siblings (OR, 0.04). Family circumstances play a bigger role than type of care required in increasing caregiver burden in families of PSHCN aged less than 15 years.