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Alzheimer disease and associated disorders
2023 Jan-Mar 01;37 (1): 59-65.

Development and Validation of a Multidimensional Short Version Zarit Burden Interview (ZBI-9) for Caregivers of Persons With Cognitive Impairment.

Lim Zhi-Xiang, Wee Shiong Lim, Ee-Yuee Chan
Author Information
  1. Lim Zhi-Xiang: Nursing Research Unit, Nursing Service.
  2. Wee Shiong Lim: Department of Geriatric Medicine, Institute of Geriatrics and Active Aging, Tan Tock Seng Hospital, 11 Jan Tan Tock Seng.
  3. Ee-Yuee Chan: Nursing Research Unit. ORCID
PMID: 36706328 DOI: 10.1097/WAD.0000000000000537

Abstract

BACKGROUND: There is a lack of appreciation of the full dimensionality of the original 22-item Zarit Burden Interview (ZBI) in the development of short versions. Existing short versions are premised upon a 1-factor or 2-factor structure or statistical techniques for item selection. Thus, there is a need for ZBI short versions that considers the multidimensional constructs of role strain, personal strain, and worry about performance (WaP) during item selection to provide a more holistic and comprehensive evaluation.
PURPOSE: To develop and validate a short version of ZBI through a combined quantitative and qualitative approach that incorporates the validated 4-factor structure of role strain demands; role strain-control; personal strain, and WaP.
patients: We studied 202 caregivers of patients with dementia (84.2%) or mild Cognitive Impairment (15.8%) attending a memory clinic in Singapore.
METHODS: Confirmatory factor analysis and qualitative considerations from expert consensus were used for item selection. Confirmatory factor analysis fit statistics support the 4-factor structure. The 9-item ZBI-9 showed good internal consistency (Cronbach's α=0.87) and convergent validity with anxiety and depression (Pearson correlation: Hospital anxiety and depression sub-scales, r≥0.56, P <0.001; ZBI- 22, r=0.95, P <0.001). Using a cut-off score of ≥13, ZBI-9 displayed good discriminatory ability for depressive symptoms (area under curve=0.79, P <0.001; sensitivity=70%, specificity=75%). The ZBI-9 also displayed comparable performance to the 22-item full version and three 12-item short versions.
CONCLUSION: The ZBI-9 is a multidimensional short-version assessment tool for caregivers of persons with dementia and mild Cognitive Impairment that is reliable, valid, and discriminates depressive symptoms.

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MeSH Term

Humans
Caregivers
Dementia
Cognitive Dysfunction
Anxiety
Factor Analysis, Statistical
Reproducibility of Results
Psychometrics
Surveys and Questionnaires
Journal Article Research Support, Non-U.S. Gov't

Word Cloud

Created with Highcharts 10.0.0shortZBI-9versionsstrainZBIstructureitemselectionroleP<0001full22-itemZaritBurdenInterviewmultidimensionalpersonalperformanceWaPversionqualitative4-factorcaregiversdementiamildcognitiveimpairmentConfirmatoryfactoranalysisgooddisplayeddepressivesymptomsBACKGROUND:lackappreciationdimensionalityoriginaldevelopmentExistingpremisedupon1-factor2-factorstatisticaltechniquesThusneedconsidersconstructsworryprovideholisticcomprehensiveevaluationPURPOSE:developvalidatecombinedquantitativeapproachincorporatesvalidateddemandsstrain-controlPATIENTS:studied202patients842%158%attendingmemoryclinicSingaporeMETHODS:considerationsexpertconsensususedfitstatisticssupport9-itemshowedinternalconsistencyCronbach'sα=087convergentvalidityanxietydepressionPearsoncorrelation:HospitalAnxietyDepressionsub-scalesr≥056ZBI-22r=095Usingcut-offscore≥13discriminatoryabilityareacurve=079sensitivity=70%specificity=75%alsocomparablethree12-itemCONCLUSION:short-versionassessmenttoolpersonsreliablevaliddiscriminatesDevelopmentValidationMultidimensionalShortVersionCaregiversPersonsCognitiveImpairment

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