Assessing family caregiver's mental health using a statistically derived cut-off score for the Zarit Burden Interview

Abstract

Decades of research have confirmed that being a family caregiver is a stressful role. However, the point at which these stressors constitute a real risk for decreased mental health has not been established. The purpose of the present study was to determine a statistically valid cut-off score for the Zarit Burden Interview (ZBI) in order to identify family caregivers at risk for depression and in need of further assessment and intervention. The ZBI and the Geriatric Depression Scale or the CES-D were administered to three different populations of family caregivers of older adults: stroke caregivers (n=80), chronic obstructive pulmonary disease (COPD) caregivers (n=48), and general disability caregivers (n=70). Using three different statistical methods, a ZBI cut-off score was determined. Next, contingency analysis was used to compare depression scale scores and ZBI cut-offs for the three groups of caregivers. Findings suggest that a cut-off score ranging from 24-26 has significant predictive validity for identifying caregivers at risk for depression. A ZBI cut-off of 24 correctly identified 72% of caregivers with probable depression. The validity of ZBI cut-offs scores warrants further confirmation with larger samples. Valid cut-off scores would enable health care providers to assess family caregivers at risk and provide necessary interventions to improve their quality of life in this important role.

Patient function and caregiver burden after ambulatory surgery: a cohort study of patients older than 65

“…Nevertheless, caregiver experience was highly variable with eight caregivers (8%) reporting degrees of caregiver burden at baseline that were consistent with caring for a patient with cancer. 10 A similar number, but not the same individual caregivers, revealed these clinically significant levels of burden at POD 30.…”

“…Scores range from 0-88 with higher scores indicating increased burden of care. Mean (SD) ZBI scores of 20.4 (13) and 23.2 (13) were reported among those caring for patients with chronic obstructive lung disease 10 and cancer, 11 respectively (Mapi Research Trust, Lyon, France. Internet: www.mapi-trust.org.…”

Assessment of physical function and participation in chronic pain clinical trials: IMMPACT/OMERACT recommendations

“…As previously described, a number of measures can be used to assess the impact of pain on work functioning, within and There are a number of tools to measure caregiver burden. 50,58,75,89,100,125,167 However, to date this concept has not received sufficient attention, especially in the field of pain. Caregiver burden has been included as an outcome measure in phase 3 clinical trials in Alzheimer's disease, the index condition for studying caregiver burden 29 , and such measures may have a role in later-phase pain clinical trials.…”

Comparative Analysis of Informal Caregiver Burden in Advanced Cancer, Dementia, and Acquired Brain Injury

“…35 Additionally, a cutoff score of 24 (within the ZBI total range of 0e88) has been statistically derived for medical practitioners to identify and assess caregivers at risk of depression and encourage them to seek support. 37 Some differences in caregiver burden between diagnostic groups have been identified using the ZBI (total burden score), specifically between types of dementia, 38 dementia and nondementia patients, 39,40 and between Parkinson's disease and dementia caregivers in Tanzania. 41 Caregivers of patients with advanced cancer, dementia, and ABI may face not only some common challenges but also some differences in burden.…”