Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment

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...

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Main Authors: Lim, Zhi-Xiang, Lim, Wee Shiong, Chan, Ee-Yuee
Other Authors: Lee Kong Chian School of Medicine (LKCMedicine)
Format: Article
Language:English
Published: 2023
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Online Access:https://hdl.handle.net/10356/170105
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spelling sg-ntu-dr.10356-1701052023-09-03T15:37:09Z Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment Lim, Zhi-Xiang Lim, Wee Shiong Chan, Ee-Yuee Lee Kong Chian School of Medicine (LKCMedicine) Tan Tock Seng Hospital Science::Medicine Alzheimer Disease Caregiver Burden 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. Published version The research was funded by the Ng Teng Fong Healthcare Innovative Program, Singapore (NTF_JUN2018_I_C1_C_02). 2023-08-28T05:43:38Z 2023-08-28T05:43:38Z 2023 Journal Article Lim, Z., Lim, W. S. & Chan, E. (2023). Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment. Alzheimer Disease and Associated Disorders, 37(1), 59-65. https://dx.doi.org/10.1097/WAD.0000000000000537 0893-0341 https://hdl.handle.net/10356/170105 10.1097/WAD.0000000000000537 36706328 2-s2.0-85148773099 1 37 59 65 en NTF_JUN2018_I_C1_C_02 Alzheimer Disease and Associated Disorders © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. application/pdf
institution Nanyang Technological University
building NTU Library
continent Asia
country Singapore
Singapore
content_provider NTU Library
collection DR-NTU
language English
topic Science::Medicine
Alzheimer Disease
Caregiver Burden
spellingShingle Science::Medicine
Alzheimer Disease
Caregiver Burden
Lim, Zhi-Xiang
Lim, Wee Shiong
Chan, Ee-Yuee
Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment
description 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.
author2 Lee Kong Chian School of Medicine (LKCMedicine)
author_facet Lee Kong Chian School of Medicine (LKCMedicine)
Lim, Zhi-Xiang
Lim, Wee Shiong
Chan, Ee-Yuee
format Article
author Lim, Zhi-Xiang
Lim, Wee Shiong
Chan, Ee-Yuee
author_sort Lim, Zhi-Xiang
title Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment
title_short Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment
title_full Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment
title_fullStr Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment
title_full_unstemmed Development and validation of a multidimensional short version Zarit Burden Interview (ZBI-9) for caregivers of persons with cognitive impairment
title_sort development and validation of a multidimensional short version zarit burden interview (zbi-9) for caregivers of persons with cognitive impairment
publishDate 2023
url https://hdl.handle.net/10356/170105
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