Graessel Elmar, Berth Hendrik, Lichte Thomas, Grau Hannes
Centre of Health Services Research in Medicine, Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg, Schwabachanlage 6, D-91054 Erlangen, Germany.
BMC Geriatr. 2014 Feb 20;14:23. doi: 10.1186/1471-2318-14-23.
Subjective burden is a central variable describing the situation encountered by family caregivers. The 10-item short version of the Burden Scale for Family Caregivers (BSFC-short/BSFC-s) was developed to provide an economical measure of this variable. The present study examined the reliability and validity of the BSFC-s.
Comprehensive data from "the IDA project" were the basis of the calculations, which included 351 dyads and examined medical data on people with dementia, interview data from their family caregivers, and health insurance data. A factor analysis was performed to explore the structure of the BSFC-s; Cronbach's alpha was used to evaluate the internal consistency of the scale. The items were analyzed to determine the item difficulty and the discriminatory power. Construct validity was tested with five hypotheses. To establish the predictive validity of the BSFC-s, predictors of institutionalization at a follow-up time of 2.5 years were analyzed (binary logistic regression).
The BSFC-s score adhered to a one-factor structure. Cronbach's alpha for the complete scale was .92. A significant increase in the BSFC-s score was observed when dementia progressed, disturbing behavior occurred more frequently, care requirements increased, and when caregivers were diagnosed with depression. Caregiver burden was the second strongest predictor of institutionalization out of a total of four significant predictors.
All hypotheses that referred to the construct validity were supported. The BSFC-short with its ten items is a very economical instrument for assessing the caregiver's total subjective burden in a short time frame. The BSFC-s score has predictive validity for the institutionalization of people with dementia. Therefore it is an appropriate outcome measure to evaluate caregiver interventions. The scale is available for free in 20 languages (http://www.caregiver-burden.eu). This availability facilitates the comparison of international research findings.
主观负担是描述家庭照顾者所面临状况的核心变量。为了对这一变量进行经济有效的测量，开发了《家庭照顾者负担量表简版（10项）》（BSFC - short/BSFC - s）。本研究检验了BSFC - s的信效度。
“IDA项目”的综合数据是计算的基础，该数据包括351对样本，并对痴呆症患者的医疗数据、其家庭照顾者的访谈数据以及健康保险数据进行了研究。进行因子分析以探索BSFC - s的结构；使用克朗巴哈系数来评估量表的内部一致性。对各条目进行分析以确定条目难度和区分度。通过五个假设检验结构效度。为了确定BSFC - s的预测效度，分析了随访2.5年时机构化的预测因素（二元逻辑回归）。
BSFC - s得分符合单因素结构。整个量表的克朗巴哈系数为0.92。当痴呆症进展、干扰行为更频繁出现、护理需求增加以及照顾者被诊断出患有抑郁症时，观察到BSFC - s得分显著增加。在总共四个显著预测因素中，照顾者负担是机构化的第二强预测因素。
所有涉及结构效度的假设均得到支持。包含十个条目的BSFC简版是在短时间内评估照顾者总主观负担的非常经济有效的工具。BSFC - s得分对痴呆症患者的机构化具有预测效度。因此，它是评估照顾者干预措施的合适结局指标。该量表有20种语言版本可免费获取（http://www.caregiver - burden.eu）。这种可获取性便于比较国际研究结果。
