Cheng Sheung-Tak, Kwok Timothy, Lam Linda C W
Department of Health and Physical Education, Hong Kong Institute of Education, Hong Kong.
Department of Medicine & Therapeutics, Chinese University of Hong Kong, Hong Kong.
Int Psychogeriatr. 2014 Sep;26(9):1455-1463. doi: 10.1017/S104161021400101X.
To investigate dimensions of caregiver burden through factor analysis of the Zarit Burden Interview (ZBI), and to examine predictors of different dimensions of burden.
Confirmatory factor analyses were performed on 395 Hong Kong Chinese Alzheimer caregivers to examine whether several proposed factor structures fit the data well. Subsequently, participants were split into two roughly equal subsamples, for the purpose of identifying the most optimal factor structure through exploratory factor analysis in Sample A ( = 183) and an independent verification through confirmatory factor analysis in Sample B ( = 212). ZBI subscales representing the established factors were correlated with caregiver and care-recipient variables known to be associated with burden.
Confirmatory factor analyses showed that factor models reported elsewhere did not fit the data well. Subsequently, exploratory factor analysis in Sample A suggested a 4-factor structure. After dropping three items due to poor factor loadings, the 4-factor structure was found to fit the data moderately well in Sample B. The four factors tapped personal strain, captivity, self-criticism, and loss of control. However, self-criticism was basically unrelated to the other three factors and showed a rather different pattern of correlations with caregiver and care-recipient variables. Self-criticism was more common among child caregivers and those who did not live with the care-recipient and was less involved in day-to-day care, yet feeling obligated and close to the care-recipient.
The dimensions of caregiver burden may be culturally specific. More research is needed to examine cultural considerations in measuring caregiver burden.
通过对 Zarit 负担访谈量表（ZBI）进行因子分析来探究照顾者负担的维度，并检验不同负担维度的预测因素。
对 395 名香港华裔阿尔茨海默病患者照顾者进行验证性因子分析，以检验几种提出的因子结构是否与数据拟合良好。随后，将参与者分成两个大致相等的子样本，目的是通过样本 A（n = 183）中的探索性因子分析确定最优因子结构，并通过样本 B（n = 212）中的验证性因子分析进行独立验证。代表已确定因子的 ZBI 分量表与已知与负担相关的照顾者和受照顾者变量进行相关分析。
验证性因子分析表明，其他地方报道的因子模型与数据拟合不佳。随后，样本 A 中的探索性因子分析提出了一个四因子结构。由于因子载荷较差剔除三个项目后，发现该四因子结构在样本 B 中与数据拟合程度中等。这四个因子分别反映了个人压力、受限感、自我批评和失去控制感。然而，自我批评与其他三个因子基本无关，并且在与照顾者和受照顾者变量的相关模式上有相当大的差异。自我批评在儿童照顾者以及那些不与受照顾者同住且较少参与日常照顾，但感到有义务且与受照顾者关系密切的照顾者中更为常见。
照顾者负担的维度可能具有文化特异性。需要更多研究来考察测量照顾者负担时的文化因素。
