Department of Neurology, Xuan Wu Hospital, Capital Medical University, Beijing, P.R. China.
Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, P.R. China.
J Alzheimers Dis. 2017;59(4):1317-1325. doi: 10.3233/JAD-170172.
Despite its popularity, the latent structure of 22-item Zarit Burden Interview (ZBI) remains unclear. There has been no study exploring how caregiver multidimensional burden changed.
The aim of the work was to validate the latent structure of ZBI and to investigate how multidimensional burden evolves with increasing global burden.
We studied 1,132 dyads of dementia patients and their informal caregivers. The caregivers completed the ZBI and a questionnaire regarding caregiving. The total sample was randomly split into two equal subsamples. Exploratory factor analysis (EFA) was performed in the first subsample. In the second subsample, confirmatory factor analysis (CFA) was conducted to validate models generated from EFA. The mean of weighted factor score was calculated to assess the change of dimension burden against the increasing ZBI total score.
The result of EFA and CFA supported that a five-factor structure, including role strain, personal strain, incompetency, dependency, and guilt, had the best goodness-of-fit. The trajectories of multidimensional burden suggested that three different dimensions (guilt, role strain and personal strain) became the main subtype of burden in sequence as the ZBI total score increased from mild to moderate. Factor dependency contributed prominently to the total burden in severe stage.
The five-factor ZBI is a psychometrically robust measure for assessing multidimensional burden in Chinese caregivers. The changes of multidimensional burden have deepened our understanding of the psychological characteristics of caregiving beyond a single total score and may be useful for developing interventions to reduce caregiver burden.
尽管 Zarit 负担访谈（ZBI）22 项量表广受欢迎，但它的潜在结构仍不清楚。目前还没有研究探讨照顾者多维负担的变化情况。
本研究旨在验证 ZBI 的潜在结构，并探讨多维负担如何随全球负担的增加而变化。
我们研究了 1132 对痴呆症患者及其非专业照顾者。照顾者完成了 ZBI 和一份关于照顾的问卷。总样本被随机分为两个相等的子样本。在第一个子样本中进行探索性因素分析（EFA）。在第二个子样本中，进行验证性因素分析（CFA）以验证 EFA 生成的模型。计算加权因子得分的平均值，以评估随着 ZBI 总分的增加，各维度负担的变化情况。
EFA 和 CFA 的结果支持五因素结构，包括角色紧张、个人紧张、无能、依赖和内疚，具有最佳的拟合优度。多维负担的轨迹表明，随着 ZBI 总分从轻度到中度增加，三个不同的维度（内疚、角色紧张和个人紧张）依次成为负担的主要亚型。在严重阶段，因子依赖对总负担的贡献显著。
五因素 ZBI 是一种用于评估中国照顾者多维负担的心理测量学上可靠的测量工具。多维负担的变化加深了我们对照顾者心理特征的理解，超越了单一的总分，可能有助于制定减轻照顾者负担的干预措施。
