Cited by 1,426Nursing care and researchIntergenerational Family Dynamics and CaregivingFamily Caregiving in Mental Illness

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Validation of a Caregiver Strain Index

Robinson, B. C.·1983·Journal of Gerontology

DOI 10.1093/geronj/38.3.344

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Abstract

This paper outlines the development of a Caregiver Strain Index (CSI) with a sample of spouses, family, friends, and neighbors, aged 22 to 83, who provided varying degrees of care to recently hospitalized hip surgery and heart patients aged 65 and over. Internal consistency (Cronbach's alpha) for the 13-item CSI on 81 cases was .86. Evidence of construct validity was obtained in three areas: ex-patient characteristics; subjective perceptions of the care-taking relationship by caregivers; and emotional health of caregivers. These results indicate that the CSI is a brief, easily administered instrument which identified strain within our sample of informal care providers. Further development of the CSI is being undertaken for predicting specific caregiver populations at risk. This simple index might be usefully included in any interview or assessment package that examines intergenerational relations involving dependency and care.

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Crossref · 10.1093/geronj/38.3.344

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Method
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Lee, Y.-R., & Sung, K. (1998) · The International Journal of Aging and Human Development · doi:10.2190/pm2c-v93r-ne8h-jwgv · Cited by 94
Elder care and the impact of caregiver strain on the health of employed caregivers
Duxbury, L. E., Higgins, C., & Smart, R. (2011) · Work · doi:10.3233/wor-2011-1204 · Cited by 93
“This construct was operationalized using a modified threeitem version of Robinson’s [36] Caregiver Strain Index.”
BackgroundMethod
Partners of Cancer Patients
Carlson, L. E., Bultz, B. D., Speca, M., & Pierre, M. S. (2000) · Journal of Psychosocial Oncology · doi:10.1300/j077v18n02_03 · Cited by 99
“Similarly, during chemotherapy, both male and female caregivers of male patients reported more strain on the Caregiver Strain Index; however, the majority of caregivers were female (Schumacher, Bodd, & Paul, 1993).”
BackgroundInfluential
Does couple identity mediate the stress experienced by caregiving spouses?
Badr, H., Acitelli, L. K., & Taylor, C. L. C. (2007) · Psychology and Health · doi:10.1080/14768320600843077 · Cited by 94
“, 1995), and much attention in the literature has been devoted to minimizing the negative effects of caregiving (Given et al., 1992; Nolan, Grant, & Ellis, 1990; Pearlin et al., 1990; Robinson, 1983).”
Background
Long-term effects of a group support program and an individual support program for informal caregivers of stroke patients: which caregivers benefit the most?
van den Heuvel, E. T. P., de Witte, L., Stewart, R. E., Schure, L., Sanderman, R., & Jong, B. M. (2002) · Patient Education and Counseling · doi:10.1016/s0738-3991(01)00230-0 · Cited by 92
“73) were used to evaluate the amount of social support and satisfaction with social support.(17) Five different types of social support (emotional support in case of problems, appreciation support, instrumental support, social companionship, informative support) were each evaluated by two items.”
Method
Care for a break? An investigation of informal caregivers’ attitudes toward respite care using Q-methodology
van Exel, J. N. A., de Graaf, G., & Brouwer, W. B. F. (2007) · Health Policy · doi:10.1016/j.healthpol.2007.02.002 · Cited by 92
The Effect of Caregiver's Burden on Change in Frail Older Persons' Use of Formal Helpers
Miller, B. H., & McFall, S. L. (1991) · Journal of Health and Social Behavior · doi:10.2307/2137150 · Cited by 92
Responses of elderly spouse caregivers
Given, B. A., Stommel, M., Collins, C. E., et al. (1990) · Research in Nursing & Health · doi:10.1002/nur.4770130204 · Cited by 92
Exercise- and strategy-based physiotherapy-delivered intervention for preventing repeat falls in people with Parkinson’s: the PDSAFE RCT
Ashburn, A., Pickering, R. M., McIntosh, E., Hulbert, S., Rochester, L., Roberts, H. C., Nieuwboer, A., Kunkel, D., Goodwin, V. A., Lamb, S. E., et al. (2019) · Health Technology Assessment · doi:10.3310/hta23360 · Cited by 100
Factors associated with carer strain in carers of people with multiple sclerosis
Chipchase, S. Y. (2001) · Disability and Rehabilitation · doi:10.1080/09638280110062158 · Cited by 91
Testing a Family‐Centered Intervention to Promote Functional and Cognitive Recovery in Hospitalized Older Adults
Boltz, M. P., Resnick, B. M., Chippendale, T. L., & Galvin, J. E. (2014) · Journal of the American Geriatrics Society · doi:10.1111/jgs.13139 · Cited by 95
Screening for caregivers at risk: Extended validation of the short version of the Burden Scale for Family Caregivers (BSFC-s) with a valid classification system for caregivers caring for an older person at home
Pendergrass, A., Malnis, C., Graf, U., Engel, S., & Graessel, E. (2018) · BMC Health Services Research · doi:10.1186/s12913-018-3047-4 · Cited by 91
“the Zarit Burden Interview [7], the Caregiver Strain Index [8], and the CarerQol [9]).”
Method
Caregiver burden and sibling relationships in families raising children with disabilities and typically developing children.
Roper, S. O., Allred, D. W., Mandleco, B. L., Freeborn, D., & Dyches, T. T. (2014) · Families Systems & Health · doi:10.1037/fsh0000047 · Cited by 90
Cognitive function and quality of life after successful resuscitation from cardiac arrest
Beesems, S. G., Wittebrood, K. M., de Haan, R. J., & Koster, R. W. (2014) · Resuscitation · doi:10.1016/j.resuscitation.2014.05.027 · Cited by 89
‘It’s a huge maze, the system, it’s a terrible maze’: Dementia carers’ constructions of navigating health and social care services
Peel, E., & Harding, R. (2013) · Dementia · doi:10.1177/1471301213480514 · Cited by 89
“The final section was about support and information and included the Caregiver Strain Index (Robinson, 1983).”
BackgroundInfluential
Mutuality of the marital relationship in Parkinson's disease
Tanji, H., Anderson, K. E., Gruber‐Baldini, A. L., Fishman, P. S., Reich, S. G., Weiner, W. J., & Shulman, L. M. (2008) · Movement Disorders · doi:10.1002/mds.22089 · Cited by 89
“There are 15 items and examples include, ‘‘How close do you feel to him or her?’’ and ‘‘How much do you confide in him or her?’’ Caregiver strain was assessed with the Caregiver Strain Index (CSI) with high scores indicating greater caregiver burden.(16) Thirteen scale items are rated including, ‘‘Sleep is disturbed’’…”
Method
Gender Differences in Spouse Caregiver Strain: Socialization and Role Explanations
Miller, B. H. (1990) · Journal of Marriage and the Family · doi:10.2307/353028 · Cited by 89
The ALS Health Profile Study: quality of life of amyotrophic lateral sclerosis patients and carers in Europe
Jenkinson, C., Fitzpatrick, R., Swash, M., & Peto, V. (2000) · Journal of Neurology · doi:10.1007/s004150070069 · Cited by 88
Caring for a child with Cerebral Palsy: The experience of Zimbabwean mothers
Dambi, J. M., Jelsma, J. M., & Mlambo, T. (2015) · African Journal of Disability · doi:10.4102/ajod.v4i1.168 · Cited by 89
“…deemed an appropriate tool as it captures the multidimensionality of the burden of care, has demonstrated sound psychometric properties, it is short and easy to administer, and has been used previously in caregivers of children with CP (Narekuli, Raja & Kumaran 2011; Robinson 1983; Sullivan 2002).”
BackgroundMethodInfluential
The impact of stroke on the well‐being of the patient's spouse: an exploratory study
Draper, P., & Brocklehurst, H. (2007) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2006.01575.x · Cited by 88
Taking charge after stroke: promoting self-directed rehabilitation to improve quality of life – a randomized controlled trial
Harwood, M. L. N., Weatherall, M., Talemaitoga, A., Barber, P. A., Gommans, J., Taylor, W. J., McPherson, K. M., & McNaughton, H. (2011) · Clinical Rehabilitation · doi:10.1177/0269215511426017 · Cited by 85
Short-term effects of a group support program and an individual support program for caregivers of stroke patients
van den Heuvel, E. T. P., de Witte, L., Nooyen-Haazen, I., Sanderman, R., & Jong, B. M. (2000) · Patient Education and Counseling · doi:10.1016/s0738-3991(99)00066-x · Cited by 88
Factor structure and construct validity of the Adult Social Care Outcomes Toolkit for Carers (ASCOT-Carer)
Rand, S. E., Malley, J., Netten, A., & Forder, J. (2015) · Quality of Life Research · doi:10.1007/s11136-015-1011-x · Cited by 89
“As there are no other instruments that measure carers’ SCRQoL, the convergent validity of the ASCOT-carer was studied by the association between SCRQoL score and instruments that measure the following associated constructs: the subjective effect of caregiving (CSI [31]), health-related quality of life (EQ-5D [35, 36])…”
BackgroundMethod
Family functioning in the caregivers of patients with dementia
Heru, A. M., Ryan, C. E., & Iqbal, A. (2004) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1119 · Cited by 87
“The Caregiver Strain scale (CSI) (Robinson, 1983) and visual analogue scales measured the strains and burdens of caregiving.”

Authors: Robinson, B. C.
Affiliations: University of California, San Francisco (US)
Corresponding author: Robinson, B. C.
Venue: Journal of Gerontology
Publisher: Oxford University Press (OUP)
Published: 1983-05-01
Volume: 38
Issue: 3
Pages: 344-348
ISSN: 0022-1422 (ISSN-L)
DOI: 10.1093/geronj/38.3.344
OpenAlex: W2128077231
Cited by: 1,426
References: 0
Citations by year: 2026: 41 · 2025: 36 · 2024: 56 · 2023: 48 · 2022: 67 · 2021: 69 · 2020: 50 · 2019: 57 · 2018: 61 · 2017: 48 · 2016: 55 · 2015: 59 · 2014: 55 · 2013: 47 · 2012: 55
FWCI: 24.74
Type: journal article
Language: en
Open access: closed
Locations: Journal of Gerontology (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Nursing › Research and Theory › Nursing care and research
Social Sciences › Sociology and Political Science › Intergenerational Family Dynamics and Caregiving
Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
Keywords: Caregiver Strain Index, caregiver burden, informal caregivers, family caregivers, spouses, cardiac surgery patients, older adults, intergenerational dependency, scale validation, construct validity
MeSH terms: Adult, Aged, Attitude to Health, Home Nursing, Humans, Life Style, Middle Aged, Surveys and Questionnaires, Stress, Psychological

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Validation of a Caregiver Strain Index

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