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Validation of a Caregiver Strain Index
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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“The CSI has shown good psychometric properties [32].”
From A web-based self-help intervention for partners of cancer patients based on Acceptance and Commitment Therapy: a protocol of a randomized controlled trial. (2015) · cites this paper as [32]
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Family caregiving: measurement of emotional well-being and various aspects of the caregiving role
Schofield, H., Murphy, B. M., Herrman, H., Bloch, S., & Singh, B. (1997) · Psychological Medicine · doi:10.1017/s0033291797004820 · Cited by 87
“While early burden instruments simply yield a global score (Zarit et al. 1980; Robinson, 1983), others have a number of dimensions, allowing identifications of particularly stressful areas of caregiving (Greene et al.”
BackgroundShin, D. W., Park, J. H., Shim, E., Park, J., Choi, J., Kim, S. G., & Park, E. (2010) · Psycho-Oncology · doi:10.1002/pon.1857 · Cited by 86
“To compile an exhaustive list of relevant caregiver needs items, we performed an extensive review of caregiver-related assessment tools and selected 20 existing self-report instruments with demonstrated psychometric properties, including the Family Inventory of Needs [31], Caregivers Needs Scale [36], the Home Caregiv…”
MethodDeimling, G. T., Bass, D. M., Townsend, A. L., & Noelker, L. S. (1989) · Journal of Aging and Health · doi:10.1177/089826438900100105 · Cited by 87
Hoefman, R. J., van Exel, N. J. A., Looren de Jong, S., Redekop, W. K., & Brouwer, W. B. F. (2011) · Quality of Life Research · doi:10.1007/s11136-010-9829-8 · Cited by 86
“Increased burden measured in terms of the dimensions of the CarerQol-7D was associated with increased burden measured with other burden instruments, such as the Caregiver Strain Index (CSI, [29]) and the Self-rated Burden scale (SRB, [30]).”
MethodHealth-related Quality of Life in Type 2 Diabetes (T2ARDIS-2)
Holmes, J. A., McGill, S., Kind, P., et al. (2000) · Value in Health · doi:10.1046/j.1524-4733.2000.36028.x · Cited by 86
Diwan, S., Hougham, G. W., & Sachs, G. A. (2004) · Journal of Palliative Medicine · doi:10.1089/jpm.2004.7.797 · Cited by 86
“Table 2 presents data on the factor structure of the CSI and reliability of the subscales.”
InfluentialMiyashita, M., Narita, Y., Sakamoto, A., Kawada, N., Akiyama, M. O., Kayama, M., Suzukamo, Y., & Fukuhara, S. (2008) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2008.09.022 · Cited by 86
“conducted and numerous instruments measuring care burden have been developed [1,3–12].”
BackgroundCaregiving and Chronic Care: The Guided Care Program for Families and Friends
Wolff, J. L., Rand‐Giovannetti, E., Palmer, S., Wegener, S. T., Reider, L. M., Frey, K. P., Scharfstein, D. O., & Boult, C. (2009) · The Journals of Gerontology Series A · doi:10.1093/gerona/glp030 · Cited by 86
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Wilson, B. A., Emslie, H. C., Quirk, K., & Evans, J. J. (1999) · Rehabilitation Psychology · doi:10.1037/0090-5550.44.3.284 · Cited by 88
Al‐Janabi, H., Flynn, T. N., & Coast, J. (2011) · PharmacoEconomics · doi:10.2165/11593940-000000000-00000 · Cited by 85
Subjective Burden and Cultural Motives for Caregiving in Informal Caregivers of Older People
Casado, R. D. P., Osuna, A. F., & Moral, P. Á. P. (2011) · Journal of Nursing Scholarship · doi:10.1111/j.1547-5069.2011.01407.x · Cited by 85
Factors contributing to caregivers' stress and burden in Parkinson's disease
Santos‐García, D., & de la Fuente‐Fernández, R. (2014) · Acta Neurologica Scandinavica · doi:10.1111/ane.12305 · Cited by 91
“Caregivers completed the Zarit Caregiver Burden Inventory (ZCBI) (24) and Caregiver Strain Index (CSI) (25).”
MethodRadford, K., Sutton, C., Sach, T., Holmes, J. A., Watkins, C. L., Forshaw, D., Jones, T. M., Hoffman, K., O’Connor, R. J., Tyerman, R., et al. (2018) · Health Technology Assessment · doi:10.3310/hta22330 · Cited by 83
“Per cent work time missed owing to health 15 (94) 32 (91) 34 (89) 36 (95) Per cent impairment while working owing to health 12 (75) 34 (97) 35 (92) 37 (97) Per cent overall work impairment owing to health 12 (75) 32 (91) 34 (89) 36 (95) Per cent activity impairment due to health (n1 = 22, n2 = 22, n3 = 34, n = 78) 78…”
Leff, B. A., Burton, L. C., Mader, S. L., Naughton, B. J., Burl, J. B., Koehn, D., Clark, R. D., Greenough, W. B., Guido, S., Steinwachs, D. M., et al. (2007) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.2007.01459.x · Cited by 82
van Exel, J. N. A., Brouwer, W. B. F., van den Berg, B., Koopmanschap, M., & van den Bos, G. A. M. (2004) · Clinical Rehabilitation · doi:10.1191/0269215504cr743oa · Cited by 83
Evaluation of cognitive assessment in stroke rehabilitation
McKinney, M., Blake, H., Treece, K. A., Lincoln, N. B., Playford, E. D., & Gladman, J. R. F. (2002) · Clinical Rehabilitation · doi:10.1191/0269215502cr479oa · Cited by 83
Factors Influencing Family Caregiver Burden and Health
Bull, M. J., Bowers, J. E., Kirschling, J. M., & Neufeld, A. (1990) · Western Journal of Nursing Research · doi:10.1177/019394599001200605 · Cited by 83
Caregiver burden and depression among informal caregivers of HIV-infected individuals
Pirraglia, P. A., Bishop, D. S., Herman, D. S., Trisvan, E., Lopez, R., Torgersen, C. S., Hof, A. M., Anderson, B. J., Miller, I. W., & Stein, M. D. (2005) · Journal of General Internal Medicine · doi:10.1111/j.1525-1497.2005.0073.x · Cited by 81
“86, and its validity has been demonstrated.(10,11) We sought to identify those informal caregivers who reported a high degree of caregiving burden.”
BackgroundRandomized Controlled Trial of an Early Discharge Rehabilitation Service
Donnelly, M., Power, M., Russell, M., & Fullerton, K. J. (2003) · Stroke · doi:10.1161/01.str.0000106911.96026.8f · Cited by 84
COPPADIS Study Group, Santos‐García, D., Mir, P., Cubo, E., Vela, L., Rodríguez‐Oroz, M., Martı́, M. J., Arbelo, J. M., Infante, J., Kulisevsky, J., et al. (2016) · BMC Neurology · doi:10.1186/s12883-016-0548-9 · Cited by 83
“Caregiver baseline evaluation includes the degree of burden (Zarit Caregiver Burden Inventory [ZCBI] [28], Caregiver Strain Index [CSI] [29]), mood (BDI-II) and QoL (PQ-10, EUROHIS-QOL 8 itemindex).”
MethodThe contribution of occupation to function in persons with Alzheimer's disease
Baum, C. M. (1995) · Journal of Occupational Science · doi:10.1080/14427591.1995.9686396 · Cited by 82
Joling, K. J., Windle, G., Dröes, R., Meiland, F. J. M., van Hout, H. P. J., Vroomen, J. L. M., van de Ven, P. M., Moniz-Cook, E. D., & Woods, B. T. (2016) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000449131 · Cited by 81
Brandt, M., Johannsen, L. M., Inhestern, L., & Bergelt, C. (2022) · Orphanet Journal of Rare Diseases · doi:10.1186/s13023-022-02407-5 · Cited by 83
Caregiving and Post-Caregiving Experiences of Midlife and Older Gay Men and Lesbians
Hash, K. M. (2006) · Journal of Gerontological Social Work · doi:10.1300/j083v47n03_08 · Cited by 81
“…be a very challenging role, as numerous studies have pointed to the often aversive effects caregiving can have on a caregiver, including physical, psychological, financial and relationship strains (Brody, 1981; Cantor, 1983; Poulshock & Deimling, 1984; Robinson, 1983; Zarit, Todd, & Zarit, 1986).”
BackgroundEconomic Evaluation of A Support Program for Caregivers of Demented Elderly
Drummond, M., Mohide, E. A., Tew, M., Streiner, D. L., Pringle, D. M., & Gilbert, J. R. (1991) · International Journal of Technology Assessment in Health Care · doi:10.1017/s0266462300005109 · Cited by 81
“Accordingly, the psychometric properties of several measures of burden (10;20;30) were appraised, but none of the measures had been shown in previous studies to be responsive to change.”
MethodBurden and health outcomes of family caregivers of hospitalized bone marrow transplant patients
Foxall, M. J., & Gaston‐Johansson, F. (1996) · Journal of Advanced Nursing · doi:10.1111/j.1365-2648.1996.tb02926.x · Cited by 81
Nicholls, W., Hulbert-Williams, N., & Bramwell, R. (2014) · Psycho-Oncology · doi:10.1002/pon.3664 · Cited by 99
“Romantic ECR [52] Short Orientation Memory Concentration Test [89] BDI [79] Memorial Symptom Assessment Scale [90] 20”
Zanten, S. A. V. D. B.-V., Dongelmans, D. A., Dettling-Ihnenfeldt, D. S., Vink, R., & van der Schaaf, M. (2016) · Rehabilitation Psychology · doi:10.1037/rep0000081 · Cited by 81
Difficulty Assisting with Health Care Tasks Among Caregivers of Multimorbid Older Adults
Giovannetti, E. R., Wolff, J. L., Xue, Q., Weiss, C. O., Leff, B. A., Boult, C., Hughes, T. B., & Boyd, C. M. (2011) · Journal of General Internal Medicine · doi:10.1007/s11606-011-1831-5 · Cited by 78
Communication outcome after stroke: a new measure of the carer’s perspective
Long, A., Hesketh, A., & Bowen, A. (2009) · Clinical Rehabilitation · doi:10.1177/0269215509336055 · Cited by 80
Peters, M., Fitzpatrick, R. M., Doll, H., Playford, E. D., & Jenkinson, C. (2011) · Parkinsonism & Related Disorders · doi:10.1016/j.parkreldis.2011.02.009 · Cited by 82
“The Caregiver Strain Index (CSI) was selected to assess carer burden [17].”
MethodHigh perceived caregiver burden for relatives of patients following hip fracture surgery
Ariza‐Vega, P., Ortiz‐Piña, M., Kristensen, M. T., et al. (2017) · Disability and Rehabilitation · doi:10.1080/09638288.2017.1390612 · Cited by 78
“86) and construct validity is supported by correlations with the physical and emotional health of the caregiver and with the subjective views of the caregiving situation [18].”
BackgroundMethodInfluentialNon-pharmacological interventions for chronic pain in multiple sclerosis
Amatya, B., Young, J., & Khan, F. (2018) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd012622.pub2 · Cited by 78
Tsai, S., & Wang, H. (2009) · Journal of Clinical Nursing · doi:10.1111/j.1365-2702.2008.02524.x · Cited by 78
Respite care—An explorative study of demand and use in Dutch informal caregivers
van Exel, J. N. A., Morée, M., Koopmanschap, M. A., Goedheijt, T. S., & Brouwer, W. B. F. (2005) · Health Policy · doi:10.1016/j.healthpol.2005.11.002 · Cited by 78
Fjærtoft, H., Indredavik, B., Johnsen, R., & Lydersen, S. (2004) · Clinical Rehabilitation · doi:10.1191/0269215504cr773oa · Cited by 78
Doress-Worters, P. B. (1994) · Sex Roles · doi:10.1007/bf01544282 · Cited by 78
Prigerson, H. G., Cherlin, E. J., Chen, J. H., Kasl, S. V., Johnson‐Hürzeler, R., & Bradley, E. H. (2003) · American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200305000-00008 · Cited by 94
Meshefedjian, G. A., McCusker, J., Bellavance, F., & Baumgarten, M. (1998) · The Gerontologist · doi:10.1093/geront/38.2.247 · Cited by 77
McKinlay, J. B., Crawford, S. L., & Tennstedt, S. L. (1995) · Journal of Aging and Health · doi:10.1177/089826439500700403 · Cited by 77
Physical Well-Being of Oncology Caregivers: An Important Quality-of-Life Domain
Glajchen, M. (2012) · Seminars in Oncology Nursing · doi:10.1016/j.soncn.2012.09.005 · Cited by 76
Aggarwal, B., Liao, M., Christian, A. H., & Mosca, L. J. (2008) · Journal of General Internal Medicine · doi:10.1007/s11606-008-0852-1 · Cited by 78
Barber, C. E., & Pasley, B. K. (1995) · Journal of Applied Gerontology · doi:10.1177/073346489501400203 · Cited by 76
Integrated Care Pathways and Quality of Life on a Stroke Rehabilitation Unit
Sulch, D., Melbourn, A., Perez, I., & Kalra, L. (2002) · Stroke · doi:10.1161/01.str.0000017144.04043.87 · Cited by 75
Huijbregts, M. P. J., Myers, A. M., Streiner, D. L., & Teasell, R. W. (2008) · Topics in Stroke Rehabilitation · doi:10.1310/tsr1505-503 · Cited by 74
Loo, Y. X., Shi, Y., & Low, L. L. (2021) · Singapore Medical Journal · doi:10.11622/smedj.2021033 · Cited by 95
“consistent with other international studies which found that caregiver outcomes may not directly correlate with caregiver sociodemographic factors.((23,57-59)) For example, female caregivers were shown to be at higher risk in some studies,((60,61)) but not in others.”
ResultMason, S. M. (2003) · Emergency Medicine Journal · doi:10.1136/emj.20.2.196 · Cited by 75
Wolfe, C. D. A., Tilling, K. M., & Rudd, A. G. (2000) · Clinical Rehabilitation · doi:10.1191/0269215500cr362oa · Cited by 75
Sources of Stress Among Families Caring for Relatives With Alzheimer's Disease
Given, C. W., Collins, C. E., & Given, B. A. (1988) · Nursing Clinics of North America · doi:10.1016/s0029-6465(22)01366-4 · Cited by 75
Information provision for stroke patients and their caregivers
Förster, A., Smith, J., Young, J. B., Knapp, P., House, A. O., & Wright, J. (2001) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd001919 · Cited by 75
Spoorenberg, S. L. W., Uittenbroek, R. J., Middel, B., Kremer, B. P. H., Reijneveld, S. A., & Wynia, K. (2013) · BMC Geriatrics · doi:10.1186/1471-2318-13-62 · Cited by 78
“It contains thirteen items which are scored on a dichotomous rating scale, with four to six positive responses indicating increased burden and seven or more positive responses indicating a high level of strain [50].”
BackgroundMalhotra, R., Chan, A. W.-M., Malhotra, C., & Østbye, T. (2012) · Aging & Mental Health · doi:10.1080/13607863.2012.702728 · Cited by 74
“While some instruments assess only the negative (Novak & Guest, 1989; Robinson, 1983) or positive effect (Tarlow et al., 2004) of caregiving, the Caregiver Reaction Assessment (CRA) (Given et al., 1992) includes both.”
BackgroundGender differences among Canadian spousal caregivers at the end of life
Brazil, K., Thabane, L., Foster, G., & Bédard, M. (2008) · Health & Social Care in the Community · doi:10.1111/j.1365-2524.2008.00813.x · Cited by 71
“86) (Robinson 1983).”
Development of a Brief Assessment Scale for Caregivers of the Medically Ill
Glajchen, M., Kornblith, A. B., Homel, P., Fraidin, L., Mauskop, A., & Portenoy, R. K. (2005) · Journal of Pain and Symptom Management · doi:10.1016/j.jpainsymman.2004.06.017 · Cited by 72
A comprehensive assessment of family caregivers of stroke survivors during inpatient rehabilitation
Young, M. E., Lutz, B. J., Creasy, K. R., Cox, K. J., & Martz, C. (2014) · Disability and Rehabilitation · doi:10.3109/09638288.2014.881565 · Cited by 73
Yin, T., Zhou, Q. P., & Bashford, C. W. (2002) · Nursing Research · doi:10.1097/00006199-200205000-00009 · Cited by 74
“…have been developed to measure caregiver burden, such as the Burden Interview (Zarit, Reever, & Bach-Peterson, 1980), the Caregiver Strain Index (Robinson, 1983), the Caregiver Burden Inventory (Novak & Guest, 1989), and the Subjective and Objective Burden Scale (Montgomery, Gonyea, & Hooyman,…”
MethodEvaluation of a multiprofessional community stroke team: a randomized controlled trial
Lincoln, N., Walker, M. F., Dixon, A., et al. (2004) · Clinical Rehabilitation · doi:10.1191/0269215504cr700oa · Cited by 74
van Wijnen, H. G., Rasquin, S. M. C., Heugten, C. M. V., Verbunt, J., & Moulaert, V. R. M. (2017) · Clinical Rehabilitation · doi:10.1177/0269215516686155 · Cited by 74
Reid, J., & Kennie, D. C. (1989) · BMJ · doi:10.1136/bmj.299.6690.25-a · Cited by 73
Honan, C. A., McDonald, S., Tate, R. L., Ownsworth, T., Togher, L., Fleming, J., Anderson, V. A., Morgan, A. T., Catroppa, C., Douglas, J. M., et al. (2017) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2017.1339616 · Cited by 75
“They include the Caregiver Strain Index (CSI; Robinson, 1983), Family Assessment Device (FAD; Miller, Bishop, Epstein, & Keitner, 1985), Lubben Social Network Scale-Revised (LSNS-R; Lubben & Gironda, 2004), Social Support Survey (SSS; Sherbourne & Stewart, 1991), and Care and Needs Scale (CANS; Tate, 2004).”
MethodAl‐Janabi, H., Frew, E. J., Brouwer, W. B. F., Rappange, D. R., & van Exel, J. N. A. (2010) · International Journal of Nursing Studies · doi:10.1016/j.ijnurstu.2009.12.015 · Cited by 72
“Someof themost commonly used outcomemeasures for carers were developed with a focus on the negative aspects of caring (Zarit et al., 1980; Robinson, 1983).”
BackgroundThe Effectiveness of a Telephone Support Program for Caregivers of Frail Older Adults
Smith, T. L., & Toseland, R. W. (2006) · The Gerontologist · doi:10.1093/geront/46.5.620 · Cited by 72
“The 13- item Caregiver Strain Index generates an overall strain score and has good internal consistency (a = .86; Robinson, 1983).”
BackgroundCaregivers of persons with stroke: Their physical and emotional wellbeing
Williams, A. M. (1993) · Quality of Life Research · doi:10.1007/bf00435225 · Cited by 72
Families of Elderly Stroke Patients
Silliman, R. A., Fletcher, R. H., Earp, J. L., et al. (1986) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1986.tb04905.x · Cited by 72
Caregiver-mediated exercises for improving outcomes after stroke
Vloothuis, J. D., Mulder, M., Veerbeek, J. M., Konijnenbelt, M. H., Visser‐Meily, J. M. A., Ket, J. C. F., Kwakkel, G., & van Wegen, E. E. H. (2016) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd011058.pub2 · Cited by 107
Hoefman, R., van Exel, J. N. A., Foets, M., & Brouwer, W. B. F. (2011) · Aging & Mental Health · doi:10.1080/13607863.2011.575351 · Cited by 74
“Research on the impact of informal care often measures this in terms of objective (van den Berg, Brouwer, & Koopmanschap, 2004) or subjective burden (Al-Janabi, Frew, Brouwer, Rappange, & Van Exel, 2010; Robinson, 1983; Scholte op Reimer, de Haan, Pijnenborg, Limburg, & Van den Bos, 1998; Vernooij-Dassen, Persoon, & F…”
BackgroundTaylor-Richardson, K. D., Heflinger, C. A., & Brown, T. N. (2006) · Journal of Emotional and Behavioral Disorders · doi:10.1177/10634266060140030301 · Cited by 71
“Attempts have been made to assess the impact a person’s illness has on her caregivers (Brannan, Heflinger, & Bickman, 1997; Messer,Angold, Costello, & Burns, 1996; Novak& Guest, 1989; Robinson, 1983; Yatchmenoff, Koren, Friesen, Gordon, & Kinney, 1998; Zarit, Reever, & Bach-Peterson, 1980); however, no common model ex…”
BackgroundFrom Hospital to Home to Participation: A Position Paper on Transition Planning Poststroke
Miller, K. K., Lin, S. H., & Neville, M. (2018) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2018.10.017 · Cited by 72
Sinclair, A. J., Armes, D. G., Randhawa, G., & Bayer, A. J. (2010) · Diabetic Medicine · doi:10.1111/j.1464-5491.2010.03066.x · Cited by 70
Adult carers quality of life questionnaire (AC-QoL): development of an evidence-based tool
Joseph, S., Becker, S., Elwick, H., & SILBURN, R. L. (2012) · Mental Health Review Journal · doi:10.1108/13619321211270380 · Cited by 70
Green, J., Young, J. B., Förster, A., et al. (2005) · BMJ · doi:10.1136/bmj.38498.387569.8f · Cited by 70
Factors associated with strain in co-resident spouses of patients following stroke
Blake, H., & Lincoln, N. B. (2000) · Clinical Rehabilitation · doi:10.1191/026921500667530134 · Cited by 69
Harvey, K., Catty, J., Langman, A., Winfield, H., Clement, S., Burns, E., White, S. J., & Burns, T. (2008) · Acta Psychiatrica Scandinavica · doi:10.1111/j.1600-0447.2007.01148.x · Cited by 68
“Self-Rating Depression Scale (70) Depression and anxiety 9 3 – – 3 3 – 3 3 State-Trait Anxiety Inventory (71) Depression and anxiety 7 3 – – 3 – – 3 x Family Adaptability and Cohesion Scale II (72) Effect on family 4 3 – 3 3 – 3 3 3 Family Assessment Measure (73) Effect on family 3 3 – 3 3 3 – 3 x Family Environment S…”
Middleton, J. W., Simpson, G. K., Wolf, A. D., Quirk, R., Descallar, J., & Cameron, I. D. (2014) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2014.03.017 · Cited by 69
Effects of Guided Care on Family Caregivers
Wolff, J. L., Giovannetti, E. R., Boyd, C. M., Reider, L. M., Palmer, S., Scharfstein, D. O., Marsteller, J. A., Wegener, S. T., Frey, K. P., Leff, B. A., et al. (2009) · The Gerontologist · doi:10.1093/geront/gnp124 · Cited by 69
Assessment of emotional problems in people with multiple sclerosis
Nicholl, C., Lincoln, N. B., Francis, V. M., & Stephan, T. F. (2001) · Clinical Rehabilitation · doi:10.1191/0269215501cr427oa · Cited by 69
Stress among Family Caregivers of Older Persons in Singapore
Mehta, K. K. (2006) · Journal of Cross-Cultural Gerontology · doi:10.1007/s10823-006-9009-z · Cited by 68
“This questionnaire was a locally validated scale modified from the Caregiver Strain Index (for more details, see Robinson, 1983).”
MethodAskim, T., Rohweder, G., Lydersen, S., & Indredavik, B. (2004) · Clinical Rehabilitation · doi:10.1191/0269215504cr752oa · Cited by 68
Caregiver strain following critical care discharge: An exploratory evaluation
McPeake, J. M., Devine, H., MacTavish, P., Fleming, L., Crawford, R., Struthers, R., Kinsella, J., Daniel, M., Shaw, M., & Quasim, T. (2016) · Journal of Critical Care · doi:10.1016/j.jcrc.2016.05.023 · Cited by 66
Kendall, M., Cowey, E., Mead, G. E., Barber, M., McAlpine, C. H., Stott, D. J., Boyd, K. J., & Murray, S. A. (2018) · Canadian Medical Association Journal · doi:10.1503/cmaj.170604 · Cited by 67
Multiple Sclerosis: Stressors and Coping Strategies in Spousal Caregivers
O'Brien, M. T. (1993) · Journal of Community Health Nursing · doi:10.1207/s15327655jchn1003_1 · Cited by 68
Smith, F., Francis, S.-A., Gray, N., Denham, M., & Graffy, J. (2003) · Health & Social Care in the Community · doi:10.1046/j.1365-2524.2003.00415.x · Cited by 67
Emotional well-being of close relatives to stroke survivors
Wyller, T. B., Thommessen, B., Sødring, K. M., Sveen, U., Pettersen, A. M., Bautz‐Holter, E., & Laake, K. (2003) · Clinical Rehabilitation · doi:10.1191/0269215503cr627oa · Cited by 66
Behavioural activation therapy for post-stroke depression: the BEADS feasibility RCT
Thomas, S., Drummond, A. E., Lincoln, N. B., Palmer, R., das Nair, R., Latimer, N. R., Hackney, G., Mandefield, L., Walters, S. J., Hatton, R. D., et al. (2019) · Health Technology Assessment · doi:10.3310/hta23470 · Cited by 67
Parham, R., Jacyna, N., Hothi, D. K., Marks, S. D., Holttum, S., & Camic, P. M. (2014) · Journal of Health Psychology · doi:10.1177/1359105314524971 · Cited by 66
“The impetus for this research was the lack of a measure of caregiver burden specifically developed for caregivers of children with CKD, with measures of caregiver burden in existence largely developed for caregivers of older adults or those with mental health diagnoses (Robinson, 1983; Schene et al., 1994; Visser-Meil…”
BackgroundCaregiver burden after stroke: changes over time?
van Meijeren-Pont, W., Groeneveld, I. F., Arwert, H. J., Meesters, J. J. L., Mishre, R. R., Vlieland, T. P. M. V., Goossens, P. H., & on behalf of the SCORE-study group (2018) · Disability and Rehabilitation · doi:10.1080/09638288.2018.1499047 · Cited by 67
“of which the Caregiver Strain Index [17], the Caregivers Burden Scale [18], the Caregiver Reaction Assessment [19], the Sense of Competence Questionnaire [20], the Relatives Stress Scale [21], and the Zarit Burden Interview [22] are most frequently cited [23].”
BackgroundMethodBurden of Spinal Muscular Atrophy (SMA) on Patients and Caregivers in Canada
McMillan, H. J., Gerber, B., Cowling, T., Khuu, W., Mayer, M., Wu, J. W., Maturi, B., Klein-Panneton, K., Cabalteja, C., & Lochmüller, H. (2021) · Journal of Neuromuscular Diseases · doi:10.3233/jnd-200610 · Cited by 67
“The CSI is scored from 0–13; the higher the number of “Yes” answers, the higher the strain on the caregiver, with a score equal to or greater than 7 indicating high stress and burden [32].”
BackgroundRelationships between language-based disability and quality of life in chronically aphasic adults
Ross, K., & Wertz, R. T. (2002) · Aphasiology · doi:10.1080/02687030244000130 · Cited by 66
“…life measures—the Sickness Impact Profile (SIP, Bergner, Bobbitt, Carter, & Gilson, 1981); Quality of Life Index (QLI, Spitzer et al., 1981); Reintegration to Normal Living Index (RNL, Wood-Dauphinee , Opzoomer, Williams, Marchand, & Spitzer, 1988); and Caregiver Strain Index (CSI, Robinson, 1983).”
BackgroundWilkinson, P. R., Wolfe, C. D. A., Warburton, F., Rudd, A. G., Howard, R., Russell, R. W. R., & Beech, R. (1997) · BMJ Quality & Safety · doi:10.1136/qshc.6.3.125 · Cited by 65
Rodrigue, J. R., Dimitri, N. C., Reed, A., et al. (2010) · Clinical Transplantation · doi:10.1111/j.1399-0012.2010.01224.x · Cited by 65
“Caregiver strain and benefit Mean total CSI scores were 7.00 ± 3.9 and 7.89 ± 3.0 for pre-LTx and post-LTx caregivers, respectively.”
BackgroundInfluentialHastrup, L. H., van den Berg, B., & Gyrd‐Hansen, D. (2011) · Scandinavian Journal of Public Health · doi:10.1177/1403494811414247 · Cited by 65
“The subjective caregiver burden was measured using Caregiver Strain Index (CSI) [26].”
BackgroundMethodPlacebo‐like response in absence of treatment in children with Autism
Jones, R. M., Carberry, C., Hamo, A., & Lord, C. (2017) · Autism Research · doi:10.1002/aur.1798 · Cited by 66
“Because they captured different constructs than the paper and smartphone questionnaire data, the clinician ratings on the CARS and the caregiver reported stress on the CGSQ were analyzed at T1 versus T2 with two paired sample t-tests.”
MethodInfluentialCaregiver Burden and Burnout: A Guide for Primary Care Physicians
Kasuya, R. T., Polgar-Bailey, P., & Takeuchi, R. (2000) · Postgraduate Medicine · doi:10.1080/19419260.2000.12277452 · Cited by 65
Whalen, K. J., & Buchholz, S. W. (2009) · The JBI Database of Systematic Reviews and Implementation Reports · doi:10.11124/01938924-200907320-00001 · Cited by 83
Older Adults: The “Panini Sandwich” Generation
Abramson, T. A. (2015) · Clinical Gerontologist · doi:10.1080/07317115.2015.1032466 · Cited by 65
“To assess strain, it might be advantageous to consider The Caregiver Strain Index (CSI; Robinson, 1983).”
BackgroundRafiq, M. K., Bradburn, M. J., Proctor, A., Billings, C., Bianchi, S. M., McDermott, C. J., & Shaw, P. J. (2015) · Amyotrophic Lateral Sclerosis and Frontotemporal Degeneration · doi:10.3109/21678421.2015.1051992 · Cited by 65
The desire for support and respite care: preferences of Dutch informal caregivers
Koopmanschap, M. A., van Exel, J. N. A., van den Bos, G. A. M., van den Berg, B., & Brouwer, W. B. F. (2004) · Health Policy · doi:10.1016/j.healthpol.2003.10.002 · Cited by 64
“Scores on the CSI range between 0 and 13, a higher indicating a higher subjective burden of informal caregiving [11].”
BackgroundPorter, L. S., Keefe, F. J., Davis, D., Rumble, M. E., Scipio, C. D., & Garst, J. L. (2012) · Supportive Care in Cancer · doi:10.1007/s00520-011-1367-6 · Cited by 64
“Caregiver strain was assessed with the Caregiver Strain Index [28], a 13-item scale with high internal consistency [28, 29] that assesses a variety of stressors commonly experienced by caregivers (alpha00.”
Perrin, P. B., Johnston, A., Vogel, B., Heesacker, M., Vega-Trujillo, M., Anderson, J., & Rittman, M. (2010) · The Journal of Rehabilitation Research and Development · doi:10.1682/jrrd.2009.10.0170 · Cited by 64
“The Caregiver Strain Index is a 13-item tool that measures strain related to care provision [25–26].”
BackgroundMiyashita, M., Yamaguchi, A., Kayama, M., Narita, Y., Kawada, N., Akiyama, M. O., Hagiwara, A., Suzukamo, Y., & Fukuhara, S. (2006) · Health and Quality of Life Outcomes · doi:10.1186/1477-7525-4-52 · Cited by 64
“Since then, a number of burden scales to assess the care burden of family caregivers of impaired or elderly patients have been developed in various countries, including Japan, such as the Zarit Burden Interview (ZBI), Caregiver Strain Index (CSI), Care Burden Inventory (CBI), Caregiver Reaction Assessment (CRA), Care…”
Metadata
- 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)
- 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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