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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Method
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Background
Caught between competing emotions and tensions while adjusting to a new everyday life: a focus group study with family caregivers of out-of-hospital cardiac arrest survivors
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“Robinson BC. Validation of caregiver Strain Index.”
BackgroundInfluential
Impact of Patient and Caregiver Transfer Training Provided by a Physical Therapist in the Hospice Setting
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Method
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Method
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Haun, M. W., Sklenarova, H., Winkler, E. C., et al. (2014) · Supportive Care in Cancer · doi:10.1007/s00520-014-2241-0 · Cited by 12
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Background
Caregiver-guided pain coping skills training for patients with advanced cancer: Background, design, and challenges for the CaringPals study
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“Partners reporting ineffective family functioning had significantly higher scores on caregiver burden a 1 missing; FAD-GF = McMaster Family Assessment Device-General Functioning; ABI = Acquired Brain Injury; UCO = Utrecht Communication Observation; HADS = Hospital Anxiety and Depression Scale; CSI = Caregiver Strain I…”
MethodInfluential
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BackgroundInfluential
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Validating a Measure Across Groups
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“Early measurement tools were aimed at assessing caregiver burden (Robinson, 1983; Zarit, Reever & Bach-Peterson, 1980).”
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Gimeno, A. B. E., & Lampré, M. P. M. (2008) · Revista Española de Geriatría y Gerontología · doi:10.1016/s0211-139x(08)71174-0 · Cited by 12
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“23,24 Caregiver strain was measured by the Caregiver Strain Index.”
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Health Maintenance of the Elderly
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“The CSI (Robinson 1983) consists of 13 dichotomic questions addressed to the caregiver about the presence/absence (scores 1/0) of restrictions in work, leisure, family life and personal plans, impairment of sleep, emotional changes, shocking experiences with the patient, financial…”
BackgroundMethodInfluential
The Modified Caregiver Strain Index in Black and White Dementia Caregivers at Hospital Discharge
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“It was originally developed by Robinson (1983) to evaluate strain in caregivers among older adults with heart disease or hip fracture upon discharge from the hospital.”
Background
Changes in the coping styles of spouses and the influence of these changes on their psychosocial functioning the first year after a patient's stroke
Gregório, G. W., Visser‐Meily, J. M. A., Tan, F. E. S., Post, M. W. M., & van Heugten, C. M. (2011) · Journal of Psychosomatic Research · doi:10.1016/j.jpsychores.2011.01.013 · Cited by 11
Evaluating Health Interventions for Older People
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“This has led to the development of instruments to assess care-giver strain (Robinson, 1983; Gerritsen and Van der Ende, 1994).”
Background
Inpatient dependency in activities of daily living predicts informal caregiver strain: A cross‐sectional study
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Method
Caregiver strain in progressive supranuclear palsy and corticobasal syndromes
Kellermair, L., Fuchs, A., Eggers, C., Schwingenschuh, P., Kögl, M., Fellner, F. A., Forstner, T., Mangesius, S., Guger, M., & Ransmayr, G. N. (2021) · Journal of Neural Transmission · doi:10.1007/s00702-021-02379-z · Cited by 13
“Variable All patients (n = 68) PSP (n = 53) CBS (n = 15) The proportion of caregivers with a CSI total score ≥ 7 (major caregiver strain; Robinson 1983) was 16% at baseline and increased to 30% until FU4.”
Background
Psychometric properties of the Caregiving Burden Scale for Family Caregivers with Relatives in Nursing Homes: Scale development
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“Previous caregiving burden scales (Kosberg & Cairl, 1986; Montgomery, 1985; Pearlin, Mullan, Semple & Skaff, 1990; Robinson, 1983; Vitaliano, Russo, Young, Becker & Maiuro, 1991; Zarit et al., 1986) were reviewed in detail and modified to make new scale items that suited nursing home situations…”
Background
Mixed-Methods Exploration of Family Caregiver Strain in the Nursing Home
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“The CSI is a 13-item scale designed to quantify strain among informal caregivers.(13) At least 1 item evaluates each of the following potential areas for caregiver strain: employment, financial, physical, social, and time.”
Background
Bathing adaptations in the homes of older adults (BATH-OUT): protocol for a feasibility randomised controlled trial (RCT)
Whitehead, P. J., James, M., Belshaw, S., Dawson, T., Golding-Day, M. R., & Walker, M. F. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-013448 · Cited by 11
“mental component summaries)(22) and Caregiver Strain Index.(25) We will also gather data on the carers’ use of health and social care services.”
Background
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Alwan, M., Leachtenauer, J. C., Dalal, S., Mack, D. C., Kell, S., Turner, B. L., & Felder, R. A. (2006) · doi:10.1109/ictta.2006.1684510 · Cited by 11
Is lower cognitive function in one spouse associated with depressive symptoms in the other spouse?
Skarupski, K. A., de Leon, C. F. M., McCann, J. J., Bienias, J. L., Wilson, R. S., & Evans, D. A. (2006) · Aging & Mental Health · doi:10.1080/13607860600844184 · Cited by 11
“Our results are contrary to other older studies that have reported either no gender differences in the spousal cognitive status – depressive symptoms relationship (Robinson, 1983; Zarit, Reever, & Bach-Peterson, 1980), or more negative outcomes for wives than husbands (Fitting et al.”
Result
The Impact of Community Paediatric Occupational Therapy on Children with Disabilities and Their Carers
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“The Caregiver Strain Index (CSI) (Robinson 1983) was developed to measure the strain experienced by informal carers.”
Method
Health in the Sandwich Generation
Dellasega, C. A. (1989) · Geriatric Nursing · doi:10.1016/s0197-4572(89)80178-8 · Cited by 11
Aging and Social Policy
Smyer, M. A. (1984) · Journal of Family Issues · doi:10.1177/019251384005002006 · Cited by 11
Psychometric validation of the Turkish version of the Supportive Care Needs Survey for Partners and Caregivers (SCNS‐P&C‐T) of cancer patients
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Sexual and Gender Minority Differences in Likelihood of Being a Caregiver and Levels of Caregiver Strain in a Sample of Older Adults
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“The caregiver strain index (Robinson, 1983) was included to assess stress experienced by individuals during their daily work as caregivers.”
Method
Social support provided by and strain experienced by African-American cancer caregivers
Cooper, D. L., Powe, B. D., & Smith, T. G. (2013) · Supportive Care in Cancer · doi:10.1007/s00520-013-1849-9 · Cited by 10
“86 [18]; for the current sample, the reliability was 0.”
Background
Physiotherapy in palliative medicine: patient and caregiver wellness
Bernabeu‐Wittel, M., Moreno-Gaviño, L., Nieto‐Martín, M. D., Lanseros-Tenllado, J., Sáenz-Santamaría, A., Martínez-Pérez, O., González, C. A., Pereira-Domínguez, M., & Ollero‐Baturone, M. (2021) · BMJ Supportive & Palliative Care · doi:10.1136/bmjspcare-2020-002826 · Cited by 10
“37 Finally, global satisfaction with the physio-therapy programme was also assessed using the Client Satisfaction Questionnaire (CSQ-8).”
Method
The Effect of Mindfulness-Based Stress Reduction Program on Stress and Quality of Life in Family Caregivers of Patients with Cancer: Randomized Controlled Trial
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“The scale was developed by Robinson (1983 ) to measure the subjective care burden of caregivers and to quickly identify families with care concerns (Robinson, 1983 ).”
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Rubin, O., & Schreiber-Divon, M. (2014) · Psychology · doi:10.4236/psych.2014.56069 · Cited by 10
“…questionnaire, containing information about the age of the mother, level of income, number of children and age of the child, the research tools included: Caregiver Strain Index developed by Robinson (Robinson, 1983), including 13 5-point Likert scale items, with Cronbach’s alpha of α = .86.”
MethodInfluential
Improving outcomes in adults with epilepsy and intellectual disability (EpAID) using a nurse-led intervention: study protocol for a cluster randomised controlled trial
RING, H. A., Gilbert, N., Hook, R. W., et al. (2016) · Trials · doi:10.1186/s13063-016-1429-7 · Cited by 10
“– The effect of the intervention on carers and patients, measured using the Carer Strain Index [36], which is collected in the baseline period and after at least 24 weeks in the trial.”
Method
Providing on-line support to families of people with brain injury and challenging behaviour: A feasibility study
McDonald, S., Trimmer, E. M., Newby, J. M., Grant, S., Gertler, P., & Simpson, G. K. (2019) · Neuropsychological Rehabilitation · doi:10.1080/09602011.2019.1696846 · Cited by 10
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Stiekema, A. P. M., Resch, C., Donkervoort, M., Jansen, N., Jurrius, K. H. M., Zadoks, J. M., & Heugten, C. M. V. (2020) · Trials · doi:10.1186/s13063-020-04804-2 · Cited by 10
Multiverse to inform neurological research: an example using recovery outcome of neglect
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“Carer strain index [30] 13* Follow-up 145 7.”
Resilient carers and caregivers
Payne, S. A. (2007) · doi:10.1093/acprof:oso/9780199206414.003.0006 · Cited by 10
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Page, B. M., Urbach, D. R., Wolfstadt, J. I., Varkul, O., Clavel, N. A., & Brull, R. (2023) · Canadian Journal of Surgery · doi:10.1503/cjs.010022 · Cited by 11
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Service Utilization by Wife Caregivers of Frail Older Veterans
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Harwood, R., Goldberg, S. E., Brand, A., van der Wardt, V., Booth, V., Lorito, C. D., Hoare, Z., Hancox, J. E., Bajwa, R. K., Burgon, C., et al. (2022) · medRxiv · doi:10.1101/2022.12.20.22283699 · Cited by 10
“Measure Group n Baseline Mean (SD) Follow Up Mean (SD) Difference Interpretation Falls Efficacy Scale – International/28 Higher is inferior Control 134 10.3 (4.1) 10.9 (4.8) + 0.5 Deterioration Intervention 138 10.4 (3.9) 11.0 (4.5) +0.6 Deterioration HADS Anxiety/21 Higher is inferior Control 133 3.7 (2.9) 4.2 (3.6)…”
MethodInfluential
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“Internal consistency for that study the internal consistency of the CSI was 0.84.”
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“The CSI is a short and easily selfadministered measurement scale [23].”
Background
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“We measured caregiver strain using the Caregiver Strain Index (CSI) [28] and the Self-Rated Burden scale (SRB) [29].”
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“Existing assessments typically focus on burden and do not assess feelings of loss, ways of coping, or family and work conflicts (e.g., Zarit Burden Interview, Zarit, Orr, & Zarit, 1985; Caregiver Burden Interview, Novak & Guest, 1989 Caregiver Strain Index; Robinson, 1983).”
Background
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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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