Validity and reliability of the Zarit Burden Interview in assessing caregiving burden
Open accessAbstract
INTRODUCTION: This study aims to validate the Zarit Burden Interview as an instrument to measure the level of burden experienced by caregivers of patients with dementia (PWD) in Singapore. MATERIALS AND METHODS: Adult family caregivers of PWD were recruited from the ambulatory dementia clinic of a tertiary hospital and the Alzheimer's Disease Association. All subjects completed a battery of questionnaires which consisted of demographic questions and the following instruments: the Zarit Burden Interview (ZBI), Burden Assessment Scale (BAS), General Health Questionnaire (GHQ-28), Dementia Management Strategies Scale (DMSS), and the Revised Memory and Behaviour Problems Checklist (RMBPC). A subgroup of subjects also completed the ZBI for the second time 2 weeks after the fi rst survey. RESULTS: A total of 238 subjects completed the survey. As hypothesised, the Zarit burden score was strongly correlated with BAS, GHQ-28, DMSS, and RMBPC scores (Pearson's correlation coefficient: 0.53 to 0.73); caregivers who undertook the major role in caregiving, had spent >1 year in caregiving, or experienced financial problems had higher Zarit burden scores than those who were not main carers, with ≤1 year of caregiving, or reported no/minimal financial problems, respectively. The Cronbach's alpha value for the ZBI items was 0.93; the intra-class correlation coefficient for the test-retest reliability of the Zarit burden score was 0.89 (n = 149). CONCLUSION: The results in this study demonstrated that the Zarit Burden Interview is a valid and reliable instrument for measuring the burden of caregivers of PWD in Singapore.
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
The claims and statistics of this paper haven’t been checked yet.
Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
The ZBI remains one of the most widely validated measures in caregiving research.
“The ZBI remains one of the most widely validated measures in caregiving research (Hébert et al., 2000; Seng et al., 2010).”
From Mindfulness and rumination: stress pathways for caregivers of persons living with dementia. (2026) · cites this paper as Seng et al., 2010
Self-check
Percentages, sums and reported differences re-computed from the paper’s own numbers.
The self-check needs the paper’s full text.
Cites
Relatives of the Impaired Elderly: Correlates of Feelings of Burden
Zarit, S. H., Reever, K. E., & Bach-Peterson, J. (1980) · The Gerontologist · doi:10.1093/geront/20.6.649 · Cited by 5,810 · see citing works
Caregiving as a Risk Factor for Mortality: The Caregiver Health Effects Study
Schulz, R., & Beach, S. R. (1999) · JAMA · doi:10.1001/jama.282.23.2215 · Cited by 3,340 · see citing works
Quality of Life: Assessment, Analysis, and Interpretation
Machin, P. M. F. A. D. (2000) · Medical Entomology and Zoology · Cited by 1,509 · see citing works
Validation of a Caregiver Strain Index
Robinson, B. C. (1983) · Journal of Gerontology · doi:10.1093/geronj/38.3.344 · Cited by 1,426 · see citing works
Family Caregiving of Persons With Dementia: Prevalence, Health Effects, and Support Strategies
Schulz, R., & Martire, L. M. (2004) · The American Journal of Geriatric Psychiatry · doi:10.1097/00019442-200405000-00002 · Cited by 1,189 · see citing works
Assessment of behavioral problems in dementia: the revised memory and behavior problems checklist.
Teri, L., Truax, P., Logsdon, R., Uomoto, J., Zarit, S., & Vitaliano, P. P. (1992) · Psychology and Aging · doi:10.1037/0882-7974.7.4.622 · Cited by 1,162 · see citing works
Assessment of behavioral problems in dementia: The Revised Memory and Behavior Problems Checklist.
Teri, L. L., Truax, P. A., Logsdon, R. G., Uomoto, J. M., Zarit, S., & VITALIANO, P. P. (1992) · Psychology and Aging · doi:10.1037//0882-7974.7.4.622 · Cited by 1,117 · see citing works
Fayers, P. M., & Machin, D. (2000) · Wiley eBooks · doi:10.1002/0470846283 · Cited by 769 · see citing works
The psychological and physical health of family members caring for an elderly person with dementia
Baumgarten, M., Battista, R. N., Infante‐Rivard, C., Hanley, J. A., Becker, R., & Gauthier, S. G. (1992) · Journal of Clinical Epidemiology · doi:10.1016/0895-4356(92)90189-t · Cited by 405 · see citing works
Psychological, Social, and Health Consequences of Caring for a Relative with Senile Dementia
Haley, W. E., Levine, E. G., Brown, S., Berry, J. W., & Hughes, G. H. (1987) · Journal of the American Geriatrics Society · doi:10.1111/j.1532-5415.1987.tb04661.x · Cited by 331 · see citing works
The Screen for Caregiver Burden
VITALIANO, P. P., Russo, J. E., Young, H. M., Becker, J., & Maiuro, R. D. (1991) · The Gerontologist · doi:10.1093/geront/31.1.76 · Cited by 321 · see citing works
Reliability and validity of the Japanese version of the Zarit Caregiver Burden Interview
Arai, Y., Kudo, K., Hosokawa, T., Washio, M., Miura, H., & Hisamichi, S. (1997) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.1997.tb03199.x · Cited by 311 · see citing works
Black, W., & Almeida, O. P. (2004) · International Psychogeriatrics · doi:10.1017/s1041610204000468 · Cited by 307 · see citing works
Care arrangements for people with dementia in developing countries
(2004) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1046 · Cited by 274 · see citing works
Burden assessment scale for families of the seriously mentally ill
Reinhard, S. C., Gubman, G. D., Horwitz, A. V., & Minsky, S. K. (1994) · Evaluation and Program Planning · doi:10.1016/0149-7189(94)90004-3 · Cited by 269 · see citing works
Taub, A., Andreoli, S. B., & Bertolucci, P. H. F. (2004) · Cadernos de Saúde Pública · doi:10.1590/s0102-311x2004000200004 · Cited by 162 · see citing works
A practical guide to caring for caregivers.
Parks, S. M., & Novielli, K. D. (2000) · PubMed · Cited by 155 · see citing works
Emotional Distress amongst the Supporters of the Elderly Mentally Infirm
Gilleard, C. J., Belford, H., Gilleard, E., Whittick, J. E., & Gledhill, K. (1984) · The British Journal of Psychiatry · doi:10.1192/bjp.145.2.172 · Cited by 144 · see citing works
Dementia Management Strategies and Adjustment of Family Members of Older Patients
Hinrichsen, G. A., & Niederehe, G. (1994) · The Gerontologist · doi:10.1093/geront/34.1.95 · Cited by 131 · see citing works
Chinese Version of the Zarit Caregiver Burden Interview: A Validation Study
Ko, K., Yip, P., Liu, S., & Huang, C. (2008) · American Journal of Geriatric Psychiatry · doi:10.1097/jgp.0b013e318167ae5b · Cited by 123 · see citing works
An analysis of the caregiver’s burden and the" breaking-point" when home care becomes inadequate
Annerstedt, L., ElmstÅhl, S., Ingvad, B., & Samuelsson, S.-M. (2000) · Scandinavian Journal of Public Health · doi:10.1177/140349480002800106 · Cited by 119 · see citing works
Arai, A., Matsumoto, T., Ikeda, M., & Arai, Y. (2007) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1935 · Cited by 116 · see citing works
Gort, A. M., Mingot‐Castellano, M. E., Gómez, X., Soler, T., Torres, G., Sacristán, O., Miguelsanz, S., Nicolas, F., Perez, A., de Miguel, M., et al. (2007) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.1770 · Cited by 96 · see citing works
Validation of the Chinese version of the Zarit Burden Interview.
Chan, T. S.-F., LAM, L. C. W., & Chiu, H. F. K. (2005) · Hong Kong journal of psychiatry · Cited by 80 · see citing works
The comparison of burden between caregiving spouses of depressive and demented patients
Leinonen, E. V. J., Korpisammal, L., Pulkkinen, L., & Pukuri, T. (2001) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.351 · Cited by 72 · see citing works
Kumamoto, K., & Arai, Y. (2004) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2004.01310.x · Cited by 66 · see citing works
Studying the mental health of a nation: a preliminary report on a population survey in Singapore.
Fones, C. S. L., Kua, E. H., Ng, T. P., & Ko, S. M. (1998) · PubMed · Cited by 63 · see citing works
Assessment of Behavioural and Psychological Symptoms Associated with Dementia
Conn, D. K., & Thorpe, L. U. (2007) · Canadian Journal of Neurological Sciences / Journal Canadien des Sciences Neurologiques · doi:10.1017/s0317167100005606 · Cited by 59 · see citing works
The Metric Properties of Zarit Caregiver Burden Scale
Wang, G., Cheng, Q., Wang, Y., Deng, Y., Ren, R., Xu, W. L., Zeng, J., Bai, L., & Chen, S. (2008) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0b013e3181902334 · Cited by 57 · see citing works
Validation of the Zarit Burden Interview for Chinese Canadian Caregivers
Lai, D. W. L. (2007) · Social Work Research · doi:10.1093/swr/31.1.45 · Cited by 41 · see citing works
Review: Pathways to Morbidity in Carers of Dementia Sufferers
Wijeratne, C. (1997) · International Psychogeriatrics · doi:10.1017/s1041610297004225 · Cited by 37 · see citing works
Chiam, P. C., Ng, T., Tan, L., Ong, P. S., Ang, A. L., & Kua, E. H. (2004) · PubMed · Cited by 23 · see citing works
Luo, N., Seng, B., & Li, S. (2003) · Annals of the Academy of Medicine Singapore · doi:10.47102/annals-acadmedsg.v32n5sps43 · Cited by 1 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
Xiong, C., Biscardi, M., Astell, A., Nalder, E., Cameron, J. I., Mihailidis, A., & Colantonio, A. (2020) · PLOS ONE · doi:10.1371/journal.pone.0231848 · Cited by 290 · see citing works
Ong, H. L., Vaingankar, J. A., Abdin, E., Sambasivam, R., Fauziana, R., Tan, M., Chong, S. A., Goveas, R. R., Chiam, P. C., & Subramaniam, M. (2018) · BMC Psychiatry · doi:10.1186/s12888-018-1616-z · Cited by 279 · see citing works
Caregiver burden and coping strategies in caregivers of older patients with stroke
Kazemi, A., Azimian, J., Mafi, M., Allen, K., & Motalebi, S. A. (2021) · BMC Psychology · doi:10.1186/s40359-021-00556-z · Cited by 167 · see citing works
“Higher scores indicate greater burden [63].”
Caregiver burden in owners of a sick companion animal: a cross‐sectional observational study
Spitznagel, M. B., Jacobson, D. M., Cox, M. D., & Carlson, M. D. (2017) · Veterinary Record · doi:10.1136/vr.104295 · Cited by 156 · see citing works
Bleijlevens, M. H. C., Stolt, M., Stephan, A., Zabalegui, A., Saks, K., Sutcliffe, C., Lethin, C., Soto, M. E., & Zwakhalen, S. M. G. (2014) · Journal of Advanced Nursing · doi:10.1111/jan.12561 · Cited by 119 · see citing works
Burden on Family Caregivers Caring for Patients with Schizophrenia.
Shamsaei, F., Cheraghi, F., & Bashirian, S. (2015) · Europe PMC (PubMed Central) · Cited by 116 · see citing works
Psychometrics of the Zarit Burden Interview in Caregivers of Patients With Heart Failure
Al-Rawashdeh, S. Y., Lennie, T. A., & Chung, M. L. (2016) · The Journal of Cardiovascular Nursing · doi:10.1097/jcn.0000000000000348 · Cited by 114 · see citing works
“The ZBI’s psychometric proprieties have been extensively examined in caregivers of patients with dementia10Y12,15,17,18 and demonstrate strong evidence for reliability and validity in that population.9 The ZBI has also been examined in caregivers of patients with cancer 13 and brain injury.14 The reported Cronbach’s !…”
MethodResultInfluentialVaingankar, J. A., Chong, S. A., Abdin, E., Picco, L., Jeyagurunathan, A., Zhang, Y., Sambasivam, R., Chua, B. Y., Ng, L. L., Prince, M. J., et al. (2015) · International Psychogeriatrics · doi:10.1017/s104161021500160x · Cited by 108 · see citing works
“Data for this study were collected during the Well - being of the Singapore Elderly (WiSE) study, which was a large, population - based, cross - sectional survey conducted to estimate the prevalence and factors associated with dementia in Singapore.”
InfluentialYu, J.-H., Yap, P., & Liew, T. (2019) · Aging & Mental Health · doi:10.1080/13607863.2018.1450841 · Cited by 89 · see citing works
Adib‐Hajbaghery, M., & Ahmadi, B. (2019) · PubMed Central · doi:10.30476/ijcbnm.2019.73893.0 · Cited by 92 · see citing works
Griva, K., Goh, C. S. Y., Kang, A. W. C., Yu, Z., Chan, M. C., Wu, S. Y., Krishnasamy, T., & Foo, M. (2015) · Quality of Life Research · doi:10.1007/s11136-015-1074-8 · Cited by 87 · see citing works
“Mean levels of burden for both assisted PD and self-care PD caregivers or family member were in moderate range— lower than those reported by caregivers of dementia patients [35].”
MethodResultInfluentialDeeken, F., Rezo, A., Hinz, M., Discher, R., & Rapp, M. A. (2018) · American Journal of Geriatric Psychiatry · doi:10.1016/j.jagp.2018.12.003 · Cited by 84 · see citing works
Loo, Y. X., Shi, Y., & Low, L. L. (2021) · Singapore Medical Journal · doi:10.11622/smedj.2021033 · Cited by 90 · see citing works
“ZBI is the most widely used among the included studies and has been validated in Singapore.”
MethodInfluentialNguyen, D. L., Chao, D., Ma, G., & Morgan, T. R. M. (2015) · PubMed Central · Cited by 73 · see citing works
Why Family Caregivers Choose to Institutionalize a Loved One with Dementia: A Singapore Perspective
Tew, C. W., Tan, L. F., Luo, N., Ng, W. Y., & Yap, P. L. K. (2010) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000320260 · Cited by 68 · see citing works
Caregiver Burden and Dementia: A Systematic Review of Self-Report Instruments
Tu, J. Y., Jin, G., Chen, J.-H., & Chen, Y.-C. (2022) · Journal of Alzheimer s Disease · doi:10.3233/jad-215082 · Cited by 63 · see citing works
Liew, T. M., Tai, B. C., Yap, P., & Koh, G. C.-H. (2019) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2018.11.016 · Cited by 61 · see citing works
Self-citationArcher, J., Reiboldt, W., Claver, M. L., & Fay, J. (2021) · Gerontology and Geriatric Medicine · doi:10.1177/2333721421990150 · Cited by 58 · see citing works
“The Zarit Burden Interview (ZBI) was the first to measure subjective caregiver burden and remains a popular, reliable tool with a Chronbach’s alpha of 0.92 (Hébert et al., 2000) and a test-retest reliability score of 0.89 (Seng et al., 2010).”
MethodInfluentialPark, J., Tolea, M. I., Arcay, V., Lopes, Y., & Galvin, J. E. (2018) · Social Work in Mental Health · doi:10.1080/15332985.2018.1526756 · Cited by 57 · see citing works
“Reliability has been reported from α = 0.81 (Leggett et al., 2010) to α = 0.93 (Yap, 2010).”
BackgroundInfluentialKoh, G. C., Yen, S., Tay, A. E., Cheong, A., Ng, Y. S., Silva, D. A. D., Png, C., Caves, K. M., Koh, K. W. L., Kumar, Y. P., et al. (2015) · BMC Neurology · doi:10.1186/s12883-015-0420-3 · Cited by 54 · see citing works
“Trial Registration: This trial protocol was registered under ClinicalTrials.gov on 18 July 2013 as study title “The Singapore Tele-technology Aided Rehabilitation in Stroke (STARS) Study” (ID: The STARS Study, ClinicalTrials.gov Identifier: NCT01905917).”
BackgroundMethodInfluentialWang, Y., Tyagi, S., Hoenig, H., Lee, K. E., Venketasubramanian, N., Menon, E., Silva, D. A. D., Yap, P. L. K., Tan, B. Y., Young, S. H. Y., et al. (2021) · BMC Public Health · doi:10.1186/s12889-021-11991-3 · Cited by 52 · see citing works
“13Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore 117597, Singapore.”
BackgroundOyegbile, Y. O., & Brysiewicz, P. (2017) · International Journal of Africa Nursing Sciences · doi:10.1016/j.ijans.2017.11.005 · Cited by 50 · see citing works
Caregiver burden among caregivers of children with autism spectrum disorder
van Niekerk, K., Stancheva, V. P., & Smith, C. (2023) · South African Journal of Psychiatry · doi:10.4102/sajpsychiatry.v29i0.2079 · Cited by 48 · see citing works
“The ZBI questionnaire is a standardised questionnaire validated for research use in the caregiving population by Seng et al. 41 Previous research has identified that the 12-item short-form version was suitable for screening for caregiver burden, demonstrated good psychometric properties and was…”
MethodYing, J., Yap, P. L. K., Gandhi, M., & Liew, T. M. (2019) · Dementia and Geriatric Cognitive Disorders · doi:10.1159/000500940 · Cited by 45 · see citing works
Hareendran, A., Devadas, K., Sreesh, S., Oommen, T. T., Varghese, J., Lubina, S., Nahaz, N., Krishna, A., & Kunhi, N. M. M. (2020) · Liver International · doi:10.1111/liv.14614 · Cited by 44 · see citing works
Dimensional analysis of burden in family caregivers of patients with obsessive–compulsive disorder
Torres, A. R., Hoff, N. T., Padovani, C. R., & Ramos‐Cerqueira, A. T. D. A. (2012) · Psychiatry and Clinical Neurosciences · doi:10.1111/j.1440-1819.2012.02365.x · Cited by 44 · see citing works
Kim, K., Kang, G. W., & Woo, J. (2018) · Journal of Korean Medical Science · doi:10.3346/jkms.2018.33.e111 · Cited by 43 · see citing works
Cheah, W. K., Han, H. C., Chong, M. S., Anthony, P. V., & Lim, W. S. (2012) · International Psychogeriatrics · doi:10.1017/s104161021200110x · Cited by 42 · see citing works
Clark, I. N., Stretton-Smith, P. A., Baker, F. A., Lee, C., & Tamplin, J. (2020) · Frontiers in Psychology · doi:10.3389/fpsyg.2020.01951 · Cited by 43 · see citing works
“Existing literature on TSW with people with dementia living in community and residential aged care contexts also indicates several benefits (Silber and Hes, 1995; Hong and Choi, 2011; Ahessy, 2017; Baker and Stretton-Smith, 2017).”
BackgroundGiordano, A., Cimino, V., Campanella, A., Morone, G., Fusco, A., Farinotti, M., Palmisano, L., Confalonieri, P. A., Lugaresi, A., Grasso, M. G., et al. (2016) · Journal of the Neurological Sciences · doi:10.1016/j.jns.2016.05.016 · Cited by 41 · see citing works
Lau, J. H., Abdin, E., Jeyagurunathan, A., Seow, E., Ng, L. L., Vaingankar, J. A., Chong, S. A., & Subramaniam, M. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02014-2 · Cited by 40 · see citing works
“The ZBI has shown to have strong internal consistency, test-retest reliability, and construct validity in a sample of family caregivers in Singaporean [33].”
BackgroundMemantine improves goal attainment and reduces caregiver burden in Parkinson's disease with dementia
Leroi, I., Atkinson, R., & Overshott, R. (2014) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4077 · Cited by 39 · see citing works
“It contains 22 items and uses 5-point Likert scales (0= never and 4=nearly always) to measure subjective caregiver burden (Seng et al., 2010).”
Yuan, Q., Wang, P., Tan, T. H., Devi, F., Poremski, D., Magadi, H., Goveas, R., Ng, L. L., Chong, S. A., & Subramaniam, M. (2021) · The Gerontologist · doi:10.1093/geront/gnaa080 · Cited by 35 · see citing works
Liew, T. M., Yeap, B. I., Koh, G. C., Gandhi, M., Tan, K. S., Luo, N., & Yap, P. L. K. (2017) · The Gerontologist · doi:10.1093/geront/gnx097 · Cited by 36 · see citing works
Rajabi‐Mashhadi, M. T., Mashhadinejad, H., Ebrahimzadeh, M. A., Golhasani‐Keshtan, F., Ebrahimi, H., & Zarei, Z. (2015) · Europe PMC (PubMed Central) · Cited by 37 · see citing works
Applicability of the pre‐death grief concept to dementia family caregivers in Asia
Liew, T. M. (2015) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.4387 · Cited by 36 · see citing works
“ZBI has been validated in Singapore (Seng et al., 2010), with good reliability and construct validity.”
BackgroundCaregiver Burden in Adults With Inflammatory Bowel Disease
Shukla, R., Thakur, E. R., Bradford, A. M., & Hou, J. K. (2017) · Clinical Gastroenterology and Hepatology · doi:10.1016/j.cgh.2017.05.020 · Cited by 36 · see citing works
Lerner, D., Chang, H., Rogers, W. H., Benson, C. J., Lyson, M. C., & Dixon, L. B. (2017) · Psychiatric Services · doi:10.1176/appi.ps.201600422 · Cited by 35 · see citing works
Lee, R. Z. Y., Yu, J., Rawtaer, I., Allen, P., Bao, Z., Feng, L., Feng, Q., Lee, J. K., Lim, C. T., Ling, L. H., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-035003 · Cited by 35 · see citing works
Byrne, A., Torrens‐Burton, A., Sivell, S., Moraes, F. Y., Bulbeck, H., Bernstein, M., Nelson, A., & Fielding, H. (2022) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013440.pub2 · Cited by 34 · see citing works
Carlozzi, N. E., Ianni, P. A., Tulsky, D. S., Brickell, T. A., Lange, R. T., French, L. M., Cella, D. F., Kallen, M. A., Miner, J. A., & Kratz, A. L. (2018) · Archives of Physical Medicine and Rehabilitation · doi:10.1016/j.apmr.2018.05.020 · Cited by 34 · see citing works
Tawfik, N. M., Sabry, N. A., Darwish, H., Mowafy, M. A., & Soliman, S. (2021) · Journal of Primary Care & Community Health · doi:10.1177/21501327211014088 · Cited by 38 · see citing works
Liew, T. M., Tai, B. C., Yap, P., & Koh, G. C. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5014 · Cited by 32 · see citing works
Self-citationMoreno, A., Nicholls, E., Ojeda, N., Aragón, C. J. D. L. R., Rivera, D., & Arango‐Lasprilla, J. C. (2015) · Journal of Cross-Cultural Gerontology · doi:10.1007/s10823-015-9270-0 · Cited by 32 · see citing works
“Higher scores indicate more burden (Ankri et al. 2005; Bachner and O’Rourke 2007; Chattat et al. 2011; Cheah et al. 2012; Hirono et al. 1998; Lu et al. 2009; Seng et al. 2010; Taub et al. 2004).”
BackgroundLégaré, F., Brière, N., Stacey, D., Lacroix, G., Desroches, S., Dumont, S., Fraser, K. D., Rivest, L., Durand, P. J., Turcotte, S., et al. (2016) · BMJ Open · doi:10.1136/bmjopen-2016-014023 · Cited by 32 · see citing works
(2017) · The American Pharmacists Association eBooks · doi:10.21019/9781582122885.nationalclinicalguidelines · Cited by 32 · see citing works
Adekpedjou, R., Stacey, D., Brière, N., Freitas, A., Garvelink, M. M., Turcotte, S., Menear, M., Bourassa, H., Fraser, K., Durand, P. J., et al. (2018) · PLoS ONE · doi:10.1371/journal.pone.0202975 · Cited by 32 · see citing works
Carbajal, A. B., Paredes-Ángeles, R., & Tafur-Mendoza, A. A. (2022) · Frontiers in Psychology · doi:10.3389/fpsyg.2022.792805 · Cited by 34 · see citing works
“, 2009), Singapore (Seng et al., 2010), Portugal (da Cruz, 2010), Brazil (Taub et al.”
BackgroundAdekpedjou, R., Stacey, D., Brière, N., Freitas, A., Garvelink, M. M., Dogba, M. J., Durand, P. J., Desroches, S., Croteau, J., Rivest, L., et al. (2019) · The Gerontologist · doi:10.1093/geront/gnz045 · Cited by 31 · see citing works
Mendez, K. J. W., Budhathoki, C. B., Labrique, A. B., Sadak, T. I., Tanner, E. K., & Han, H. (2021) · JMIR mhealth and uhealth · doi:10.2196/27926 · Cited by 31 · see citing works
“CHERRIES: Checklist for Reporting Results of Internet E-Surveys IIRS: Illness Intrusiveness Ratings Scale IRB: Institutional Review Board OR: odds ratio REDCap: Research Electronic Data Capture TAM: Technology Acceptance Model ZBI: Zarit Burden Interview Edited by L Buis; submitted 13.02.21; peer-reviewed by MI Cajita…”
MethodInfluentialRajasekaran, T., Tan, T. J., Ong, W. S., Koo, K. N., Chan, L. L., Poon, D., Chowdhury, A. R., Krishna, L. K. R., & Kanesvaran, R. (2016) · Journal of Geriatric Oncology · doi:10.1016/j.jgo.2016.03.003 · Cited by 30 · see citing works
Gater, A., Rofail, D., Marshall, C., Tolley, C., Abetz‐Webb, L., Zarit, S. H., & Berardo, C. G. (2015) · Patient · doi:10.1007/s40271-015-0114-3 · Cited by 30 · see citing works
Outcome Measures for Parkinson's Disease Dementia: A Systematic Review
Holden, S. K., Jones, W. E., Baker, K. A., Boersma, I. M., & Kluger, B. M. (2015) · Movement Disorders Clinical Practice · doi:10.1002/mdc3.12225 · Cited by 28 · see citing works
“62).(107) Inter-rater reliability has not been established for the ZBI in PDD.”
BackgroundRady, A. M., Mouloukheya, T., & Gamal, E. (2021) · Frontiers in Psychiatry · doi:10.3389/fpsyt.2021.623499 · Cited by 27 · see citing works
“The items are scored on 5-point Likert-like scale (33).”
BackgroundNelson, K. E., Saylor, M. A., Anderson, A., Buck, H. G., Davidson, P. M., DeGroot, L. G., Fisher, M. C., Gilotra, N. A., Pavlovic, N., & Szanton, S. L. (2022) · Heart & Lung · doi:10.1016/j.hrtlng.2022.04.009 · Cited by 26 · see citing works
Burden and Depression among Caregivers of Hemodialysis Patients
Shakya, D. (2017) · Palliative Medicine & Care Open Access · doi:10.15226/2374-8362/4/1/00131 · Cited by 26 · see citing works
Parkinson's Disease Caregiver Strain in Singapore
Tan, S., Williams, A. F., Tan, E., Clark, R. B., & Morris, M. E. (2020) · Frontiers in Neurology · doi:10.3389/fneur.2020.00455 · Cited by 26 · see citing works
“The ZBI has previously been shown to be a valid and reliable instrument for caregivers with dementia in Singapore (37).”
MethodQuality of Life Assessments in Individuals With Young-Onset Dementia and Their Caregivers
Dixit, D., Spreadbury, J. H., Orlando, R., Hayward, E., & Kipps, C. (2020) · Journal of Geriatric Psychiatry and Neurology · doi:10.1177/0891988720933348 · Cited by 24 · see citing works
Pinyopornpanish, K., Pinyopornpanish, M., Wongpakaran, N., Wongpakaran, T., Soontornpun, A., & Kuntawong, P. (2020) · BMC Research Notes · doi:10.1186/s13104-020-04967-w · Cited by 24 · see citing works
“The ZBI has demonstrated high correlations with other psychological tools [17, 23-25, 29].”
BackgroundMethodLee, K. H., Low, L. L., Lu, S. Y., & Lee, C. E. (2022) · The Lancet Regional Health - Western Pacific · doi:10.1016/j.lanwpc.2022.100561 · Cited by 24 · see citing works
Alhasan, D. M., Hirsch, J. A., Jackson, C. L., Miller, M. C., Cai, B., & Lohman, M. C. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18030913 · Cited by 23 · see citing works
“Caregiver mental health was greatly associated with care recipients’ NPSs and disease progression; in cases where NPSs persisted, they increased the burden on the caregiver indirectly by increasing the risk for institutionalization, comorbidities, and mortality [54].”
BackgroundMethodLau, S., Chong, M. S., Ali, N. B., Chan, M. Y., Chua, K. C., & Lim, W. S. (2015) · Alzheimer Disease & Associated Disorders · doi:10.1097/wad.0000000000000085 · Cited by 23 · see citing works
Afram, B., Verbeek, H., Bleijlevens, M. H. C., Challis, D., Leino‐Kilpi, H., Karlsson, S., Soto, M. E., Guiteras, A. R., Saks, K., Zabalegui, A., et al. (2014) · Journal of Advanced Nursing · doi:10.1111/jan.12479 · Cited by 23 · see citing works
Liew, T. M., Yap, P. L. K., Luo, N., Hia, S. B., Koh, G. C., & Tai, B. C. (2018) · BMC Geriatrics · doi:10.1186/s12877-018-0804-5 · Cited by 23 · see citing works
“ZBI and CES-D have previously been validated in Singapore [30, 31].”
BackgroundTyagi, S., Koh, G. C., Luo, N., Tan, K. B., Hoenig, H., Matchar, D. B., Yoong, J., Chan, A. W.-M., Lee, K. E., Venketasubramanian, N., et al. (2020) · BMJ Open · doi:10.1136/bmjopen-2019-036631 · Cited by 23 · see citing works
Galvin, J. E., Cummings, J. L., Benea, M. L., de Moor, C., Allegri, R., Atri, A., Chertkow, H. M., Paquet, C., Porter, V. R., Ritchie, C. W., et al. (2024) · Alzheimer s & Dementia · doi:10.1002/alz.13785 · Cited by 22 · see citing works
Liew, T. M., & Yap, P. L. K. (2018) · Journal of the American Medical Directors Association · doi:10.1016/j.jamda.2018.11.005 · Cited by 22 · see citing works
Evaluation of Anxiety, Depression and Burden on Caregivers of Children with Cerebral Palsy
Barutçu, A., Barutçu, S., Kolkiran, S., & Özdener, F. (2021) · Developmental Neurorehabilitation · doi:10.1080/17518423.2021.1917718 · Cited by 21 · see citing works
“89, respectively).(17) Lastly, Functional Independence Measure (FIM) was used to measure the level of assistance required by the patient.”
MethodBoucher, A., Haesebaert, J., Freitas, A., Adekpedjou, R., Landry, M., Bourassa, H., Stacey, D., Croteau, J., Guérard, G. P., & Légaré, F. (2019) · BMC Geriatrics · doi:10.1186/s12877-019-1249-1 · Cited by 22 · see citing works
Koh, W. L. E., Low, F., Kam, J. W., Rahim, S., Ng, W. F., & Ng, L. L. (2019) · Dementia · doi:10.1177/1471301218823439 · Cited by 20 · see citing works
“It had also demonstrated to be a valid and reliable tool to measure the burden of family caregivers of persons with dementia in Singapore (Seng et al., 2010).”
MethodDepression and psychosocial burden among caregivers of children with chronic kidney disease
Mahmoud, D. A. M., Saad, A. E., Abdelhamid, Y. H., & Hawary, Y. E. (2021) · Middle East Current Psychiatry · doi:10.1186/s43045-021-00092-x · Cited by 20 · see citing works
Adhikari, S. P., Gurung, G., Khadka, B., & Rana, C. (2020) · Spinal Cord · doi:10.1038/s41393-020-0451-5 · Cited by 20 · see citing works
Tay, L. X., Ong, S. C., Ong, H. M., Teh, E. E., Ch’ng, A. S. H., Tiong, I. K., Razali, R. M., & Parumasivam, T. (2025) · Scientific Reports · doi:10.1038/s41598-025-95210-8 · Cited by 21 · see citing works
“In terms of reliability and validity, Boon et al. demonstrated good consistency (Cronbach’s alpha of 0.93) and good test-retest reliability (alpha of 0.89) 59 .”
InfluentialDyadic approach to post-stroke hospitalizations: role of caregiver and patient characteristics
Tyagi, S., Koh, G. C., Luo, N., Tan, K. B., Hoenig, H., Matchar, D. B., Yoong, J., Chan, A. W.-M., Lee, K. E., Venketasubramanian, N., et al. (2019) · BMC Neurology · doi:10.1186/s12883-019-1510-4 · Cited by 19 · see citing works
“Validated previously in Singapore [22], we used the abbreviated 12-item version for the current study with a total score ranging from 0 to 48.”
MethodCastillo, L. I. R., Tran, V., & Hadjistavropoulos, T. (2023) · Aging & Mental Health · doi:10.1080/13607863.2023.2177832 · Cited by 19 · see citing works
“The ZBI (Zarit et al., 1985) is a reliable and valid 22-item questionnaire designed to measure the burden experienced in various dimensions life as a result of caregiving (Yap, 2010).”
MethodInformal caregiver burden in middle-income countries Results from Memory Centers in Lima - Peru
Custodio, N., Lira, D., Herrera‐Pérez, E., del Prado, L. N., Parodi, J. F., Guevara‐Silva, E. A., Castro‐Suárez, S., Mar, M., Montesinos, R., & Cortijo, P. (2014) · Dementia & Neuropsychologia · doi:10.1590/s1980-57642014dn84000012 · Cited by 19 · see citing works
Adisso, É. L., Taljaard, M., Stacey, D., Brière, N., Zomahoun, H. T. V., Durand, P. J., Rivest, L., & Légaré, F. (2022) · JMIR Aging · doi:10.2196/39386 · Cited by 18 · see citing works
“Other secondary outcomes included health-related quality of life, assessed only in the frail older adults with the 36 items of the Nottingham Health Profile [33-35], and burden of care, assessed only in the caregivers with the Zarit Burden Inventory scale [36-38].”
Ofovwe, C. E., & Osasona, S. O. (2022) · African Health Sciences · doi:10.4314/ahs.v22i2.75 · Cited by 18 · see citing works
Sung, P., Lee, J., & Chan, A. W.-M. (2022) · Journal of Aging and Health · doi:10.1177/08982643221137939 · Cited by 18 · see citing works
“The next four items were adopted from the ComSA risk screener, which aimed to screen biopsychosocial health and related risks of older Singaporeans (Aw et al., 2020).”
MethodInfluentialSchizophrenia: its psychological effects on family caregivers
Riley-McHugh, D., Brown, C. H., & Lindo, J. (2016) · International Journal of Advanced Nursing Studies · doi:10.14419/ijans.v5i1.5565 · Cited by 17 · see citing works
“The Zarit Burden Questionnaire has been used to measure the caregivers’ perceived burden of providing family care (Seng et al. 2010).”
MethodAlshammari, B., Noble, H. R., McAneney, H., & O’Halloran, P. D. (2019) · BMC Nephrology · doi:10.1186/s12882-019-1424-9 · Cited by 17 · see citing works
A Brief, 6-Item Scale for Caregiver Grief in Dementia Caregiving
Liew, T. M., & Yap, P. L. K. (2018) · The Gerontologist · doi:10.1093/geront/gny161 · Cited by 15 · see citing works
“It should correlate strongly ( r > .50 ; Juniper, Guyatt, & Jaeschke, 1996) with scales for caregiver burden (ZBI) and caregiver depression (CES-D) because they measure related, though discriminable, phenomena in caregiving; 2.”
InfluentialPsychometric properties of the Hebrew version of the Zarit Caregiver Burden Scale short version
Iecovich, E. (2011) · Aging & Mental Health · doi:10.1080/13607863.2011.596807 · Cited by 15 · see citing works
“Although there are various tools to probe caregiver burden (Visser-Meily, Post, Riphagen, & Lindeman, 2004), the most commonly used on an international level is the Zarit Burden Interview (ZBI) and the short version of the ZBI (Bédard et al., 2001; Martı́nCarrasco et al., 2010; Seng et al., 2010).”
MethodMujjuzi, I., Mutegeki, P., Nabuwufu, S., Wosukira, A., Namata, F., Alayo, P., Amanya, S. B., & Nyeko, R. (2021) · AIDS Research and Treatment · doi:10.1155/2021/6660337 · Cited by 14 · see citing works
“, which showed a lower care burden among caregivers who had fewer financial problems [22].”
BackgroundMethodResultKermani, R. J. N., Cohen‐Zimerman, S., Wagner, A. K., & Grafman, J. H. (2021) · Epilepsy & Behavior · doi:10.1016/j.yebeh.2021.107768 · Cited by 14 · see citing works
Burden and resilience in caregivers of patients on maintenance haemodialysis
Joy, J., J., H. K. T., Abraham, P. M., & Gopalakrishnan, S. (2019) · International Journal of Research in Medical Sciences · doi:10.18203/2320-6012.ijrms20194586 · Cited by 14 · see citing works
“More the score, greater is the burden perceived.(11)”
BackgroundPutera, A. M., Irwanto, I., & Maramis, M. M. (2020) · HIV/AIDS - Research and Palliative Care · doi:10.2147/hiv.s269629 · Cited by 14 · see citing works
Hall, D., Wilkerson, J., Lovato, J. F., Sink, K. M., Chamberlain, D., Alli, R., Clarke, P., Rogers, S. D., Villalba, J., Williams, J. H., et al. (2014) · Journal of Mental Health Counseling · doi:10.17744/mehc.36.2.l880r8h860071414 · Cited by 14 · see citing works
“93) and test-retest reliability (r = 0.89; Seng et al., 2010).”
InfluentialLee, J., & Cagle, J. G. (2020) · Palliative Medicine · doi:10.1177/0269216320973161 · Cited by 14 · see citing works
Improving Daily Life Skills in People with Dementia: Testing the STOMP Intervention Model
Dao, H. D. (2014) · Journal of Alzheimer’s Disease & Parkinsonism · doi:10.4172/2161-0460.1000165 · Cited by 13 · see citing works
“89 [55].”
Chan, I., Yap, P., Wee, S., & Liew, T. (2019) · International Journal of Geriatric Psychiatry · doi:10.1002/gps.5238 · Cited by 12 · see citing works
Yuan, Q., Tan, G. T. H., Wang, P., Devi, F., Goveas, R. R., Magadi, H., Ng, L. L., Chong, S. A., & Subramaniam, M. (2021) · BMC Geriatrics · doi:10.1186/s12877-021-02238-2 · Cited by 13 · see citing works
“This 22-item scale was first developed in 1980, and has been validated in various countries including Singapore [11].”
MethodCaregiver burden in children with intellectual disability: Does special school education help?
Ramasubramanian, V., Chellamuthu, R., Selvikumari, R., Pandian, P. R. S., & Gopi, R. (2019) · Industrial Psychiatry Journal · doi:10.4103/ipj.ipj_7_15 · Cited by 12 · see citing works
Demirbas, M., Hahn‐Pedersen, J. H., & Jørgensen, H. L. (2023) · Neurology and Therapy · doi:10.1007/s40120-023-00493-6 · Cited by 12 · see citing works
“The overall score of the ZBI ranges from 0 to 88 points [11, 26] and has four levels of burden: no or little burden (0–20 points), mild to moderate burden (21–40 points), moderate to severe burden (41–60 points) and severe burden (61–88 points) [27].”
BackgroundLiew, T. M., Tai, B. C., Wee, S. L., Koh, G. C., & Yap, P. (2020) · Journal of the American Geriatrics Society · doi:10.1111/jgs.16717 · Cited by 12 · see citing works
“ZBI is a widely used scale to assess perceived burden of caregivers of older persons.(9) Its 22 items are rated on five-point Likert scales, and summed to generate total scores ranging from 0 to 88 (higher scores indicate greater burden).”
BackgroundKoh, Y. S., Subramaniam, M., Matchar, D. B., Hong, S.-I., & Koh, G. C. (2022) · BMC Psychology · doi:10.1186/s40359-022-00828-2 · Cited by 12 · see citing works
“It is a 12-item instrument that allows respondents to rate negatively phrased questions on caregiving from 0 = Never to 4 = Nearly always [25].”
BackgroundGhosh, S., Choi, W. Y., Williams, A., Duggleby, W., Ploeg, J., Markle‐Reid, M., & Peacock, S. (2019) · Canadian Journal on Aging / La Revue canadienne du vieillissement · doi:10.1017/s071498081900045x · Cited by 12 · see citing works
“The ZBI has been proven to be a valid and reliable tool for determining caregiver burden by Seng et al. (2010).”
InfluentialSociodemographic Profiles of Caregivers and Their Association with Burden of Care in Dementia
Rosdinom, R., Norzarina, M. Z., Zanariah, M. S., & ZamZam, R. (2011) · The Malaysian journal of psychiatry · Cited by 12 · see citing works
Byrne, A., Sivell, S., de Moraes, F. Y., Bulbeck, H., Torrens‐Burton, A., Bernstein, M., Nelson, A., & Fielding, H. (2019) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd013440 · Cited by 12 · see citing works
Validation of the Needs Assessment of Family Caregivers-Cancer scale in an Asian population
Yang, W. F. Z., Liu, J., Chan, Y. H., Griva, K., Kuparasundram, S., & Mahendran, R. (2020) · BMC Psychology · doi:10.1186/s40359-020-00445-x · Cited by 14 · see citing works
“While the ZBI was originally developed to assess burden experienced by caregivers of persons with dementia, it has now been widely used in many clinical contexts, such as Parkinson’s disease and chronic diseases, [33–36] and also shown to be reliable and valid for use in cancer caregivers [37, 38] and in an Asian popu…”
Method
- Authors
- Seng, B. K., Luo, N., Ng, W. Y., Lim, J., Chionh, H. L., Goh, J., & Yap, P.
- Affiliations
- National University of Singapore (SG)
- Alexandra Hospital (SG)
- Venue
- Annals of the Academy of Medicine Singapore
- Publisher
- Academy of Medicine, Singapore
- Published
- 2010-10-15
- Volume
- 39
- Issue
- 10
- Pages
- 758-763
- ISSN
- 0304-4602 (ISSN-L)
- OpenAlex
- W126441541
- Cited by
- 288
- References
- 32
- Citations by year
- 2026: 20 · 2025: 22 · 2024: 25 · 2023: 41 · 2022: 27 · 2021: 28 · 2020: 31 · 2019: 22 · 2018: 16 · 2017: 10 · 2016: 10 · 2015: 15 · 2014: 13 · 2013: 3 · 2012: 2
- FWCI
- 1.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Annals of the Academy of Medicine Singapore (publishedVersion)
- PubMed (publishedVersion)
- National University of Singapore (submittedVersion)
- Topics
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Health Professions › Pharmacy › Nursing care and research
- Social Sciences › Psychology › Clinical Psychology › Family Caregiving in Mental Illness
- Keywords
- Zarit Burden Interview, caregiver burden, dementia, family caregivers, psychometric validation, test-retest reliability, Singapore
- MeSH terms
- Adult, Dementia, Female, Humans, Interview, Psychological, Male, Middle Aged, Psychiatric Status Rating Scales, Stress, Psychological, Caregivers, Cost of Illness
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
