Cross-sectional Study on Caregiver Burden Assessment

The present cross-sectional study was conducted in accordance with the Revised Standards for Quality Improvement Reporting Excellence (SQUIRE 2.0 - checklist) for the description of the results. The sample consisted of 341 persons who met the following inclusion criteria, aged 60 years or older; performed the role of caregiver of their elderly dependent family member living in the same household, and enrolled in one of the primary healthcare centers in the city of São Carlos, state of São Paulo, Brazil, located 235 km from the state capital. The exclusion criterion of the research was refusal by the participant to sign the Free and Informed Consent Form.
The degree of dependence of the elderly dependent on care was verified using the evaluation of the level of dependence for basic and instrumental activities of daily living analyzed by the Katz Index and Lawton and Brody’s Scale.
The data were collected by an oral interview, where carers with cognitive deficits were excluded with self-report. Therefore, interviewees who could understand and complete the data collection instruments were selected for the study.
The interview was conducted at the homes of the participants between April and November 2014 by students and health professionals who had undergone training for the administration of the following data collection instruments:
For the identification of an assessment tool that could serve as the standard reference, the following were also administered to the participants:
This study was conducted in accordance with all ethical precepts that govern research involving human subjects and received approval from the Human Research Ethics Committee of the Universidade Federal de São Carlos (certificate numbers: 416.467/2013 and 711.592/2014). All participants signed a statement of informed consent prior to the onset of the data collection process, and the care recipients that were completely dependent (13.5%) were consented by the legal guardian, who was predominantly represented by the caregiver.
The data were entered in a double-blinded dataset in MS Excel 2010. The SPSS program version 21.0 (IBM, Chicago, Illinois, USA) was used for the data analysis. The data presented adherence to normality, as verified by the Kolmogorov-Smirnov test, and therefore parametric statistical tests were run. Descriptive statistics were performed to describe the sample (Table 1). Internal consistency of the ZBI-12 was measured using Cronbach’s alpha, considering α > 0.8 to be indicative of very good to excellent internal consistency. Correlation coefficients were calculated for the item-item and item-score evaluations to determine the strength of the internal correlation of each item. Pearson’s correlation coefficients were calculated to analyze the strength of correlations between the ZBI-12 items and total GDS, PSS and L&B scale scores for the determination of the standard reference (Table 2). To suggest a cut-off point for the ZBI-12, the PSS scores were divided into quartiles and four groups created. For each group, the mean and standard-deviation of ZBI-12 were reported. The mean value on the ZBI-12 for the highest group was the suggested cut-off point (Table 3). One-way ANOVA with Tukey’s post hoc test was used for the comparison of mean ZBI-12 scores according to the PSS quartiles. A p-value ≤ 0.05 was considered indicative of statistical significance.