Skip to main content
SpringerLink
Log in

Die subjektive Belastung pflegender Ehepartner von Demenzkranken

Hinweise zur Validität der deutschen Version des Zarit Burden Interviews

Caregiver burden with dementia patients

A validation study of the German language version of the Zarit Burden Interview

  • Originalarbeit
  • Published:
Zeitschrift für Gerontologie und Geriatrie Aims and scope Submit manuscript

Zusammenfassung

Trotz der Vielzahl europäischer Studien über pflegende Angehörige von Demenzkranken gibt es bis heute keine veröffentlichte validierte deutsche Version des am häufigsten angewandten Instruments zur Erfassung der Belastung familiärer Pflegepersonen (Zarit Burden Interview, ZBI). Primäres Ziel dieser Studie war die Analyse der teststatistischen Gütekriterien der deutschen Version des ZBI (G-ZBI). Die Stichprobe bestand aus 37 älteren Paaren (n=74), bei denen der Ehemann von einer Demenzerkrankung betroffen war und die Ehefrau den Großteil der Pflege des kranken Partners übernommen hatte. Das G-ZBI weist eine hohe psychometrische Qualität (Cronbachs α=0,91) sowie überzeugende korrelative Zusammenhänge als Validitätshinweise auf (z. B. Wohlbefinden der Pflegeperson, Pflegebedürftigkeit und neuropsychiatrische Symptome des Demenzkranken). Eine Faktorenanalyse als Maß der Konstruktvalidität zeigt uneindeutige Befunde, unterstützt aber die in der Literatur häufig angenommene Eindimensionalität des Instruments. Die psychometrischen Gütekriterien legen nahe, dass das G-ZBI die Qualität eines reliablen und validen Instruments zur Erfassung der subjektiven Belastung pflegender Ehepartner von Demenzkranken besitzt. Die Anwendung des G-ZBI hat praktische und klinische Relevanz bei der Identifikation besonders belasteter und gefährdeter familiärer Pflegepersonen.

Abstract

Despite the large number of studies dealing with dementia caregivers in Europe, a valid German version of the most widely used measurement of caregiver burden, the Zarit Burden Interview, has not been published. The purpose of this study was to evaluate the psychometric properties of the German Zarit Burden Interview (G-ZBI). A sample of community-dwelling older couples (n=37) with the husband suffering from dementia and the wife being the primary caregiver participated in this study. The G-ZBI and related constructs were assessed in order to test for reliability and construct validity. The G-ZBI revealed psychometric properties comparable with those of the original instrument and empirically validated translations. Results indicate high internal consistency (Cronbach’s α=0.91) and good validity due to strong correlations with caregiver life satisfaction and depression, as well as patients’ dependency, neuropsychiatric symptoms, and dementia severity. The psychometric qualities of the G-ZBI indicate that it is both a reliable and valid instrument to assess caregiver burden and to detect highly stressed individuals.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Abb. 1

Literatur

  1. Alf C, Bancher C, Benke T et al (2006) Konsensusstatement „Demenz“ der Österreichischen Alzheimer Gesellschaft – Update 2006. Neuropsychiatr 20:221–231

    Google Scholar 

  2. Ankri J, Andrieu S, Beaufils B et al (2005) Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians. Int J Geriatr Psychiatry 20:254–260

    Article  PubMed  Google Scholar 

  3. Arai Y, Kudo K, Hosokawa T et al (1997) Reliability and validity of the Japanese version of the Zarit Caregiver Burden Interview. Psychiatry Clin Neurosci 51:281–287

    Article  CAS  PubMed  Google Scholar 

  4. Arai Y, Zarit SH, Sugiura M, Washio M (2002) Patterns of outcome of caregiving for the impaired elderly: a longitudinal study in rural Japan. Aging Ment Health 6:39–46

    Article  CAS  PubMed  Google Scholar 

  5. Arai Y, Kumamoto K, Washio M et al (2004) Factors related to feelings of burden among caregivers looking after impaired elderly in Japan under the long-term care insurance system. Psychiatry Clin Neurosci 28:396–402

    Article  Google Scholar 

  6. Bachner YG, O’Rourke N (2007) Reliability generalization of responses by care providers to the Zarit Burden Interview. Aging Ment Health 11:678–685

    Article  CAS  PubMed  Google Scholar 

  7. Backhaus K, Erichson B, Plinke W, Weiber R (2000) Multivariate Analysemethoden. Eine anwendungsorientierte Einführung, 9. Aufl. Springer, Berlin Heidelberg New York

  8. Baumgarten M, Battista RN, Infante-Rivard C et al (1992) The psychological and physical health of family members caring for an elderly person with dementia. J Clin Epidemiol 45:61–70

    Article  CAS  PubMed  Google Scholar 

  9. Bédard M, Molloy DW, Pedlar D et al (1997) Associations between dysfunctional behaviors, gender and burden in spousal caregivers of cognitively impaired older adults. Int Psychogeriatr 9:277–290

    Article  PubMed  Google Scholar 

  10. Bortz J, Doering N (1995) Forschungsmethoden und Evaluation für Sozialwissenschaftler, 2. Aufl. Springer, Berlin Heidelberg New York

  11. Braun M, Scholz U, Bailey B et al (2009) Dementia caregiving in spousal relationships: a dyadic perspective. Aging Ment Health 13:426–436

    Article  PubMed  Google Scholar 

  12. Carver RP (1978) The case against significance testing. Harv Educ Rev 48:378–399

    Google Scholar 

  13. Campbell DT, Fiske DW (1959) Convergent and discriminant validation by the multitrait-multimethod matrix. Psychol Bull 56:81–105

    Article  CAS  PubMed  Google Scholar 

  14. Chan TSF, Lam LCW, Chiu HFK (2005) Validation of the Chinese version of the Zarit Burden Interview. Hong Kong J Psychiatr 15:9–13

    Google Scholar 

  15. Clair JM, Fitzpatrick KM, La Gory ME (1995) The impact of psychosocial resources on caregiver burden and depression: Sociological variations on a gerontological theme. Sociol Perspect 38:195–215

    Google Scholar 

  16. Clyburn LD, Stones MJ, Hadjistavropoulos T, Tuokko H (2000) Predicting caregiver burden and depression in Alzheimer’s disease. J Gerontol B Psychol Sci Soc Sci 55:S2–S13

    CAS  PubMed  Google Scholar 

  17. Cohen J (1994) The earth is round. Am Psychol 49:997–1003

    Article  Google Scholar 

  18. Deutsche Alzheimer Gesellschaft (2006) Die Epidemiologie der Demenz. http://www.deutschealzheimer.de/fileadmin/alz/pdf/factsheets/FactSheet01.pdf. Gesehen 20 Mai 2008

  19. Erdfelder E, Faul F, Buchner A (1996) GPOWER: a general power analysis program. Behav Res Methods Instrum Comput 28:1–11

    Google Scholar 

  20. Gallagher-Thompson D, Dal Canto PG, Jacob T, Thompson LW (2001) A comparison of marital interaction patterns between couples in which the husband does or does not have Alzheimer’s disease. J Gerontol B Psychol Sci Soc Sci 56:140–150

    Google Scholar 

  21. Gallant MP, Connell CM (1997) Predictors of decreased self-care among spouse caregivers of older adults with dementing illnesses. J Aging Health 9:373–395

    Article  CAS  PubMed  Google Scholar 

  22. Garand L, Dew MA, Urda B et al (2007) Marital quality in the context of mild cognitive impairment. West J Nurs Res 29:976–992

    Article  PubMed  Google Scholar 

  23. Gort AM, Mazarico S, Ballesté J et al (2003) Use of Zarit scale for assessment of caregiver burden in palliative care. Med Clin (Barc) 121:132–133

    Google Scholar 

  24. Gort AM, Mingot M, Gomez X et al (2007) Use of the zarit scale for assessing caregiver burden and collapse in caregiving at home in dementias. Int J Geriatr Psychiatry 22:957–962

    Article  PubMed  Google Scholar 

  25. Grober E, Hall C, Lipton RB, Teresi JA (2008) Primary care screen for early dementia. J Am Geriatr Soc 56:206–213

    Article  PubMed  Google Scholar 

  26. Harkness JA, Schoua-Glusberg A (1998) Questionnaires in translation. In: Harkness JA (ed) Cross-cultural survey equivalence. ZUMA-Nachrichten Spezial Bd 3. ZUMA, Mannheim, S 87–126

  27. Hautzinger M (1988) Die CES-D-Skala. Ein Depressionsmessinstrument für Untersuchungen in der Allgemeinbevölkerung. Diagnostica 38:167–173

    Google Scholar 

  28. Hébert R, Bravo G, Préville, M (2000) Reliability, validity and reference values of the Zarit Burden Interview for assessing informal caregivers of community-dwelling older persons with dementia. Can J Aging 19:494–507

    Google Scholar 

  29. Kaufer DI, Cummings JL, Ketchel P et al (2000) Validation of the NPI-Q, a brief clinical form of the neuropsychiatric inventory. J Neuropsychiatry Clin Neurosci 12:233–239

    CAS  PubMed  Google Scholar 

  30. Kessler J, Markowitsch HJ, Denzler PE (1990) Mini-Mental-State: deutsche Fassung. Beltz, Weinheim

  31. Knight BG, Fox LS, Chou CP (2000) Factor structure of the Burden Interview. J Clin Geropsychol 6:249–258

    Article  Google Scholar 

  32. Knop DS, Bergman-Evans B, McCabe BW (1998) In sickness and in health: an exploration of the perceived quality of the marital relationship, coping and depression in caregivers of spouses with Alzheimer’s disease. J Psychosoc Nurs Ment Health Serv 36:16–21

    CAS  PubMed  Google Scholar 

  33. Mahoney F, Barthel D (1965) Functional evaluation: the Barthel Index. Miss State Med J 14:61–65

    CAS  Google Scholar 

  34. Maki N, Ikeda M, Hokoishi K et al (2000) The validity of the MMSE and SMQ as screening tests for dementia in the elderly general population- a study of one rural community in Japan. Dement Geriatr Cogn Disord 11:193–196

    Article  CAS  PubMed  Google Scholar 

  35. Majerovitz SD (2007) Predictors of burden and depression among nursing home family caregivers. Aging Ment Health 11:323–329

    Article  PubMed  Google Scholar 

  36. Molloy DW, Lever JA, Bédard M et al (1996) Burden in caregivers of older adults with impaired cognition: The relationship with dysfunctional behaviors, daily living and mood. Ann R Coll Physicians Surg Can 29:151–154

    Google Scholar 

  37. Narayan S, Lewis M, Tornatore J et al (2001) Subjective responses to caregiving for a spouse with dementia. J Gerontol Nurs 27:19–28

    CAS  PubMed  Google Scholar 

  38. Onishi J, Suzuki Y, Umegaki H et al (2005) Influence of behavioural and psychological symptoms of dementia (BPSD) and environment care on caregiver’s burden. Arch Gerontol Geriatr 41:159–168

    Article  PubMed  Google Scholar 

  39. O’Rourke N (2004) Reliability generalization of responses by care providers to the center for epidemiologic studies-depression scale. Educ Psychol Meas 64:973–990

    Article  Google Scholar 

  40. O’Rourke N, Tuokko HA (2003) The relative utility of four abridged versions of the Zarit Burden Interview. J Ment Health Aging 9:55–64

    Google Scholar 

  41. Papastavrou E, Kalokerinou A, Papacostas SS et al (2007) Caring for a relative with dementia: family caregiver burden. J Adv Nurs 58:446–457

    Article  PubMed  Google Scholar 

  42. Perren S, Schmid R, Wettstein A (2006) Caregivers‘ adaptation to change: the impact of increasing impairment of persons suffering from dementia on their caregivers‘ subjective well-being. Aging Ment Health 10:539–548

    CAS  PubMed  Google Scholar 

  43. Pinquart M, Soerensen S (2003) Associations of stressors and uplifts of caregiving with caregiver burden and depressive mood: a meta-analysis. J Gerontol B Psychol Sci Soc Sci 58:112–128

    Google Scholar 

  44. Pruchno RA, Resch NL (1989) Aberrant behaviors and Alzheimer’s disease: mental health effects on spouse caregivers. J Gerontol 44:S177–S182

    CAS  PubMed  Google Scholar 

  45. Robinson KM, Adkisson P, Weinrich S (2001) Problem behaviour, caregiver reactions and impact among caregivers of persons with Alzheimer’s disease. J Adv Nurs 36:573–582

    Article  CAS  PubMed  Google Scholar 

  46. Rozzini L, Cornali C, Chilovi B et al (2006) Predictors of institutionalization in demented patients discharged from a rehabilitation unit. J Am Med Dir Assoc 7:345–349

    Article  PubMed  Google Scholar 

  47. Schreiner AS, Morimoti T, Arai Y, Zarit S (2006) Assessing family caregiver’s mental health using a statistically derived cut-off score for the Zarit burden interview. Aging Ment Health 10:107–111

    Article  CAS  PubMed  Google Scholar 

  48. Schulz R, Martire LM (2004) Family caregiving of persons with dementia. Am J Geriatr Psychiatry 12:240–249

    PubMed  Google Scholar 

  49. Schumacher J (2003) SWLS – Satisfaction with Life Scale. http://www.praxis-schumacher.net/swls.html. Gesehen 15 April 2007

  50. Schweizerische Alzheimervereinigung (2007) 98.000 Personen mit Demenz leben heute in der Schweiz. http://www.alz.ch/d/data/data_179.pdf. Gesehen 31 Jan 2008

  51. Sherwood PR, Given CW, Given BA, Eye A von (2005) Caregiver burden and depressive symptoms: analysis of common outcomes in caregivers of elderly patients. J Aging Health 17:125–147

    Article  PubMed  Google Scholar 

  52. Sink KM, Covinsky KE, Barnes DE et al (2006) Caregiver characteristics are associated with neuropsychiatric symptoms of dementia. J Am Geriatr Soc 54:796–803

    Article  PubMed  Google Scholar 

  53. Sörensen S, Pinquart M (2005) Racial and ethnic differences in the relationship of caregiving stressors, resources and sociodemographic variables to caregiver depression and perceived physical health. Aging Ment Health 9:482–459

    Article  PubMed  Google Scholar 

  54. Statistisches Bundesamt (2005) Bericht: Pflegestatistik 2003 – Pflege im Rahmen der Pflegeversicherung – Deutschlandergebnisse. http://www.destatis.de/jetspeed/portal/cms/Sites/destatis/Internet/DE/Content/Publikationen/Fachveroeffentlichungen/Sozialleistungen/Sozialpflege1Bericht2003,property=file.pdf. Gesehen 15 Jan 2008

  55. Thompson RL, Lewis SL, Murphy MR et al (2004) Are there sex differences in emotional and biological responses in spousal caregivers of patients with Alzheimer’s disease? Biol Res Nurs 5:319–330

    Article  PubMed  Google Scholar 

  56. Vacha-Haase T, Kogan LR, Thompson B (2000) Sample compositions and variabilities in published studies versus those in test manuals: validity of score reliability inductions. Educ Psychol Meas 60:509–522

    Article  Google Scholar 

  57. Wang G, Cheng Q, Wang Y et al (2008) The metric properties of Zarit caregiver burden scale: validation study of a Chinese version. Alzheimer Dis Assoc Disord 22:321–326

    Article  PubMed  Google Scholar 

  58. Werner O, Campbell D (1970) Translating, working through interpreters and the problem of decentering. In: Naroll R, Cohen R (eds) Handbook of cultural anthropology. American Museum of National History, New York

  59. Zarit SH, Orr NK, Zarit JM (1985) The hidden victims of Alzheimer’s disease: families under stress. New York University, New York

  60. Zarit SH, Reever KE, Bach S (1980) Relatives of the impaired elderly: correlates of feelings of burden. Gerontologist 20:649–655

    CAS  PubMed  Google Scholar 

  61. Zarit SH, Zarit JM (1987) Instructions for the burden interview. Pennsylvania State University, Philadelphia/PA

Download references

Danksagung

Die Autoren bedanken sich bei lic. phil. Melanie Wight, Fachgruppe Gerontopsychologie des Psychologischen Instituts der Universität Zürich, für ihr Engagement sowie den kooperierenden Kliniken für die erfolgreiche Zusammenarbeit und die Realisierbarkeit des Projekts „Sozialer Austausch und Wohlbefinden bei Paaren mit Demenz“: Dr. Uwe Sperling, Universitätsklinik Mannheim; Dr. med. Jaqueline Minder, Integrierte Psychiatrie Winterthur/Schweiz; Ursula Hanhart, Gerontologin SAG, Memory-Klinik Entlisberg/Schweiz; Ulrich Frischknecht, Psychiatrie-Zentrum Männedorf/Schweiz; Nancy Dilger, lic. phil. und Dr. med. Oliver Kellner, Psychiatrie-Zentrum Hard/Schweiz.

Interessenkonflikt

Die korrespondierende Autorin gibt an, dass kein Interessenkonflikt besteht.

Author information

Authors and Affiliations

  1. Fachgruppe Sozial- und Gesundheitspsychologie, Psychologisches Institut, Universität Zürich, Binzmühlestr. 14, 8050, Zürich, Schweiz

    M. Braun, U. Scholz & R. Hornung

  2. Fachgruppe Gerontopsychologie, Psychologisches Institut, Universität Zürich, Binzmühlestr. 24, 8050, Zürich, Schweiz

    M. Martin

Authors
  1. M. Braun
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. U. Scholz
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. Hornung
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Martin
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to M. Braun.

Additional information

Das Manuskript wurde von allen Autoren gesehen und überarbeitet. Alle Autoren haben einen bedeutenden Teil zur Gestaltung dieses Manuskripts beigetragen.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Braun, M., Scholz, U., Hornung, R. et al. Die subjektive Belastung pflegender Ehepartner von Demenzkranken. Z Gerontol Geriat 43, 111–119 (2010). https://doi.org/10.1007/s00391-010-0097-6

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00391-010-0097-6

Schlüsselwörter

Keywords

Search

Navigation