The Measurement of Caregiver Burden

The assessment of burden has become a challenging task for most researchers because cultural, ethical, religious and other personal values may influence perceptions of meaning and consequences of burden. This article reviewed selected instruments that have been used in the last 15 years including Zarit's Burden Interview, Montgomery's Burden Scale, Vitaliano's Screen for Caregiver Burden, Novak's Caregiver Burden Inventory, and Kosberg and Cairl's Cost of Care Index. Several criteria were used to evaluate the burden scales: (a) the implicit/explicit theoretical foundation, (b) the specific construction and level of measurement, (c) available psychometric properties, and (d) overall evaluation. The traditional unidimensional measurement methods impose several limitations on the research results and subsequent interpretations. Multidimensional instruments match burden's definition and overcome these limitations that permit the exploration of the internal psychological structure of a respondent's perceptions of burden. Due to the relatively unconstraining assumptions and methods of response elicitation required, multidimensional instruments are particularly useful for investigating questions in the complex areas of burden. Overall, the multidimensional burden measures for caregivers that identify components of the construct can help in advancing knowledge, and evaluating interventions. In addition, the multidimensional burden measures can also be used for professional assessment, decisions, and counseling.