比較Zarit照顧者負荷量表各版本於失智症照顧者之心理計量特性

Comparison of Psychometric Properties of Each Forms in the Zarit Burden Interview in Caregivers of People With Dementia

背景與目的：失智症者有許多精神及異常行為，使照顧者承受巨大的壓力，故需透過量表瞭解其負荷程度。Zarit照顧者負荷量表（Zarit Burden Interview, ZBI）目前廣泛用於評估失智症照顧者負荷，完整版有22題，亦有18、14、12、9、8、7、6、4、1題之短版。本研究為驗證ZBI各版本應用於失智症照顧者之內在一致性信度（internal consistency）及收斂效度（convergent validity）。方法：共招募80名受試者，填寫ZBI、Novak照顧者負荷量表（Caregiver Burden Inventory, CBI）、Elmståhl照顧者負荷量表（Caregiver Burden Scale, CBS）。以Cronbach’s α檢驗內在一致性信度，以皮爾森相關係數分析ZBI完整版與各短版及ZBI各版本與CBI、CBS之相關程度。結果：ZBI完整版、12題-Hébert及Ballesteros版本為優良內在一致性信度，其餘短版為良好內在一致性信度。於收斂效度方面，ZBI完整版與各短版相關程度高，ZBI各版本與CBI評估概念相似，與CBS中環境面向相關程度較低。結論：ZBI完整版可較全面評估失智症照顧者負荷，若填寫有時間的限制，可使用12題-Hébert或12題-Ballesteros版本。經收斂效度驗證，結果為ZBI較無評估失智症照顧者於環境之負荷。

Background: People with dementia show mental symptoms and abnormal behaviors, which turns out great pressures on caregivers. It is necessary to use assessments to understand the levels of burden for caregivers in order to verify their burden conditions. The Zarit burden interview (ZBI) is the most widely measure to assess the caregiver burden. The ZBI contains 22 items. It also has short form (i.e., 18-item, 14-item, 12-item, 9-item, 8-item, 7-item, 6-item, 4-item and 1-item). The purpose of this study was to compare internal consistency and convergent validity of the ZBI and its short forms in caregivers of people with dementia for affirming the utility. Methods: Eighty caregivers of people with dementia completed four caregiver burden measures, including: the ZBI, Caregiver burden inventory (CBI), Caregiver burden scale (CBS). Cronbach’s alpha (α) was used to examine the internal consistency of the ZBI and its short forms. Pearson’s r was applied to analyze the correlations among the ZBI full version and short forms, and among the ZBI full version/short forms, CBI and CBS for examining the convergent validity. Results: For reliability, the ZBI full version and the 12-item Hébert and 12-item Ballesteros versions demonstrated excellent internal consistency, while the other short form displayed good internal consistency. For convergence validity, ZBI full version and short forms, showing high correlations, the concepts of the ZBI/short forms were similar to those of the CBI. Compared with other dimensions of the CBS, the ZBI/short forms revealed relative low correlations with the environmental dimension of the CBS. Conclusions: According to the results of the psychometric properties in this study, the ZBI full version can better assess the burden of dementia caregivers comprehensively. If there is a time limit for filling in, dementia caregivers can use the 12-item Hébert and 12-item Ballesteros. This study was verified by convergent validity, and the results indicated that the ZBI content had less assessment of caregiver burden in the environmental aspect.