A burden questionnaire for caregivers of peritoneal dialysis patients

University of Barcelona, Barcino, Catalonia, Spain
Nefrologia: publicacion oficial de la Sociedad Espanola Nefrologia (Impact Factor: 1.22). 02/2006; 26(1):74-83.
Source: PubMed


Despite the interest generated by the increasing number of studies that measure Quality of Life among patients and caregivers, few of these studies measure the caregivers burden in Peritoneal Dialysis (PD).
The main target of this study was to create a burden measure questionnaire applicable amongst caregivers of PD patients.
Inclusion criteria: 1) Patients had to be in PD treatment for more than 3 months; 2) Patients had to receive help with the PD treatment from a caregiver. The study was divided into 3 phases: 1st) design and use of the initial questionnaire; 2nd) a test-retest on a modified scale; and 3rd) to provide the questionnaire-3 to two collaborative centres with similar PD programs. Four groups of caregivers were established: A1:23, A2:17, B:7 and C:16 caregivers. We applied 5 scales (5): 1--Patient Dependence on caregiver, from caregivers' view (D); 2--Complete caregiver burden (CB), including 12 items which measure the caregivers' subjective burden, 3--Reduced caregiver burden (RB), as the one before but with only 8 items, 4--Repercussions on the caregiver (R), which measures objective burden; 5--Specific PD tasks (ST), a scale that measures the effort the tasks implied in the PD treatment represent for the caregiver.
We studied 63 caregivers (table I): mean age: 53.43 (SD = 12.3); Sex: Females: 86.4%, Males: 13.6%, corresponding to 63 patients: mean age: 59.79 (SD = 15.9); Sex: Males: 80.3%, Females: 19.7%. Valuable results for reliability, unidimensionality, and discrimination were obtained in the 1st and 2nd phases, except for burden scale which was compound of two factors; then one of those factors was suppressed. In the 3rd phase, ANOVA did not show any differences between centres (table II). Consequently, all caregivers could be analysed together. Reliability results for each one of the third phase scales (table III) were: D: Cronbach alpha = 0,886; CB: alpha = 0,894; RB: alpha = 0,857; R: alpha = 0,892; ST: alpha = 0,62. Although the ST scale obtained an acceptable reliability, it was suppressed in the 3rd phase due to the low correlation with other scales and the fact that it was not applicable to all caregivers. Finally, a direct correlation was found between third phase scales (table IV): D-RB: r = 0.502, p < or = 0.001; D-R: r = 0.599, p < or = 0.001; RB-R: r = 0.775, p < or = 0.001. We must headlight that both Burden scales, and the Repercussion scale, obtained a direct correlation with the Dependency scale.
A questionnaire has been created to measure burden and repercussions on caregivers of peritoneal dialysis patients. It can already be applied, as requirements of both reliability and validity are fulfilled. This questionnaire can be a useful tool to prevent caregivers' burnout.

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Available from: Josep Teixidó-Planas, Aug 12, 2015
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    ABSTRACT: Quality of life (QL) issues are now recognized as important outcome measures in health care, cost-effective analyses of the efficacy of medical care and clinical trials, and therapeutic interventions for chronic conditions, including end-stage renal disease (ESRD). QL also factors in the decision-making process for dialysis treatment selection [1]. The past decade has seen a tremendous surge in research publications that have included measures of QL. A search on PubMed in March 2007 using the terms “quality of life” and “dialysis” yielded 1,951 publications of which 1,330 were published within the last 10 years. Hemodialysis (HD) is still the primary focus of treatment in many of these studies; only a relatively low number of studies examine quality of life in patients on peritoneal dialysis (PD). PD has less research compared to HD because it is a newer therapy and, until recently, has been limited to selected ESRD patients requiring dialysis.
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    ABSTRACT: Background: There are a limited number of scales available in the Spanish language that can be used to detect burden among individuals who care for a dependent family member. The purpose of this work was to adapt and validate the Caregiver Risk Screen (CRS) scale developed by Guberman et al. (2001) (Guberman, N., Keefe, J., Fancey, P., Nahmiash, D. and Barylak, L. (2001). Development of Screening and Assessment Tools for Family Caregivers: Final Report. Montreal, Canada: Health Transition Fund). Methods: The sample was made up of 302 informal caregivers of dependent family members (average age 57.3 years, and 78.9% were women). Scale structure was subjected to a confirmatory factor analysis. Concurrent and convergent validity were assessed by correlation with validated questionnaires for measuring burden (Zarit Burden Inventory (ZBI)) and psychological health (SCL-90-R). Results: The results show a high level of internal consistency (Cronbach's alpha = 0.86), suitable fit of the one-dimensional model tested via confirmatory factor analysis (GFI = 0.91; CFI = 0.91; RMSEA = 0.097), and appropriate convergent validity with similar constructs (r = 0.77 with ZBI; and r-values between 0.45 and 0.63 with SCL-90-R dimensions). Conclusions: The findings are promising in terms of their adaptation of the CRS to Spanish, and the results enable us to draw the conclusion that the CRS is a suitable tool for assessing and detecting strain in family caregivers. Nevertheless, new research is required that explores all the psychometric features on the scale.
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