title: Validation of the Burden Index of Caregivers (BIC), a multidimensional short care burden scale from Japan.
abstract: BACKGROUND
  We constructed a concise multidimensional care burden scale that reflects circumstances unique to Japan, with a focus on intractable neurological diseases. We surveyed 646 family caregivers of patients with intractable neurological diseases or stroke using 28 preliminary care burden scale items obtained from qualitative research. The results were used to finalize the feeling of care burden scale (BIC: burden index of caregivers), and verify its reliability and validity.
  
  
  METHODS
  The survey was conducted among caregivers providing home health care to patients with intractable neurological diseases (PD [Parkinson's disease], SCD [spinocerebellar degeneration], MSA [multiple system atrophy], and ALS [amyotrophic lateral sclerosis]) or CVA (cerebrovascular accident) using a mailed, self-administered questionnaire between November, 2003 and May, 2004.
  
  
  RESULTS
  Response rates for neurological and CVA caregivers were 50% and 67%, respectively, or 646 in total (PD, 279; SCD, 78; MSA, 39; ALS, 30; and CVA, 220). Item and exploratory factor analyses led to a reduction to 11 items, comprising 10 items from the 5 domains of time-dependent burden, emotional burden, existential burden, physical burden, and service-related burden; and 1 item on total burden. Examination of validity showed a moderate correlation between each domain of the BIC and the SF-8 (Health related quality of life scale, Short Form-8), while the correlation coefficient of the overall BIC and CES-D was 0.62. Correlation between the BIC and ZBI, a preexisting care burden scale, was high (r = 0.84), while that with the time spent on providing care was 0.47. The ICC (Intraclass correlation coefficient) by test-retest reliability was 0.83, and 0.68 to 0.80 by individual domain.
  
  
  CONCLUSIONS
  These results show that the BIC, a new care burden scale comprising 11 items, is highly reliable and valid.
authors.affiliation: Department of Adult Nursing/Palliative Care Nursing, School of Health Sciences and Nursing, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan. miyasita-tky@umin.net
authors.forename: Mitsunori
authors.initials: M
authors.lastname: Miyashita
authors.forename: Aki
authors.initials: A
authors.lastname: Yamaguchi
authors.forename: Mami
authors.initials: M
authors.lastname: Kayama
authors.forename: Yugo
authors.initials: Y
authors.lastname: Narita
authors.forename: Norikazu
authors.initials: N
authors.lastname: Kawada
authors.forename: Miki
authors.initials: M
authors.lastname: Akiyama
authors.forename: Akiko
authors.initials: A
authors.lastname: Hagiwara
authors.forename: Yoshimi
authors.initials: Y
authors.lastname: Suzukamo
authors.forename: Shunichi
authors.initials: S
authors.lastname: Fukuhara
mesh_terms: D000368:Aged; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D005260:Female; D006701:Home Nursing / Q000523:psychology*; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009422:Nervous System Diseases / Q000145:classification / Q000451:nursing*; D011594:Psychometrics / Q000295:instrumentation*; D011788:Quality of Life; D018454:Spouses / Q000523:psychology; D013315:Stress, Psychological / Q000175:diagnosis*; D020521:Stroke / Q000451:nursing; D011795:Surveys and Questionnaires