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    Zarit Burden Interview-Asli

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    Rosy Rosnawanti
    The Zarit Burden Interview is a questionnaire for caregivers of elderly or disabled relatives. It contains 22 questions that caregivers answer on a scale of 0 to 4 to assess how caring for their relative affects different aspects of their life. The total score is interpreted as little to no burden, mild to moderate burden, moderate to severe burden, or severe burden.

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    © All Rights Reserved
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    Zarit Burden Interview-Asli

    Uploaded by

    Rosy Rosnawanti
    190 views2 pages
    The Zarit Burden Interview is a questionnaire for caregivers of elderly or disabled relatives. It contains 22 questions that caregivers answer on a scale of 0 to 4 to assess how caring for their relative affects different aspects of their life. The total score is interpreted as little to no burden, mild to moderate burden, moderate to severe burden, or severe burden.

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    © © All Rights Reserved

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    The Zarit Burden Interview is a questionnaire for caregivers of elderly or disabled relatives. It contains 22 questions that caregivers answer on a scale of 0 to 4 to assess how caring for their relative affects different aspects of their life. The total score is interpreted as little to no burden, mild to moderate burden, moderate to severe burden, or severe burden.

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    190 views2 pages

    Zarit Burden Interview-Asli

    Uploaded by

    Rosy Rosnawanti
    The Zarit Burden Interview is a questionnaire for caregivers of elderly or disabled relatives. It contains 22 questions that caregivers answer on a scale of 0 to 4 to assess how caring for their relative affects different aspects of their life. The total score is interpreted as little to no burden, mild to moderate burden, moderate to severe burden, or severe burden.

    Copyright:

    © All Rights Reserved
    Download as RTF, PDF, TXT or read online from Scribd
    Download as rtf, pdf, or txt
    of 2

    T he Zarit Burden Interview

    0 : NEVER
    1 : RARELY
    2 : SOMETIMES
    3 : QUITE FREQUENTLY
    4 : NEARLY ALWAYS

    Please circle the response the best describes how you feel.

    Question Score

    1 Do you feel that your relative asks for more help than he/she needs? 0 1 2 3 4

    2 Do you feel that because of the time you spend with your relative that
    0 1 2 3 4
    you don’t have enough time for yourself?

    3 Do you feel stressed between caring for your relative and trying
    0 1 2 3 4
    to meet other responsibilities for your family or work?

    4 Do you feel embarrassed over your relative’s behaviour? 0 1 2 3 4

    5 Do you feel angry when you are around your relative? 0 1 2 3 4

    6 Do you feel that your relative currently affects our relationships


    0 1 2 3 4
    with other family members or friends in a negative way?

    7 Are you afraid what the future holds for your relative? 0 1 2 3 4

    8 Do you feel your relative is dependent on you? 0 1 2 3 4

    9 Do you feel strained when you are around your relative? 0 1 2 3 4

    10 Do you feel your health has suffered because of your involvement


    0 1 2 3 4
    with your relative?

    11 Do you feel that you don’t have as much privacy as you would like
    0 1 2 3 4
    because of your relative?

    12 Do you feel that your social life has suffered because you are caring
    0 1 2 3 4
    for your relative?
    Question Score

    13 Do you feel uncomfortable about having friends over because of your


    relative? 0 1 2 3 4

    14 Do you feel that your relative seems to expect you to take care of
    0 1 2 3 4
    him/her as if you were the only one he/she could depend on?

    15 Do you feel that you don’t have enough money to take care of your
    0 1 2 3 4
    relative in addition to the rest of your expenses?

    16 Do you feel that you will be unable to take care of your relative much
    0 1 2 3 4
    longer?

    17 Do you feel you have lost control of your life since your relative’s
    0 1 2 3 4
    illness?

    18 Do you wish you could leave the care of your relative to someone
    0 1 2 3 4
    else?

    19 Do you feel uncertain about what to do about your relative? 0 1 2 3 4

    20 Do you feel you should be doing more for your relative? 0 1 2 3 4

    21 Do you feel you could do a better job in caring for your relative? 0 1 2 3 4

    22 Overall, how burdened do you feel in caring for your relative? 0 1 2 3 4

    Interpretation of Score:
    0 - 21 little or no burden
    21 - 40 mild to moderate burden
    41 - 60 moderate to severe burden
    61 - 88 severe burden

    Patient last name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date of birth: . . . . / . . . . / . . . . . . . .


    Patient first name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . Date: . . . . / . . . . / . . . . . . . .

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