Turkiye Klinikleri Journal of Nursing Sciences

.: REVIEW
Assessing the Reliability of the Zarit Caregiver Burden Interview: A Comprehensive Reliability Generalization Meta-Analysis
Zarit Bakım Veren Yükü Ölçeği'nin Güvenilirliğinin Değerlendirilmesi: Kapsamlı Bir Güvenilirlik Genelleme Meta-Analizi
Gülyeter ERDOĞAN YÜCEa , Nuray CANERb
aAksaray University Faculty of Health Sciences, Department of Emergency Aid and Disaster Management, Aksaray, Türkiye
bErciyes University Faculty of Health Sciences, Department of Nursing, Department of Child Health and Diseases Nursing, Kayseri, Türkiye
Turkiye Klinikleri J Nurs Sci. 2025;17(3):978-91
doi: 10.5336/nurses.2024-107612
Article Language: EN
Full Text
ABSTRACT
 Caregiving is a common role, and assessing caregiver burden requires culturally appropriate tools. The Zarit Caregiver Burden Interview (ZBI) is widely used and adapted across cultures. This study aimed to perform a reliability generalization meta-analysis of Cronbach's alpha for the ZBI. A systematic search was conducted in Elton Bryson Stephens Company, PubMed, Scopus, and Web of Science databases up to September 2023. Studies reporting Cronbach's alpha for the ZBI were included. A Random Effects Model with a Restricted Maximum Likelihood approach was used to estimate pooled Cronbach's alpha values. Heterogeneity was assessed using Tau2 , I2 , and Cochran's Q statistics. Publication bias was evaluated through Rosenthal's safe N, Egger regression test, Kendall's Tau, and a funnel plot. Moderator analysis was conducted using a mixed-effects model. A total of 41 studies with 7,818 participants were analyzed. The pooled Cronbach's alpha was 0.89 (95% confidence interval: 0.88-0.91), with high heterogeneity (I2 =94.52%). Moderator analysis showed that study location and sample type significantly influenced alpha values. Higher caregiver age and greater variability in ZBI scores were associated with higher alpha values. No publication bias was detected. The ZBI is a reliable tool across various cultures and caregiver groups. It can be effectively used in clinical and research settings to assess caregiver burden.

Keywords: Caregiver; caregiver burden; Zarit Caregiver Burden Interview; reliability; meta-analysis
ÖZET
 Bakım verme, yaygın bir rol olup, bakım verenlerin yükünü değerlendirmek için kültürel olarak uygun araçlara ihtiyaç vardır. Zarit Bakım Veren Yükü Ölçeği [Zarit Caregiver Burden Interview (ZBI)], dünya genelinde yaygın olarak kullanılan ve farklı kültürlere adapte edilen bir ölçektir. Bu çalışmada, ZBI'nin Cronbach alfa katsayısına dayalı bir güvenilirlik genelleme metaanalizi yapılması amaçlanmıştır. Bu amaç doğrultusunda Elton Bryson Stephens Company, PubMed, Scopus ve Web of Science veri tabanları Eylül 2023'e kadar sistematik olarak incelenmiştir. Cronbach alfa katsayısını raporlayan çalışmalar tüm çalışmalar metaanalize dâhil edilmiştir. Cronbach alfa değeri Rastgele Etkiler Modeli ve Kısıtlı Maksimum Olabilirlik yaklaşımı ile tahmin edilmiştir. Heterojenlik Tau2 , I2 ve Cochran Q istatistikleriyle ve yayın yanlılığı, Rosenthal'ın güvenli N değeri, Egger regresyon testi, Kendall's Tau ve huni grafiğiyle incelenmiştir. Moderatör analizinde ise, karışık etkiler modeli kullanılmıştır. Toplam 7.818 katılımcının yer aldığı 41 çalışma analiz edilmiştir. Birleşik Cronbach alfa katsayısı 0,89 (%95 güven aralığı: 0,88-0,91) olarak bulunmuş ve çalışmalar arasında yüksek düzeyde heterojenlik gözlemlenmiştir (I2 =%94,52). Moderatör analizi, çalışmanın yapıldığı yer ve örneklem tipinin alfa değerlerini anlamlı bir şekilde etkilediğini göstermiştir. Bakım verenlerin yaş ortalamasının yüksek olması ve ZBI puanlarındaki değişkenliğin artması, yüksek alfa değerleriyle ilişkilendirilmiştir. Yayın yanlılığı tespit edilmemiştir. Sonuç olarak ZBI'nin, farklı kültürler ve bakım veren gruplar arasında güvenilir bir araç olduğu doğrulamıştır. ZBI hem klinik hem de araştırma ortamlarında bakım yükünü değerlendirmek için etkili bir şekilde kullanılabilir.

Anahtar Kelimeler: Bakım veren; bakım yükü; Zarit Bakım Veren Yük Ölçeği; güvenilirlik; metaanaliz
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4.4. "USER"s cannot act against "Turkiye Klinikleri", other "USER"s and third parties by using the "SITE". "Turkiye Klinikleri" has no direct and/or indirect responsibility for any damage a third party suffered or will suffer regarding "USER"s actions on the "SITE" against the rules of the hereby "Terms of Use" and the law.

4.5. "USER"s accept and undertake that the information and context they provided to the "SITE" are accurate and legal. "Turkiye Klinikleri" is not liable and responsible for promising and guaranteeing the verification of the information and context transmitted to "Turkiye Klinikleri" by the "USER"s, or uploaded, changed and provided through the "SITE" by them and whether these information are safe, accurate and legal.

4.6. "USER"s agree and undertake that they will not perform any action leading to unfair competition, weakening the personal and commercial credit of "Turkiye Klinikleri" and a third party,  encroaching and attacking on personal rights within the "SITE" in accordance with the Turkish Commercial Code Law.

4.7. "Turkiye Klinikleri" reserves the right to change the services and the context within the "SITE"  anytime. "Turkiye Klinikleri" may use this right without any notification and timelessly. "USER"s have to make the changes and/or corrections "Turkiye Klinikleri" required immediately. Any changes and/or corrections that are required by "Turkiye Klinikleri", may be made by "Turkiye Klinikleri" when needed. Any harm, criminal and civil liability resulted or will result from changes and/or corrections required by "Turkiye Klinikleri" and were not made on time by the "USER"s belongs completely to the users.

4.8. "Turkiye Klinikleri" may give links through the "SITE" to other websites and/or "CONTEXT"s and/or folders that are outside of their control and owned and run by third parties. These links are provided for ease of reference only and do not hold qualification for support the respective web SITE or the admin or declaration or guarantee for the information inside. "Turkiye Klinikleri" does not hold any responsibility over the web-sites connected through the links on the "SITE", folders and context, the services or products on the websites provided through these links or their context.

4.9. "Turkiye Klinikleri" may use the information provided to them by the "USERS" through the "SITE" in line with the terms of the "PRIVACY POLICY" and "USER CONTRACT". It may process the information or classify and save them on a database. "Turkiye Klinikleri" may also use the USER's or visitor's identity, address, e-mail address, phone number, IP number, which sections of the "SITE" they visited, domain type, browser type, date and time information to provide statistical evaluation and customized services.

5. PROPRIETARY RIGHTS

5.1. The information accessed through this "SITE" or provided by the users legally and all the elements (including but not limited to design, text, image, html code and other codes) of the "SITE" (all of them will be called as studies tied to "Turkiye Klinikleri"s copyrights) belongs to "Turkiye Klinikleri". Users do not have the right to resell, process, share, distribute, display or give someone permission to access or to use the "Turkiye Klinikleri" services, "Turkiye Klinikleri" information and the products under copyright protection by "Turkiye Klinikleri". Within hereby "Terms of Use" unless explicitly permitted by "Turkiye Klinikleri" nobody can reproduce, process, distribute or produce or prepare any study from those under "Turkiye Klinikleri" copyright protection.

5.2. Within hereby "Terms of Use", "Turkiye Klinikleri" reserves the rights for "Turkiye Klinikleri" services, "Turkiye Klinikleri" information, the products associated with "Turkiye Klinikleri" copyrights, "Turkiye Klinikleri" trademarks, "Turkiye Klinikleri" trade looks or its all rights for other entity and information it has through this website unless it is explicitly authorized by "Turkiye Klinikleri".

6. CHANGES IN THE TERMS OF USE

"Turkiye Klinikleri" in its sole discretion may change the hereby "Terms of Use" anytime announcing within the "SITE". The changed terms of the hereby "Terms of Use" will become valid when they are announced. Hereby "Terms of Use" cannot be changed by unilateral declarations of users.

7. FORCE MAJEURE

"Turkiye Klinikleri" is not responsible for executing late or never of this hereby "Terms of Use", privacy policy and "USER Contract" in any situation legally taken into account as force majeure. Being late or failure of performance or non-defaulting of this and similar cases like this will not be the case from the viewpoint of "Turkiye Klinikleri", and "Turkiye Klinikleri" will not have any damage liability for these situations. "Force majeure" term will be regarded as outside of the concerned party's reasonable control and any situation that "Turkiye Klinikleri" cannot prevent even though it shows due diligence. Also, force majeure situations include but not limited to natural disasters, rebellion, war, strike, communication problems, infrastructure and internet failure, power cut and bad weather conditions.

8. LAW AND AUTHORISATION TO FOLLOW

Turkish Law will be applied in practicing, interpreting the hereby "Terms of Use" and managing the emerging legal relationships within this "Terms of Use" in case of finding element of foreignness, except for the rules of Turkish conflict of laws. Ankara Courts and Enforcement Offices are entitled in any controversy happened or may happen due to hereby contract.

9. CLOSING AND AGREEMENT

Hereby "Terms of Use" come into force when announced in the "SITE" by "Turkiye Klinikleri". The users are regarded to agree to hereby contract terms by using the "SITE". "Turkiye Klinikleri" may change the contract terms and the changes will be come into force by specifying the version number and the date of change on time it is published in the "SITE".

 

30.03.2014

Privacy Policy

We recommend you to read the terms of use below before you visit our website. In case you agree these terms, following our rules will be to your favor. Please read our Terms of Use thoroughly.

www.turkiyeklinikleri.com website belongs to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. and is designed in order to inform physicians in the field of health

www.turkiyeklinikleri.com cannot reach to user’s identity, address, service providers or other information. The users may send this information to the website through forms if they would like to. However, www.turkiyeklinikleri.com may collect your hardware and software information. The information consists of your IP address, browser type, operating system, domain name, access time, and related websites. www.turkiyeklinikleri.com cannot sell the provided user information (your name, e-mail address, home and work address, phone number) to the third parties, publish it publicly, or keep it in the website. Gathered information has a directing feature to be a source for the website’s visitor profile, reporting and promotion of the services.

www.turkiyeklinikleri.com uses the taken information:

-To enhance, improve and maintain the quality of the website

-To generate visitor’s profile and statistical data

-To determine the tendency of the visitors on using our website

-To send print publications/correspondences

-To send press releases or notifications through e-mail

-To generate a list for an event or competition

By using www.turkiyeklinikleri.com you are considered to agree that;

-Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. cannot be hold responsible for any user’s illegal and immoral behavior,

-Terms of use may change from time to time,

-It is not responsible for other websites’ contents it cannot control or the harms they may cause although it uses the connection they provided.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. may block the website to users in the following events:

-Information with wrong, incomplete, deceiving or immoral expressions is recorded to the website,

-Proclamation, advertisement, announcement, libelous expressions are used against natural person or legal identity,

-During various attacks to the website,

-Disruption of the website because of a virus.

Written, visual and audible materials of the website, including the code and the software are under protection by legal legislation.

Without the written consent of Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. the information on the website cannot be downloaded, changed, reproduced, copied, republished, posted or distributed.

All rights of the software and the design of the website belong to Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc.

Ortadoğu Advertisement Presentation Publishing Tourism Education Architecture Industry and Trade Inc. will be pleased to hear your comments about our terms of use. Please share the subjects you think may enrich our website or if there is any problem regarding our website.

info@turkiyeklinikleri.com