The Zarit Caregiver Burden Interview

The Zarit Caregiver Burden Interview
[select name="Q1" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <-- Do you feel that you don't have enough time for yourself because of the time you spend with the person for whom you are providing care?
[select name="Q2" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel stressed between caring for this person and trying to meet other responsibilities (work, family)?
[select name="Q3" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel angry when you are around this person?
[select name="Q4" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel that this person currently affects your relationships with family members or friends in a negative way?
[select name="Q5" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel strained when you are around this person?
[select name="Q6" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel that your health has suffered because of your involvement with this person?
[select name="Q7" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel that you don't have as much privacy as you would like because of this person?
[select name="Q8" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel that your social life has suffered because you are caring for this person?
[select name="Q9" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel that you have lost control of your life since this person's illness began?
[select name="Q10" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel uncertain about what to do about this person?
[select name="Q11" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel you should be doing more for this person?
[select name="Q12" value="Never (0 points)=0|Rarely (1 point)=1|Sometimes (2 points)=2|Quite Frequently (3 points)=3|Nearly Always (4 points)=4"] <--Do you feel you could do a better job in caring for this person?

Total Score --> [calc memo="number" value="score=(Q1)+(Q2)+(Q3)+(Q4)+(Q5)+(Q6)+(Q7)+(Q8)+(Q9)+(Q10)+(Q11)+(Q12)"] / 48 (higher scores correlate with higher levels of burden)
[checkbox memo="display/hide references" name="footnotes" value=""][conditional field="footnotes" condition="(footnotes).is('')"]
reference:
[link url="//www.ncbi.nlm.nih.gov/pubmed/11574710" memo="#1"] Bédard M, Molloy DW, Squire L, Dubois S, Lever JA, O'Donnell M. The Zarit Burden Interview: a new short version and screening version. Gerontologist. 2001;41(5):657.
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