Cross-cultural adaptation and psychometric validation of an Arabic version of the 12-item Zarit burden interview

Background

Globally, there is a demand for long-term care, driven by an aging population and the prevalence of chronic diseases. Informal caregivers play a role in contributing to healthcare services. The Zarit Burden Interview (ZBI-12) is one of the several scales that assess caregiver burden; however, its psychometric evaluation is lacking in the Arab context.

Aim

To test the internal consistency, structural validity (factor structure), and convergent validity of the 12-item ZBI translated version among informal caregivers.

Design

A cross-sectional, multiregional study.

Methods

A random sample of 476 informal caregivers was recruited from 11 cities across four regions in Saudi Arabia. After translating the ZBI-12, assessing content validity, and conducting pilot testing, a structured telephone interview was conducted. For exploratory and confirmatory factor analysis, the full sample was randomly split into two subsamples. To assess its convergent validity, a correlation analysis was conducted with the psychological distress scale. Internal consistency was assessed.

Results

Structural validity analysis supported the three-factor model: role strain, personal strain, and guilt. A positive correlation with psychological distress (r=0.461) supported convergent validity. Internal consistency was evidenced by the Cronbach's alpha coefficient (α=0.929) and McDonald's omega (ω =0.923).

Conclusion

The study demonstrates evidence that the Arabic ZBI-12 is a psychometrically robust scale. The availability of this version provides healthcare providers with a screening tool to identify caregiver burden in Arabic-speaking populations. It can be used in guiding evidence-based interventions. The scale has implications for cross-cultural research and the development of health policies related to Arab informal caregiving.

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