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Cross-cultural study of caregiver burden for Alzheimer's disease in Japan and Taiwan: result from Dementia Research in Kumamoto and Tainan (DeReKaT)

Published online by Cambridge University Press:  28 January 2016

Masateru Matsushita ,
Ming-Chyi Pai ,
Cai-Ying Jhou ,
Asuka Koyama  and
Manabu Ikeda
Masateru Matsushita
Affiliation:
Center for Medical Education and Research, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
Ming-Chyi Pai*
Affiliation:
Division of Behavioral Neurology, Department of Neurology, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan Alzheimer's Disease Research Center, National Cheng Kung University Hospital, Tainan, Taiwan
Cai-Ying Jhou
Affiliation:
Alzheimer's Disease Research Center, National Cheng Kung University Hospital, Tainan, Taiwan
Asuka Koyama
Affiliation:
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
Manabu Ikeda
Affiliation:
Department of Neuropsychiatry, Faculty of Life Sciences, Kumamoto University, Kumamoto, Japan
*
Correspondence should be addressed to: Ming-Chyi Pai, Department of Neurology, National Cheng Kung University Hospital, 138 Sheng Li Road, Tainan 704, Taiwan. Phone: +886-6-235-3535 ext 5534; Fax: +886-6-208-8036. Email: [email protected].
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Abstract

Background:

Caregiver burden (CB) of Alzheimer's disease (AD) in Taiwan is becoming an urgent social issue as well as that in Japan. The comparison of CB may explain how caregiver feels burden in each country.

Methods:

The participants were 343 outpatients with AD and their caregivers of Japan (n = 230) and Taiwan (n = 113). We assessed the CB using the Japanese and Chinese version of Zarit Caregiver Burden Interview (ZBI). The initial analysis was an exploratory factor analysis for each group to confirm the factor structure of ZBI. Then, the multiple-group structural equation modeling (MG-SEM) was used to assess the measurement invariance of ZBI such as configural, metric, and scalar invariances. Lastly, we compared the latent factor means of the ZBI between Japan and Taiwan.

Results:

In both groups, the confirmatory factor analysis extracted 3 factors which were labeled “Impact on caregiver's life”, “Embarrassed/anger”, and “Dependency”. The MG-SEM indicated an acceptable model fit, and established the partial scalar measurement invariance (comparative fit index (CFI) = 0.901, root mean square error of approximation (RMSEA) = 0.066). When we compared the latent factor means, the score of “Impact on caregiver's life” in Taiwanese caregivers was significantly higher than that in Japanese (p = 0.001). However, “Dependency” in Taiwanese caregivers was lower than that in Japanese (p < 0.001).

Conclusions:

Partial measurement invariance allowed comparing the latent factor mean across two countries. The results of comparisons suggested that there may be differences in the way of feeling CB between Japan and Taiwan.

Keywords

caregiver burdenAlzheimer's diseaseinternational
Type
Research Article
Information
International Psychogeriatrics , Volume 28 , Issue 7 , July 2016 , pp. 1125 - 1132
Copyright
Copyright © International Psychogeriatric Association 2016 

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References

Ankri, J., Andrieu, S., Beaufils, B., Grand, A., and Henrard, J. C. (2005). Beyond the global score of the Zarit Burden Interview: useful dimensions for clinicians. International Journal of Geriatric Psychiatry, 20, 254–260.Google Scholar
Arai, Y., Kudo, K., Hosokawa, T., Washio, M., Miura, H. and Hisamichi, S. (1997). Reliability and validity of the Japanese version of the Zarit Caregiver Burden interview. Psychiatry and Clinical Neurosciences, 51, 281–287.Google Scholar
Aranda, M. P. and Knight, B. G. (1997). The influence of ethnicity and culture on the caregiver stress and coping process: a socio-cultural review and analysis. The Gerontologist, 37, 342–354.Google Scholar
Asada, T. (2012). Prevalence of dementia in Japan: past, present and future. Rinsho Shinkeigaku, 52, 962–964. (in Japanese)Google Scholar
Bédard, M., Molloy, D. W., Squire, L., Dubois, S., Lever, J. A. and O'Donnell, M. (2001). The Zarit Burden interview: a new short version and screening questionnaire. Gerontologist, 41, 652–657.Google Scholar
Council for Economic Planning and Development of Taiwan. (2008). 2008–2056 Population Projection in Taiwan ROC. [Cited 23 July 2014.] Available from URL: http://www.cepd.gov.tw/m1.aspx?sNo=0000455&key=&ex=%20&ic= (In Chinese).Google Scholar
Flynn Longmire, C. V. and Knight, B. C. (2011). Confirmatory factor analysis of a brief version of the Zarit Burden interview in black and white dementia caregivers. Gerontologist, 51, 453–462.Google Scholar
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). ‘Mini-mental state’. A practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatric Research, 12, 189–198.CrossRefGoogle Scholar
George, L. K. and Gwyther, L. P. (1998). Caregiver well-being: a multidimensional examination of family caregivers of demented adults. Gerontologist, 26, 254–259.Google Scholar
Héberta, R., Bravo, G. and Préville, M. (2000). Reliability, validity and reference value of the Zarit Burden interview for assessing informal caregivers of community-dwelling older persons with dementia. Canadian Journal on Aging, 19, 494–507.Google Scholar
Huang, C. Y. (2004). Informal female care givers of older adults with dementia in Taiwan. California Journal of Health Promotion, 2, 53–66.Google Scholar
Huang, H. L., Shyu, Y. I., Chang, M. Y., Weng, L. C. and Lee, I. (2009). Willingness to use respite care among family caregivers in Northern Taiwan. Journal of Clinical Nursing, 18, 191–198.Google Scholar
Knight, B. G., Robinson, G. S., Longmire, C. V. F., Chun, M., Nakao, K. and Kim, J. H. (2002). Cross cultural issues in caregiving for persons with dementia: Do familism values reduce burden and distress?. Aging International, 27, 70–94.Google Scholar
Knight, B. G., Silverstein, M., McCallum, T. J. and Fox, L. S. (2000). A sociocultural stress and coping model for mental health outcomes among African-American caregivers in Southern California. Journal of Gerontology, 55, 142–150.Google Scholar
Ko, K. T., Yip, P. K., Liu, S. I. and Huang, C. R. (2008). Chinese version of the Zarit caregiver Burden interview: a validation study. The American Journal of Geriatric Psychiatry, 16, 513–518.Google Scholar
Lin, R. T., Lai, C. L., Tai, C. T., Liu, C. K., Yen, Y. Y. and Howng, S. L. (1998). Prevalence and subtypes of dementia in southern Taiwan: impact of age, sex, education, and urbanization. Journal of the Neurological Sciences, 160, 67–75.Google Scholar
Liu, C. K., Lai, C. L., Tai, C. T., Lin, R. T., Yen, Y. Y. and Howng, S. L. (1998). Incidence and subtypes of dementia in southern Taiwan: impact of socio-demographic factors. Neurology, 50, 1572–1579.Google Scholar
Liu, C. K., Lin, R. T., Chen, Y. F., Tai, C. T., Yen, Y. Y. and Howng, S. L. (1996). Prevalence of dementia in an urban area in Taiwan. Journal of the Formosan Medical Association, 95, 762–768.Google Scholar
Liu, H. C. et al. (1995). Prevalence and subtypes of dementia in Taiwan: a community survey of 5297 individuals. Journal of the American Geriatrics Society, 43, 144–149.Google Scholar
McKhann, G. et al. (2011). The diagnosis of dementia due to Alzheimer's disease: recommendations from the national institute on aging-Alzheimer's association workgroups on diagnostic guidelines for Alzheimer's disease. Alzheimer's and Dementia, 7, 263–269.Google Scholar
O'Rourke, N. and Tuokko, H. A. (2003). The relative utility of four abridged version of the Zarit Burden interview. Journal of Mental Health and Aging, 9, 55–64.Google Scholar
Ono, T., Tamai, A., Takeuchi, D. and Tamai, Y. (2014). Factors related to day-care clinic outcomes for dementia patients: differences between hospitalization in the dementia ward and institutionalization. Psychogeriatrics, 14, 17–24.Google Scholar
Pai, M. C. (2006). The neuropsychological studies of dementias in Taiwan: focus on way-finding problems in Alzheimer's patients. Acta Neurologica Taiwanica, 15, 58–60.Google Scholar
Pai, M. C. et al. (2012). Development of a questionnaire on everyday navigational ability to assess topographical disorientation in Alzheimer's disease. American Journal of Alzheimer's Disease and Other Dementias, 27, 65–72.Google Scholar
Pai, M. C. and Jacobs, W. J. (2004). Topographical disorientation in community-residing patients with Alzheimer's disease. International Journal of Geriatric Psychiatry, 19, 250–255.Google Scholar
Salguero, R. H., Kohn, R., Salguero, L. F. and Marotta, C. A. (1998). Caregivers of persons with Alzheimer's disease: cultural differences in perceived caregiver burden in Guatemala and Rhode Island. Journal of Cross-Cultural Gerontology, 13, 229–240.Google Scholar
Schumacker, R. E. and Lomax, R. G. (2004). A Beginner's Guide to Structural Equation Modeling, 2nd Edition. New Jersey: Lawrence Erlbaum Associates.Google Scholar
Statistic Bureau, Ministry of Internal Affairs and Communications of Japan. (2013). Population estimate. [Cited 23 July 2014.] Available from URL: http://www.stat.go.jp/data/jinsui/new.htm. (In Japanese)Google Scholar
Whitlatch, C. J., Zarit, S. H. and von Eye, A. (1991). Efficacy of interventions with caregivers: a reanalysis. Gerontologist, 31, 9–14.Google Scholar