Gräßel and Adabbo (2011) defined informal caregiver burden as the subjective perception of stress that results from a domestic care situation. The extent to which a caregiver (CG) feels stressed varies from person to person. Subjective burden is associated with various effects: The greater the subjective burden of the CG, the greater the effects, namely, (a) psychological complaints, especially depression (e.g., del-Pino-Casado et al., 2019; del-Pino-Casado et al, 2021), (b) physical complaints, such as cardiovascular disease (Ahn et al., 2022), and (c) unfavorable behaviors of the CG toward the care-recipient (Boye & Yan, 2018), most frequently including verbal aggression (Storey, 2020). However, the risk that home care will have health consequences for CGs is also influenced by personality traits (e.g., neuroticism and optimism) and individual competence (e.g., perceiving oneself as competent in the care situation) (van der Lee et al., 2014).
The operationalization of the concept of the subjective burden of the CG is based on two central models: the Caregiver Stress Model by Pearlin et al. (1990) and the Transactional Stress Model by Lazarus and Folkman (1984).
The Caregiver Stress Model postulates five interrelated components of caregiver burden: socioeconomic factors (e.g., income, education), primary stressors (e.g., the subjective experience of disadvantage), secondary stressors (e.g., challenges in professional life arising from the caregiving situation), secondary intrapsychic stressors (e.g., conflicts between one’s job and caregiving demands), and the general effects of caregiver burden (e.g., health consequences).
By contrast, the Transactional Stress Model outlines the idea that stress depends on the CG’s primary and secondary appraisals (i.e., cognitive processes). Thus, a CG’s subjective burden depends on how the CG assesses the care situation (primary appraisal) and the extent to which they feel able to deal with this situation (secondary appraisal; see Graessel & Adabbo, 2011).
The Burden Scale for Family Caregivers (BSFC) is an instrument for recording a CG’s subjective burden. It was developed and validated for CGs, regardless of the cause of the need for care (e.g., stroke, cancer, rheumatism, dementia), regardless of the relationship of the CGs to the care-recipients (caregiving parent, caregiving partner, caregiving adult children, no degree of kinship with relatives), and also regardless of the intensity of the need for help (from light support to severe need for care). There is a long form of the BSFC, which has 28 items, and a short form called the BSFC-s, which has 10 items.
Ahn, S., Esquivel, J. H., Davis, E. M., Logan, J. G., & Chung, M. L. (2022). Cardiovascular disease incidence and risk in family caregivers of adults with chronic conditions: a systematic review. Journal of Cardiovascular Nursing, 37(3), E47-E60.
Boye, F. & Yan, E. (2018). Abuse of older persons with dementia: A review of the literature. Trauma, Violence & Abuse, 19(2), 127-147.
del-Pino-Casado, R., Priego-Cubero, E., López-Martínez, C. & Orgeta, V. (2021). Subjective caregiver burden and anxiety in informal caregivers: A systematic review and meta-analysis. PLOS ONE, 16(3), e0247143.
del-Pino-Casado, R., Rodriguez Cardosa, M., López-Martínez, C. & Orgeta, V. (2019). The association between subjective caregiver burden and depressive symptoms in carers of older relatives: A systematic review and meta-analysis. PLOS ONE, 14(5), e0217648.
Gräßel, E. & Adabbo, R. (2011). Perceived burden of informal caregivers of a chronically ill older family member. The Journal of Gerontopsychology and Geriatric Psychiatry, 24, 143-154. doi:10.1024/1662-9647/a000042
Lazarus, R.S. & Folkman, S. (1984). Stress, appraisal, and coping. New York, NY: Springer.
Pearlin, L.I., Mullan, J.T., Semple, S.J. & Skaff, M.M. (1990). Caregiving and the stress process: An overview of concepts and their measures. The Gerontologist, 30, 583-594. doi:10.1093/geront/30.5.583
Schulz, R. & Beach, S. R. (1999). Caregiving as a risk factor for mortality: the Caregiver Health Effects Study. Jama, 282(23), 2215-2219.
Storey, J. E. (2020). Risk factors for elder abuse and neglect: A review of the literature. Aggression and Violent Behavior, 50, 101339.
Van der Lee, J., Bakker, T. J., Duivenvoorden, H. J. & Dröes, R. M. (2014). Multivariate models of subjective caregiver burden in dementia: a systematic review. Ageing Research Reviews, 15, 76-93.
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Burden Scale for Family Caregivers (BSFC); Burden Scale for Family Caregivers – short form (BSFC-s); Informal Caregiver (CG)