Therefore, the present study was performed to define a valid cutoff score for the FBIS to screen caregivers in need of further assessment and intervention. However, use of continuous value for total burden score is inconvenient when it comes to deciding whether to include or not a caregiver in a burden prevention or treatment program, in this occasion, a dichotomous classification is more needed. For FBIS, the score is mostly used as a continuous variable yet no valid cutoff score has ever been proposed. Each item is rated on a 3-point Likert scale from 0 (no burden) to 2 (serious burden), with a total score ranging from 0 to 48. Each category is composed of 2 to 6 items, adding up to 24 items for the whole FBIS. Originally developed by Pai and Kapur in 1981, the FBIS measures two aspects of burden (objective and subjective) encompassing six categories: financial burden, disruption of routine family activities, family leisure, family interactions, and effect on physical and mental health of others. The FBIS offered a relatively short, yet comprehensive and multidimensional assessment of family burden. Among the four instruments, the Family Burden Interview Schedule (FBIS) is proposed as the most promising one for its specificity, clinical application, and evidence. However, a review of past literature only detected four instruments that are specific to measuring family burden for persons with schizophrenia. The importance of measuring family burden has long been recognized in the literature, with a large quantity of instruments developed for assessing family burden in both physical diseases such as hemanioma, atopic dermatitis, ichthyosis and mental disease such as dementia, bipolar disorder, etc. While it is widely acknowledged that these conditions can be greatly ameliorated with effective psycho-social interventions, how to measure family burden and define a valid cutoff to identify family caregivers in need of such interventions remains a key question. Decades of international research have established the positive correlation between family burden and a range of negative caregiver outcomes such as depression, anxiety, physical disease and even mortality. This cutoff score would enable health care providers to assess family caregivers at risk and provide necessary interventions to improve their quality of life.Ĭaring for a family member with mental illness like schizophrenia is a laborious and time-consuming task that usually leads to adverse physical, psychological, emotional and economic impacts on family members, known as family burden. Resultsįindings proposed a cutoff score of 23 for the FBIS, with sensitivity being 76% for PHQ-9 and 74% for GAD-7, specificity being 68% for PHQ-9 and 67% for GAD-7. Contingency analysis was conducted to compare the FBIS cutoff with depression and anxiety scale scores. A FBIS cutoff score was determined using three different statistical methods: tree-based modeling, K-means clustering technique and linear regression. The FBIS, PHQ-9, and GAD-7 were administered to a representative community sample of 327 family caregivers of schizophrenia patients. The purpose of the present study was to determine a statistically valid cutoff score for the Family Burden Interview Schedule (FBIS), using the cutoff scores of the Patient Health Questionnaire (PHQ-9) and the Generalized Anxiety Disorder Scale (GAD-7) as the reference. While it is widely acknowledged that family burden can be ameliorated with effective psycho-social interventions, how to measure family burden and define a valid cutoff to identify family caregivers in need of such interventions remains a key question.
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