However, diagnostic diaries and instruments assessing burden and response to treatment were not always in place or routinely utilised.
The purpose of this study was to obtain adjusted measures for a Mexican population calculating item discrimination properties, internal consistency and factor structure of four instruments: Zarit Burden Inventory, Maslach Burnout Inventory, the General Health Questionnaire, and Stress Symptoms Inventory.
In a more rigorous review in mental health services [ 14], staff concerns relating to routine outcome measurement were grouped into five domains: access to appropriate technology and ability to use it; appropriateness of instruments; time burden; suspicion of management or government motives; and competence and confidence in using outcome data.
The choice depends on the proposed use of the instrument, the concept to be measured, the readability of the questions, the requirements and costs associated with the use of the instrument, the burden on the subjects, and, last but not least, the measurement properties of the instruments.
The issue of the instrument adding burden to nursing care warrants discussion.
The EQ-5D-3L is widely used to measure health-related quality of life in MS. It allows both the descriptive assessment of self-reported impairment in generic dimensions of health and the estimation of utility scores, being one of the most employed instrument in burden of illness studies across several therapeutic areas [ 4– 17].
The CRA was preferred above other caregiver burden instruments for this study because other instruments were developed for caregivers of persons with mental impairment only or addressed only the negative consequences of caregiving [ 22- 24].
This review found that the most popular instruments in the burden category were developed specifically to measure burden in dementia carers, combining disease specific with population specific domains.
Furthermore, there is always a tension between the comprehensiveness of the instrument and the burden that a lengthy instrument will place on respondents.
A review of the existing caregiver burden instruments in the published literature revealed a range of validated and non-validated instruments measuring various aspects of the caregiver experience, including burden, mood, needs, and quality of life, across a range of conditions.
