Development & Validation of a Caregiving Burden Scale (CBS)

The current study outlines the development and validation of the Caregiving Burden Scale (CBS), a culturally sensitive tool designed to assess the multidimensional burden experienced by caregivers of chronically ill individuals in Pakistan. Employing a mixed-method, multi-phase design grounded in established scale development framework the process included item generation, expert evaluation, pilot testing, exploratory and confirmatory factor analyses, and reliability and validity assessments. During development stage, in Phase I, 24 items were generated. These items were written in simple, culturally resonant Urdu and addressed six domains: Economic Strain, Daily Life Interruptions, Impact on Recreational Activities, Family Dynamics Disruption, Physiological Impact, and Mental Health Impact. Phase II involved expert review by clinical psychologists and psychiatrists, resulting in minor revisions and strong agreement on item relevance. In Phase III, pilot testing with 30 caregivers confirmed the clarity, acceptability, and distribution normality of the scale items. Phase IV involved Exploratory Factor Analysis (EFA) on a sample of 200 caregivers, yielding a six-factor solution that explained significant variance across domains. Phase V involved Confirmatory Factor Analysis (CFA) further validated the model, showing acceptable fit indices (e.g., RMSEA = 0.07, CFI = 0.84). Internal consistency across all subscales was strong (α = 0.78–0.90). In the second stage, validity was established through significant correlations with a similar caregiving burden measure (r = 0.40) and negative correlations with psychological well-being (r = -0.31), confirming convergent and discriminant validity. Overall, the CBS is a psychometrically robust and culturally relevant instrument for assessing caregiving burden in Pakistan. Its use in both clinical and research settings may enhance caregiver assessment and inform targeted interventions in low-resource and collectivist cultural contexts.