Instruments for Measuring the Burden of Family Caregivers of Cancer Patients: A Systematic Review of Measurement Properties

AIMS: This study identifies instruments for assessing the burden on family caregivers of cancer patients and evaluates their psychometric properties using COSMIN criteria. DESIGN: A systematic review based on COSMIN methodology. METHODS: The review adhered to PRISMA guidelines. Relevant studies were identified through searches in PubMed, Web of Science, Cochrane Library, Embase, China National Knowledge Infrastructure, Wanfang Database, and China Science and Technology Journal Database, covering literature from inception to September 2024. Included studies focused on developing or validating measurement tools and assessing psychometric properties such as reliability, internal consistency and construct validity. Two independent researchers screened the literature, extracted data and evaluated psychometric properties using COSMIN criteria while assessing evidence quality via the GRADE method. RESULTS: A total of 32 studies were included, encompassing 17 tools for assessing caregiver burden. None reported measurement error, cross-cultural validity or responsiveness. The Caregiver's Burden Scale in End-of-Life Care (CBS-EOLC) demonstrated strong reliability, validity and internal consistency, receiving a strong recommendation for clinical practice. In contrast, the Zarit Burden Interview (ZBI), Family Caregiver Burden Interview Scale (FBIS) and Bakas Caregiving Outcomes Scale (BCOS) are not recommended due to insufficient supporting evidence. Other tools showed weak evidence, leading to weak recommendations. CONCLUSIONS: The CBS-EOLC exhibits comprehensive psychometric properties suitable for clinical applications. The ZBI, FBIS and BCOS lack adequate supporting evidence and are not recommended. Future research should focus on measurement error, cross-cultural validity and responsiveness to enhance these tools' applicability and reliability. RELEVANCE TO CLINICAL PRACTICE: This review provides evidence for healthcare providers to select instruments for assessing caregiver burden in cancer patients. IMPACT: This systematic review highlights the need for comprehensive assessments of caregiver burden based on COSMIN guidelines. NO PATIENT OR PUBLIC CONTRIBUTION: This study is a systematic review with no patient or public participation.