Background: Identification of family caregivers who are burdened by the caregiving experience is vital to prevention of poor outcomes associated with caregiving. The Zarit Burden Interview (ZBI), a well-known measure of caregiving burden in caregivers of patients with dementia, has been used without being validated in caregivers of patients with heart failure (HF). Purpose: The purpose of this study is to examine the reliability and validity of the ZBI in caregivers of patients with HF. Methods: A total of 124 primary caregivers of patients with HF completed survey questionnaires. Caregiving burden was measured by the ZBI. Reliability was examined using Cronbach’s α and item-total/item-item correlations. Convergent validity was examined using correlations with the Oberst Caregiving Burden Scale. Construct validity was demonstrated by exploratory factor analysis and known hypothesis testing (ie, the hypothesis of the association between caregiving burden and depressive symptoms). Results: Cronbach’s α for the ZBI was .921. The ZBI had good item-total (r = 0.395–0.764) and item-item (mean r = 0.365) correlations. Significant correlations between the ZBI and the Oberst Caregiving Burden Scale (r = 0.466 for the caregiving time subscale and 0.583 for the caregiving task difficulty subscale; P < .001 for both) supported convergent validity. Four factors were identified (ie, consequences of caregiving, patient’s dependence, exhaustion with caregiving and uncertainty, and guilt and fear for the patient’s future) using factor analysis, which are consistent with previous studies. Caregivers with high burden scores had significantly higher depressive symptoms than did caregivers with lower burden scores (7.0 ± 6.8 vs 3.1 ± 4.3; P < .01). Conclusion: The findings provide evidence that the ZBI is a reliable and valid measure for assessing burden in caregivers of patients with HF.

Professional autonomy is critical for nursing practice and professional development. A clear understanding of the professional autonomy concept and its applications in the real world is warranted. This paper clarified the “professional autonomy in nursing” concept using Walker and Avant’s method and the PRISMA flowchart and checklist to conduct the current analysis. Five electronic databases were searched: PubMed, ScienceDirect, ProQuest, Web of Science, and CINAHL Plus with Full Text. The search yielded 21 articles on “professional autonomy in nursing” between 2019 and 2023—however, six old articles related to measurement tools or instruments. The elements that characterize “professional autonomy in nursing” fall into four categories: shared leadership, professional skills, inter- and intra-professional collaboration, and a healthy work environment. Professional autonomy in nursing is defined as the professional nurse’s competency and innovative performance to determine independent or interdependently nursing activities while conserving accountability for decisions and reflecting advocacy and caring. The consequences of the concept are positive outcomes such as high patient satisfaction with provided care, nurses’ accountability, empowerment, a sense of self-efficacy, commitment to the profession, career, and organization, as well as high quality of work. The definitions and measurements of “professional autonomy in nursing” have developed over time, which mandates a continued study and analysis of this concept. It is essential to understand the multidimensional nature of the concept in order to offer professional development programs.

Sleep disturbance is common in patients with heart failure and their family caregivers. The purpose of this study was to determine whether sleep disturbances of patients and their spousal caregivers predicted their own and their partners’ quality of life (QoL) in 78 heart failure patient–spousal caregiver dyads. Sleep disturbance was assessed using a composite score of four common sleep complaints. QoL was assessed by the physical and mental well-being subscales of the Short-Form 12 Health Survey. The multilevel dyadic actor–partner interdependence model analysis was used to determine the association between sleep disturbance and QoL. Each individual’s sleep disturbance predicted their own poor physical and mental well-being while spousal caregivers’ sleep disturbance predicted their partners’ mental well-being. Results indicated that patients’ mental well-being is sensitive to their spouses’ sleep disturbance. Interventions targeting improving sleep and QoL may have to include both patients and spousal caregivers.