.|.|Zarit Burden Interview: Short version||Date Given: <.Date_Given.>|Clinician: <.Staff_Ordered_By.>|Location: <.Location.>||Veteran: <.Patient_Name_Last_First.>|SSN: <.Patient_SSN.>|DOB:
<.Patient_Date_Of_Birth.> (<.Patient_Age.>)|Gender: <.Patient_Gender.>||ZBI Short Version Score: <-Score->| A score of 17 or higher reflects a high burden and needs followup. ||Questions and
Answers||1. Do you feel that because of the time you spend with your relative that you dont have enough time for yourself?| <*Answer_5260*>|2. Do you feel stressed between caring for your relative
and trying to meet other responsibilities (work/family)?| <*Answer_5261*>|3. Do you feel angry when you are around your relative?| <*Answer_5262*>|4. Do you feel that your relative currently
affects your relationship with family members or friends in a negative way?| <*Answer_5263*>|5. Do you feel strained when you are around your relative?| <*Answer_5264*>|6. Do you feel that your
health has suffered because of your involvement with your relative?| <*Answer_5265*>|7. Do you feel that you dont have as much privacy as you would like because of your relative?|
<*Answer_5266*>|8. Do you feel that your social life has suffered because you are caring for your relative?| <*Answer_5267*>|9. Do you feel that you have lost control of your life since your
relatives illness?| <*Answer_5268*>|10. Do you feel uncertain about what to do about your relative?| <*Answer_5269*>|11. Do you feel you should be doing more for your relative?|
<*Answer_5270*>|12. Do you feel you could do a better job in caring for your relative?| <*Answer_5271*>||Copyright (c) 1983 Steven Zarit $~
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