Caregiver Burden Scale - An Introspective Questionnaire

Caregiver Burden Scale

An Introspective Questionnaire
Instructions:

The following list of statements reflects how people sometimes feel when caring for a pet. After each statement, please indicate how often you feel that way, according to the following scale. There are no correct or incorrect answers.

Ratings:

0. NEVER

1. RARELY

2. SOMETIMES

3. FREQUENTLY

4. ALWAYS
Do you feel that because of the time you spend caring for your pet, you don’t have enough time for yourself? *
Do you feel stressed caring for your pet and trying to meet other responsibilities for your family or work? *
Do you feel embarrassed of your pet’s behavior? *
Do you feel angry when you are around your pet? *
Do you feel that your pet currently affects your relationship with other family members or friends in a negative way?*
Are you afraid of what the future holds for your pet? *
Do you feel strained when you are around your pet? *
Do you feel your health has suffered because of your involvement with your pet? *
Do you feel that your social life has suffered because you are caring for your pet? *
Do you feel uncomfortable about having friends over because of your pet? *
Do you feel that you don’t have enough money to care for your pet in addition to the rest of your expenses?*
Do you feel that you will be unable to take care of your pet much longer?*
Do you feel that you have lost control of your life due to your pet’s behavior? *
Do you wish you could leave the care of your pet to someone else? *
Do you feel uncertain about what to do about your pet? *
Do you feel you should be doing more for your pet?*
Do you feel you could do a better job in caring for your pet? *
Overall, how burdened do you feel in caring for your pet? *
Thank you so much for taking the time to complete this self-evaluation.
Your Name:*

First NameLast Name
Your Pet's Name:*
Your Email:*
example@example.com
Date:*

MonthDayYear
Date
Hour MinutesAM/PM Option
Average Response:
Summation of Responses:
Should be Empty: