{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T12:45:52Z","timestamp":1792154752881,"version":"4.4.0"},"reference-count":32,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T00:00:00Z","timestamp":1791849600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Hosp Palliat Care"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Caregiver burden assessments lack clinical uniformity in palliative care. Existing evidence-based interventions often impose resource demands that are prohibitive for smaller programs.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>(1) Demonstrate the practical utility of routine caregiver screening paired with an interdisciplinary team (IDT) response protocol. (2) Identify patient and caregiver factors influencing burden.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>Setting: Cross-sectional study in a US outpatient palliative care clinic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Measure<\/jats:title>\n                    <jats:p>ments: The 12-item Zarit Burden Interview (ZBI-12) was administered by a nurse or social worker. Scores guided immediate, point-of-care IDT interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Of 81 approached caregivers, 74 completed the ZBI-12 (72% female; median age 56). Burden was stratified into mild (n = 37), mild-moderate (n = 22), and high (n = 15) tiers, with median scores increasing significantly (6 vs 16 vs 28;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). General counseling was consistent across tiers (\u223c54%). However, high-intensity supportive interventions rose significantly with burden severity: social work telephone follow-ups increased (0% vs 13.6% vs 33.3%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), support group referrals rose (2.7% vs 31.8% vs 46.7%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), and psychotherapy referrals increased (0% vs 4.5% vs 13.3%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.030). Multivariable linear regression showed lower patient Palliative Performance Scale (PPS) scores independently predicted higher caregiver burden. Each 10-point decrease in PPS correlated with a 2.4-point increase in total ZBI-12 score (\u03b2 = \u22120.240; 95% CI, \u22120.433 to \u22120.048;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.015).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This workflow provides a replicable roadmap to transition caregivers from \u201cinvisible patients\u201d to actively supported extensions of the care unit, reinforcing dyadic assessments as standard practice in outpatient palliative medicine.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/10499091261498169","type":"journal-article","created":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T17:09:33Z","timestamp":1791911373000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Translating Evidence Into Practice: Implementing Caregiver Burden Assessments in Palliative Care Clinic"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4612-6421","authenticated-orcid":false,"given":"Nasreen Bagwan","family":"Malik","sequence":"first","affiliation":[{"name":"Bridgeport Hospital Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherief","family":"Ghozy","sequence":"additional","affiliation":[{"name":"Mayo Clinic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kitty","family":"Fan","sequence":"additional","affiliation":[{"name":"Bridgeport Hospital Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Green","sequence":"additional","affiliation":[{"name":"Bridgeport Hospital Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Denise","family":"Mohess","sequence":"additional","affiliation":[{"name":"Bridgeport Hospital Connecticut"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,10,13]]},"reference":[{"key":"e_1_3_5_2_2","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21871"},{"key":"e_1_3_5_3_2","volume-title":"Cancer Caregiving in the U.S.: An Intense, Episodic, and Challenging Care Experience","author":"National Alliance for Caregiving, AARP","year":"2016","unstructured":"National Alliance for Caregiving, AARP. 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