DESCRIPTION: The Modified Caregiver Strain Index (MCSI), which is in Filipino is used to screen burden or strain among Filipino
caregivers of debilitated patients. It was patterned after the Caregiver Strain Index (Robinson, 1983).
SCORING: The MCSI is an eleven-statement questionnaire using a three-point Likert scale. The scores are summed; and the total score
ranges from 11 to 33. The higher the score, the higher the level of caregiver strain. There are eleven areas noted were caregiver strain may
occur and these are: sleep disruption, physical strain, family adjustments, competing demands, changes in personal plans, added
responsibilities, emotional adjustments, adjustment to patient’s personality changes and upsetting behavior, feeling of being overwhelmed
and financial strain. Suggested classification system for ease of interpretation is as follows: 23 or less = Normal, 24 to 28 = Predisposition to
Strain, and 29 and above = Severe Caregiver Strain.
RELIABILITY: The original CSI was reported to have a high internal consistency reliability (Cronbach’s alpha = .86) and construct validity
was supported by correlations with the physical and emotional health of the caregiver and with subjective views of the caregiving situation.
The instrument’s authors reported good reliability and validity for the MCSI.
VALIDITY: The MCSI has been shown to correlate with other measures of well being, depressive mood, and quality of life. However,
further internal consistency and reliability studies are recommended for Filipino medical populations. A study of adult family caregivers of
children with cancer in the Philippines showed that the MCSI also correlated well with psychosocial reaction to illness, and caregiver strain
(Medina, Martin et al, 2010).
PRIMARY REFERENCES: 1) Bautista MT, Yu-Maglonzo EI, and Pilares-Cruz MV. (1997). Modified Caregiver Strain Index. Presented at
the Department of Family Medicine, University of Santo Tomas Residents’ Annual Research Forum, November 1997. Manila, UST. 2) Yu-
Maglonzo EI. (2008). Geriatric medicine: Principles and practice (pp. 349-356). Manila: University of Santo Tomas.
OTHER REFERENCES: 1) Robinson, B. (1983). Validation of a Caregiver Strain Index. Journal of Gerontology. 38:344-348. 2) M. Medina,
A Martin, A Panganiban-Corales, L Nicodemus, and A Bausa. Impact of Illness Using the Biopsychosocial Perspective: Development and
Evaluation of the Children’s Biopsychosocial Survey and the Psychosocial Reaction to Illness Scale. SHPM Research Document (CHILD
102010-2). Section of Supportive Hospice and Palliative Medicine (SHPM), DFCM, UP-PGH. 2010.
In addition to the primary reference, this document can be cited as follows: M. Medina and the Section of Supportive Hospice and Palliative
Medicine (SHPM). Modified Caregiver Strain Index (MCSI). SHPM Program Document. Compendium of Filipino Assessment Tools for
Clinical Practice & Research (CFAT 012011-10). SHPM, DFCM, UP-PGH. 2011.
AVAILABILITY: The authors prefer to be informed if the MCSI will be used in clinical and research programs. Dr. EI Yu-Maglonzo can be
contacted through the Family Medicine Departments of the University of the Philippines – Philippine General Hospital, and the University of
Santo Tomas.
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MODIFIED CAREGIVER STRAIN INDEX (MCSI)
Yu-Maglonzo EI, Bautista MT. Modified Caregiver Strain Index (MCSI). University of Santo Tomas. Manila.
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