1 Tanja Lupieri
1 Martina Hrvačić
2 3 Suzana Uzun
1 University Hospital Sveti Duh, Zagreb, Croatia
2 University Psychiatric Hospital Vrapče, Department of Biological Psychiatry and Psychogeriatrics, Reference Center for Alzheimer’s Disease and Psychiatry of Old Age, Zagreb, Croatia
3 School of Medicine, University of Zagreb, Zagreb, Croatia
Article received: 20. 08. 2025.
Article accepted: 09. 12. 2025.
DOI: 10.24141/2/10/1/14
Author for correspondence:
Tanja Lupieri
University Hospital Sveti Duh, Zagreb, Croatia E-mail: lupieritanja@gmail.com
Keywords: dementia, Alzheimer’s disease, caregiving, caregivers, stress, psychological health, support
degenerative disorders that significantly affect the quality of life of individuals living with the condition, as well as their families and caregivers.
Dementia represents one of the greatest public health challenges of the 21st century. According to the World Health Organization, more than 55 million people worldwide are living with dementia, and this number continues to grow (1).
Dementias are neurodegenerative disorders char- acterized by progressive cognitive decline that in- terferes with daily functioning. The prevalence of dementia increases with age, and the most common type is Alzheimer’s disease.
As the disease progresses, the need for continuous care becomes more pronounced, placing the burden of care on family members or professional caregiv- ers such as nurses. Because the disease significantly impairs patients’ functional abilities, the vast major- ity of individuals with dementia depend on daily as- sistance from both formal and informal caregivers— most often family members. This raises concerns about the long-term impact of caregiving on the mental and physical health of caregivers.
The most common types of dementia are Alzheimer’s disease (accounting for 60–70% of cases), followed by vascular dementia, which is associated with cerebro- vascular damage. Early symptoms include forgetful- ness, speech and orientation difficulties, and changes in personality and behavior. As the disease advances, more intensive care and supervision are required.
Other forms include Lewy body dementia, character- ized by visual hallucinations and fluctuations in alert- ness, and frontotemporal dementia, which typically occurs at a younger age and is marked by behavioral and speech changes (1,2,3).
The occurrence of psychiatric symptoms in individu- als with Alzheimer’s disease and other forms of de- mentia presents one of the major challenges in their care. Conditions such as depression, psychotic epi- sodes, or delirium occurring alongside pre-existing dementia can significantly impair cognitive abilities, accelerate cognitive decline, and negatively affect daily functioning and the level of independence in patients (4).
Furthermore, the study by Beam and colleagues (2018) highlights significant differences in the inci- dence of dementia and Alzheimer’s disease between men and women. Findings show that women, espe- cially in older age groups, are more susceptible to developing Alzheimer’s disease. These differences cannot be fully explained by women’s longer life ex- pectancy, but rather point to possible biological and sociocultural factors. The study underscores the im- portance of developing gender-sensitive preventive and therapeutic strategies in dementia care (5).
Approximately 55 million people worldwide are cur- rently living with dementia, with over 60% residing in low- and middle-income countries. Moreover, it is projected that the number of people diagnosed with dementia will reach 78 million by 2030, and 139 million by 2050, as the proportion of older in- dividuals increases in nearly every country (6). Women exhibit a higher prevalence of dementia, pri- marily due to their longer average life expectancy
(7). In Croatia, it is estimated that over 100,000 in- dividuals are living with some form of dementia (8).
Risk factors include age and genetics (e.g., the pres- ence of the APOE ε4 allele), as well as hypertension, diabetes, depression, low educational attainment, social isolation, and physical inactivity (9,10).
The diagnostic process involves clinical evaluation (e.g., MMSE, MoCA, ADAS-Cog), laboratory testing, neu- roimaging (MRI, CT, PET), and increasingly the use of biomarkers such as CSF tau and beta-amyloid (11).
The impact of dementia has been analyzed in rela- tion to women who provide professional care—such as nurses—as well as those who assume the role of informal caregivers within the family setting. De- mentia is known to disproportionately affect women worldwide. In many societies, there is a prevailing expectation that care for older family members, in- cluding those with dementia, should occur within the family unit. This responsibility is often automatically assigned to women, leading to additional physical, emotional, and social burdens.
This issue is particularly challenging in low-income countries, where the availability of community-ba- sed support services is critical—especially for women with limited access to education or low levels of formal schooling (12). Women constitute the majo- rity of informal dementia caregivers—approximately two-thirds—with even higher proportions in low- and middle-income countries. As a result, the burden of caregiving, including health, emotional, and financial consequences, is especially pronounced for women in these regions.
Furthermore, women dominate the formal care sec- tor, providing most of the health and social care ser- vices in community settings, hospitals, and long-term care facilities (12). Specialized competencies are required among healthcare and caregiving professi- onals to adequately care for people with dementia, who often present with complex needs and multiple comorbidities (12).
Caring for a person with Alzheimer’s disease (AD) is associated with significant mental health challenges, such as depression, anxiety, and difficulties in social, family, and occupational functioning (13).
The concept of “caregiver burden,” introduced in the 1980s, refers to the emotional, financial, social, and physical strain experienced by individuals caring for someone with a chronic illness. The intensity of care- giving is directly linked to the magnitude of its health impacts. Feelings of anxiety and depression can nega- tively affect the physical health of caregivers. Elevated rates of depression and stress, along with decreased subjective well-being, are associated with the care recipient’s behavioral disturbances, cognitive impair- ments, and functional limitations, as well as the dura- tion of caregiving and the age of the caregiver (13).
The aim of this review is to present and analyze cur- rent knowledge on psychological burden and stress among formal and informal caregivers of individuals with dementia, with particular emphasis on nurses, and to identify effective interventions that contrib- ute to reducing caregiver burden and preventing burnout.
A narrative literature review was conducted by searching the PubMed, Scopus, and Web of Science databases. The review included studies published between 2015 and 2025, a time frame selected to capture the most recent scientific evidence on car- egiver burden and to reflect contemporary clinical practices and recent developments in psychological and educational interventions in dementia care. This period also aligns with a significant rise in global de- mentia prevalence, prompting an increase in caregiv- er-focused research.
The search strategy used a combination of controlled vocabulary (e.g., MeSH terms) and free-text keywords. The following keywords and their combinations were used: dementia, Alzheimer’s disease, caregiving, car- egiver burden, informal caregivers, nurses, stress, burnout, psychological health, psychological out- comes, quality of life, mental health, mindfulness, cognitive-behavioral interventions, education pro- grams, psychological support, organizational support, long-term care, caregiver interventions.
The included studies examined stress, burnout, quality of life, psychological and physical outcomes among caregivers, as well as the effects of educa- tional programs, psychological support, mindfulness- based interventions, and organizational measures.
A total of 48 articles were identified through the literature search, and all of them met the prede- fined inclusion criteria, as the search strategy was focused on the most recent evidence (2015–2025) and on clearly specified keywords related to demen- tia caregiving, caregiver burden, stress, burnout, and interventions.
Providing long-term care for individuals with Alz- heimer’s disease is largely the responsibility of both formal and informal caregivers. Care is a dynamic pro- cess between the caregiver and the patient. Informal care is rooted in family structures (e.g., family mem- bers, friends, neighbors), whereas formal care refers to services delivered by professional caregivers em- ployed within public or private care systems (13).
A study examining 100 caregivers—50 formal and 50 informal—of patients with Alzheimer’s disease used several tools to assess personal resources and men- tal health: the Social Support Questionnaire (SSQ), the General Self-Efficacy Scale (GSES), the Sense of Coherence Questionnaire (SCQ), the Depression Assessment Questionnaire (DAQ), and the General Health Questionnaire (GHQ).
The results indicated no significant differences be- tween formal and informal caregivers in terms of psychological variables such as sense of coherence, social support, self-efficacy, or mental health prob- lems. However, distinct predictors of mental health problems were identified in each group (13).
There is a notable increase in stress, depression, and fatigue, often manifesting as a sense of help- lessness. Higher levels of depressive symptoms and stress caused by patients’ challenging behaviors have been shown to predict the onset of cardiovascu- lar diseases in caregivers within 18 months of start- ing caregiving. The duration of caregiving has also been linked to immune system dysregulation, which may persist for up to four years after the death of the care recipient. Caregivers are more likely to de- velop respiratory infections, suffer from obesity, and exhibit elevated serum lipid levels, contributing to increased cardiovascular risk (13).
The financial implications of caregiving are sub- stantial. In a systematic review, authors found that most caregivers experienced increased care-related expenses, while family income decreased due to time and resources devoted to caregiving. Due to the progressive nature of dementia, resource use and family expenses increase over time, a trend ob- served even in both high- and lower-middle-income Asian countries.
Caregivers were found to utilize more healthcare re- sources, regardless of financial capacity, as reflected
in frequent emergency room visits and use of other medical services (14).
Compared to caregivers of individuals with other chron- ic conditions, those caring for people with dementia are more likely to experience depression, elevated stress, and poorer overall health (15). Both formal car- egivers, such as nurses, and informal caregivers often feel unprepared and insufficiently trained to provide dementia care. Due to unpredictable symptoms such as aggression or wandering, along with persistent stress and high care demands, caregivers are vulner- able to psychological difficulties, including depression, anxiety, insomnia, irritability, exhaustion, loneliness, guilt, helplessness, and chronic stress (16).
A clinical cross-sectional study conducted in Zagreb demonstrated that neuropsychiatric symptoms meas- ured by the NPI-Q were significantly associated with poorer quality of life and higher caregiver burden ac- cording to the ZBI scale (17). The validation of the Croatian version of the ZBI confirmed key burden di- mensions, including emotional strain, frustration, guilt, and social limitations among dementia caregivers (18). A symptom-specific analysis in the same cohort found that agitation/aggression and apathy/inactivity were the strongest predictors of increased caregiver bur- den (18). A systematic review of longitudinal studies showed that caregiver burden progressively increases as neuropsychiatric symptoms worsen and activities of daily living decline (19). A meta-analysis of 39 rand- omized controlled trials revealed that individual therapy and nurse-delivered workshops significantly reduced caregiver burden, with an effect size of approximately
0.48 (20). A review of psychoeducational interventions
concluded that programs combining education, psycho- logical support, and social resources are the most effec- tive in reducing caregiver burden (21). A study examin- ing the use of wearable devices and AI-based predictive analytics demonstrated that early detection of BPSD is feasible, enabling timelier intervention (22). A rand- omized controlled trial of an eight-week mindfulness- based health care (MBHC) program showed significant reductions in caregiver burden (ZBI) and improvements in activity balance (23). Research on organizational sup- port for nurses found that structured supervision com- bined with education significantly reduced burnout and improved job satisfaction (23). Table 1 summarizes the studies outlined above, focusing on caregiver burden and evidence-based interventions designed to reduce stress and burnout among formal and informal caregiv- ers, including nursing professionals.
Table 1. Key studies from 2015–2025 on caregiver burden and interventions to reduce caregiver stress, including among nurses | ||||
No. | Study & Sample | Intervention/Focus | Key Findings | Author |
1 | Clinical cross-sectional study, 131 patients in Zagreb | Burden measurement (ZBI), neuropsychiatric symptoms | NPIQ associated with poorer SF- 36; higher burden predicted worse physical/mental health | Lucijanić et al., 2021 (17) |
2 | Validation of ZBI (NeDEM project), Croatian caregivers | Instrument validation | Confirmed burden dimensions: burden, frustration, guilt, social limitations | Lucijanić et al., 2020 (18) |
4 | Systematic review | Caregiver burden over time in dementia and its risk factors | Increasing caregiver burden | Van den Kieboom R, Snaphaan L, Mark R, Bongers I, et al (19) |
5 | Meta-analysis of 39 RCTs, n = 4,715 | Individual therapy & nurse workshops | Reduced burden (~0.48 effect size) | Rodríguez-Alcázar, et al., 2024 (20) |
6 | Review of psychoeducational interventions | Education + psychological + social support | Most effective when combined | Walter & Pinquart, 2020 (21) |
7 | Wearables + AI to predict BPSD | Predictive analytics | Earlier intervention possible | Hsu et al., 2024 (22) |
8 | RCT, 66 informal caregivers, 8-week MBHC | Mindfulness program | Reduced ZBI (β = -7, p = 0.026), improved activity balance | Prieto-Botella et al., 2025 (23) |
Depression (melancholia) is an emotional response to chronic frustration and disappointment. In psychopa- thology, it is classified as an affective and emotional disorder (24). Depression is a common and serious health condition that differs from usual mood fluctu- ations and short-term emotional reactions to every- day challenges. It can cause significant suffering and impair functioning at work, in school, and within the family. According to the World Health Organization, approximately 332 million people globally suffer from depressive disorder, making it one of the lead- ing causes of disability (25). The prevalence of de- pression among dementia caregivers is even higher than in the general population. As dementia patients experience cognitive decline and loss of ability to perform daily activities (such as bathing, eating, etc.), the quality of caregiving is crucial. Caregivers often spend several hours per day with the patient—or
live in the same household. Numerous studies have shown that behavioral and psychological symptoms of dementia (BPSD) affect caregiver performance and, in turn, negatively impact their own physical and mental health (26).
Depression can lead to various psychological and physical health problems, including increased risk of suicide among caregivers. It undermines caregivers’ physical well-being, reduces their quality of life, and has been shown to be associated with earlier institu- tionalization of dementia patients. Caregiver depres- sion may also negatively influence the cognitive sta- tus of the person with dementia and has been linked to faster cognitive decline in patients (26).
Mild forms of depressive mood are often difficult to distinguish from normal experiences of disappoint- ment or grief. However, depression is a common, re- current, and debilitating condition that may lead to suicidal behavior, interpersonal conflict, unemploy- ment, and psychosocial dysfunction.
Demographic characteristics of caregivers (such as age, gender, employment status, and relationship to the patient) are known to influence the stress pro-
cess at multiple levels—shaping the types of stress, the perception of stressors, and outcomes such as caregiver burden and depression (26). On the other hand, caregivers who report a sense of purpose, stronger emotional closeness to the patient, and higher caregiving competence are more likely to derive positive meaning from the caregiving expe- rience and experience fewer negative outcomes in such a challenging context (27).
Burnout among caregivers and nurses who care for individuals with dementia represents a significant public health concern. This syndrome is most com- monly manifested through emotional exhaustion, depersonalization, and a reduced sense of profes- sional accomplishment.
Multiple studies confirm that emotional stress, chal- lenging patient behaviors, lack of organizational sup- port, and insufficient dementia-related education are key contributing factors to burnout. A meta-analysis by Aguayo et al. (2018), which included 17 studies, found that caregivers in nursing homes—particularly those caring for individuals with dementia—demon- strate moderate to high levels of emotional exhaus- tion, most often associated with aggressive patient behaviors and staff shortages (27).
A study involving 436 nurses and caregivers from nursing homes in Croatia and Slovenia found that nearly half of the participants exhibited high levels of professional burnout. Although demographic variables such as age, years of experience, and educational background were examined, none were statistically significant predictors of burnout levels. The results suggest that nurses and caregivers in both countries are exposed to similar o ccupational stressors, which increase the risk of emotional exhaustion and dep- ersonalization. The authors emphasize the need for systematic psychological support and preventive in- terventions within institutional care settings (28).
Uzun et al. (2019) point out that formal caregivers, es- pecially nurses caring for individuals with Alzheimer’s disease, often experience significant emotional stress, including anxiety, depression, and insomnia. They highlight the importance of early recognition of stress symptoms and the implementation of psychological support and education to prevent the deterioration of both mental and physical health in caregivers (29).
Kozumplik et al. (2019) warn that psychotic symp- toms—such as delusions in individuals with demen- tia—further increase the emotional and cognitive burden on formal caregivers and nurses. They pro- pose the implementation of educational programs and clear protocols for the identification and man- agement of these symptoms, in order to reduce the workload and psychological distress of caregiving staff (30).
The COVID-19 pandemic further exacerbated the sit- uation. A meta-analysis by Ghasemi Kooktapeh et al. (2023) revealed a notable increase in emotional ex- haustion among nurses caring for dementia patients during the pandemic, with burnout prevalence reach- ing nearly 3% (31).
Regarding informal caregivers (i.e., family members), a study by Brownie et al. (2014) found that burnout among family caregivers correlated with higher lev- els of depression and lower quality of life (32).
Organizational Support and Interventions for Preventing Burnout Among Dementia Care Professionals
Organizational support reduces the risk of burnout among dementia care professionals. A study by Ma- slach and Leiter (2016) highlights that a lack of or- ganizational support—such as poor communication with management, imbalance between effort and reward, and unclear expectations—directly increases the risk of emotional exhaustion and depersonaliza- tion among healthcare workers. The authors con- clude that a structured and consistent organizational support system acts as a protective factor against burnout syndrome (33).
Supervision and peer support are key to preserving professionals’ mental health. A study by Edwards et al. (2006) showed that regular supervision and peer support groups enable aged care professionals to ex- press emotional challenges, share experiences, and find collective solutions. Such structured support systems are associated with lower stress levels and higher job satisfaction, ultimately reducing the risk of burnout (34).
There is a clear association between the lack of or- ganizational support and an increased risk of emo- tional exhaustion, as highlighted in the study by Maslach and Leiter, which established that a dys- functional work environment significantly contrib- utes to the development of burnout among health- care professionals (33).
Burnout among caregivers and nurses working with people affected by dementia is a complex psychoso- cial phenomenon requiring a systematic, multifac- eted response. Studies indicate that the combina- tion of organizational support, continuous education, structured psychological interventions, and supervi- sion represents the most effective approach for pre- venting and alleviating burnout. Implementing such measures benefits not only the mental health of pro- fessionals but also the quality of care they provide.
Conceptualization (TL, MH); Data Curation (TL, MH), Formal Analysis (TL, MH); Investigation and Project Administration (TL, MH); Writing – Original Draft (SU), Writing – Review & Editing (SU). All authors reviewed and approved the final version of the manuscript.
The authors declare no conflicts of interest.
The authors would like to thank all researchers and clinicians whose work contributed to the development of this review article. Special appreciation is extended to colleagues from the University Hospital Sveti Duh and the University Psychiatric Hospital Vrapče for their professional support and academic environment that facilitated the preparation of this manuscript.
This research did not receive any specific grant from funding agencies in the public, commercial or not for- profit sectors.
Lobo A, Launer LJ, Fratiglioni L, Andersen K, Di Carlo A, Breteler MM, et al. Prevalence of dementia and major subtypes in Europe: A collaborative study of popula- tion-based cohorts. Neurologic Diseases in the El- derly Research Group. Neurology. 2000;54(11 Suppl 5):S4–9.
McKeith IG, Boeve BF, Dickson DW, Halliday G, Taylor JP, Weintraub D, et al. Diagnosis and management of de- mentia with Lewy bodies: Fourth consensus report of the DLB Consortium. Neurology. 2017;89(1):88–100. https://doi.org/10.1212/WNL.0000000000004058
Bang J, Spina S, Miller BL. Frontotemporal demen- tia. Lancet. 2015;386(10004):1672–82. https://doi. org/10.1016/S0140-6736(15)00461-4
Mimica N, Kušan Jukić M. Demencija i psihički poreme- ćaji. Medicus. 2017;26(2):215-22.
Beam CR, Kaneshiro C, Jang JY, Reynolds CA, Pedersen NL, Gatz M. Differences between women and men in incidence rates of dementia and Alzheimer’s disease. J Alzheimers Dis. 2018;64(4):1077–83. https://doi. org/10.3233/JAD-180141
Alzheimer Disease International. Dementia stati- stics. Available at: https://www.alzint.org/about/de- mentia-facts-figures/dementia-statistics/ Accessed: 13.08.2025.
Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, et al. Dementia prevention, interven- tion, and care: 2020 report of the Lancet Commissi- on. Lancet. 2020;396(10248):413–46. https://doi. org/10.1016/S0140-6736(20)30367-6
Norton S, Matthews FE, Barnes DE, Yaffe K, Brayne
C. Potential for primary prevention of Alzheimer’s di- sease: an analysis of population-based data. Lancet Neurol. 2014;13(8):788–94. https://doi.org/10.1016/ S1474-4422(14)70136-X
Jack CR Jr, Bennett DA, Blennow K, Carrillo MC, Dunn B, Haeberlein SB, et al. NIA-AA Research Framework:Toward a biological definition of Alzheimer’s disease. Alzheimers Dement. 2018;14(4):535–62. https://doi.org/10.1016/j. jalz.2018.02.018
Dubois B, Feldman HH, Jacova C, Hampel H, Molinue- vo JL, et al. Advancing research diagnostic criteria for Alzheimer’s disease: the IWG-2 criteria. Lancet Neurol. 2014;13(6):614–29. https://doi.org/10.1016/S1474-
4422(14)70090-0
Todd S, Barr S, Roberts M, Passmore AP. Survival in dementia and predictors of mortality: a review. Int J Geriatr Psychiatry. 2013;28(11):1109–24. https://doi. org/10.1002/gps.3946
Uzun S, Mimica N, Kozumplik O, Kušan Jukić M, Todorić Laidlaw I, Kalinić D, et al. Alzheimerova bolest – utje-
caj na život i psihičko zdravlje njegovateljica. Socijalna psihijatrija. 2019;47(1):86-101. [Croatian]
Sołtys A, Tyburski E. Predictors of mental health problems in formal and informal caregivers of pa- tients with Alzheimer’s disease. BMC Psychiatry. 2020;20:435. https://doi.org/10.1186/s12888-020-
02822-7
Abayon, AAP, Raymonds M, Brahmbhatt P, Samnani S, Hanna F. The Impact of Dementia on the Psychosocial Well-Being of Informal Caregivers in Asia: A Scoping Review Comparing High-Income and Low–Middle-Inco- me Countries. Psych. 2024;6(1):260-72. https://doi. org/10.3390/psych6010016
Sušac J, Mimica N, Uzun S, Kušan Jukić M. Difficulties of caregivers of individuals suffering from Alzheimer’s disease. Socijalna psihijatrija. 2019;47(3):405-11. https://doi.org/10.24869/spsih.2019.405
Oyebode F. Sims’ symptoms in the mind: Textbook of descriptive psychopathology 5th ed. Elsevier Saun- ders: 2015.
Lucijanić J, Baždarić K, Lucijanić M, Maleković H, Han- ževački M, Jureša V. Predictors of health-related qua- lity of life in informal caregivers of dementia patients in Zagreb, Croatia, a cross-sectional study. Psychiatria Danubina 2021;33(suppl 13):189-98.
Lucijanić J, Baždarić K, Librenjak D, Lucijanjić M, Han- ževački M, Jureša V. A validation of the Croatian ver- sion of Zarit Burden Interview and clinical predictors of caregiver burden in informal caregivers of pati- ents with dementia: a cross-sectional study. Croat Med J. 2020;61(6):527-37. https://doi.org/10.3325/ cmj.2020.61.527
van den Kieboom R, Snaphaan L, Mark R, Bongers
I. The trajectory of caregiver burden and risk fac- tors in dementia progression: a systematic review. J Alzheimers Dis. 2020;77(3):1107–15. https://doi. org/10.3233/JAD-200647
Rodríguez-Alcázar FJ, Juárez-Vela R, Sánchez-González JL, Martín-Vallejo J. Interventions effective in decrea- sing burden in caregivers of persons with dementia: a meta-analysis. Nurs Rep. 2024;14(2):931–45. https:// doi.org/10.3390/nursrep14020071
Walter K, Pinquart M. How Effective Are Dementia Caregiver Interventions? An Updated Comprehensive Meta-Analysis. Gerontologist. 2020;60(4):609-19. https://doi.org/10.1093/geront/gnz118
Hsu BWY, Li Y, Chen YM, Yang YH, Tseng VS. Predicting fine-grained behavioral and psychological symptoms of dementia based on machine learning and smart wearable devices [preprint]. arXiv [Internet]. 2024. https://doi.org/10.48550/arXiv.2410.18091 Availa- ble at: https://arxiv.org/abs/2410.18091
Prieto-Botella D, Peral-Gómez P, Mendialdua-Cana- les D, Fernández-Pires P, Benavides-Gil G, Company- Devesa V. et al. Examining the Effect of an 8-Week Mindfulness Training Program on Caregiver Burden
and Occupational Balance, and on Functional Capa- city in People with Alzheimer’s Disease: A Randomi- zed Controlled Trial. Mindfulness 2025;16:544–55. https://doi.org/10.1007/s12671-025-02527-6
Huang SS. Depression among caregivers of patients with dementia: associative factors and management approaches. World J Psychiatry. 2022;12(1):59–76. https://doi.org/10.5498/wjp.v12.i1.59
World Health Organization. Depressive disorder (de- pression) [Internet]. WHO; 2025. Available at: https:// www.who.int/news-room/fact-sheets/detail/depre- ssion, Accessed: 13.08.2025.
Fuju T, Yamagami T, Yamaguchi H, Yamazaki T. Deve- lopment of the Dementia Caregiver Positive Feeling Scale 21-item version (DCPFS-21) in Japan to reco- gnise positive feelings about caregiving for people with dementia. Psychogeriatrics. 2021;21(4):650-58. https://doi.org/10.1111/psyg.12727
Aguayo R, Vargas C, de la Fuente EI, Lozano LM. A meta-analytic reliability generalization study of the Maslach Burnout Inventory. Int J Clin Health Psychol. 2018;18(3):343–61.
Svitlić-Budisavljević S. Demografske značajke medi- cinskih sestara i profesionalno sagorijevanje: burnout u domovima za starije osobe u Hrvatskoj i Sloveniji. Socijalna psihijatrija. 2024;52(3):212–32. https://doi. org/10.24869/spsih.2024.212
Uzun S, Mimica N, Kozumplik O, Kušan Jukić M, Todorić Laidlaw I, Kalinić D, et al. Alzheimerova bolest – utje- caj na život i psihičko zdravlje njegovateljica. Socijalna psihijatrija. 2019;47(1):86–101. [Croatian]
Kozumplik O, Uzun S, Kalinić D, Požgain I, Mimica N. Jav- ljanje sumanutosti u bolesnika s demencijom – pregled literature. Socijalna psihijatrija. 2019;47(3):318–24. https://doi.org/10.24869/spsih.2019.318 [Croatian]
Ghasemi Kooktapeh Z, Dustmohammadloo H, Mehrdoost H,FatehiF.IntheLineofFire:ASystematicReviewandMeta- Analysis of Job Burnout Among Nurses. [Internet]. 2023. https://doi.org/10.48550/arXiv.2312.14853
Brownie S, Horstmanshof L, Garbutt R. Factors that impact residents’ transition and psychological adjus- tment to long-term aged care: A systematic review. Int J Nurs Stud. 2014;51(12):1654–66. https://doi. org/10.1016/j.ijnurstu.2014.04.011
Maslach C, Leiter MP. Understanding the burnout experience: recent research and its implications for psychiatry. World Psychiatry. 2016;15(2):103–11. https://doi.org/10.1002/wps.20311
Edwards D, Burnard P, Hannigan B, Cooper L, Adams J, Juggessur T, et al. Clinical supervision and burnout: the influence of clinical supervision for community men- tal health nurses. J Clin Nurs. 2006;15(8):1007–15. https://doi.org/10.1111/j.1365-2702.2006.01370.x