Sat., 10/20/07 Geriatrics/Injury Prevention, Paper #50, 9:31 am OTA-2007
The Pain of Fracture and Strain of Caregiving: The Relationship between Patient
Function and Caregiver Burden
Mary-Kate Barrette-Grischow, MA, MPH (n); Thomas F. Hull, BA (n);
Linda Silvestri, MPH (n); Bruce H. Ziran, MD (n)
St. Elizabeth Health Center, Youngstown, Ohio, USA
Purpose: Trends in modern health care show an increase in responsibilities being assumed by noncompensated caregivers (eg, family). This study examines the relationship between older orthopaedic trauma patients’ mental and physical functional outcomes via Short Form-36 (SF-36) scores and the degree of stress upon their caregivers’ lives both objectively and subjectively.
Methods: 45 pairs of patients (>59 years) and their caregivers were the basis of this study. Patients were given the standardized SF-36 and caregivers completed Montgomery et al’s Caregiver Burden Scale (three-pronged measurement of disruption of life, emotional stress, and perception of manipulative behaviors from the patient). Burden scores were analyzed as dichotomous variables labeled high burden and not high burden based on the prescribed scoring method. Statistical analysis utilized frequency tables and independent sample t tests.
Results: Mean SF-36 scores were more than one standard deviation below the national average (Physical Component Score [PCS] 32.9, Mental Component Score [MCS] 35.7). Overall caregiver stress response was high (33% high life disruption, 47% high emotional impact of care responsibilities, only 12% high perception of manipulative behaviors). Low PCS was associated with high life disruption for the caregiver (P <0.01). Patient bodily pain and physical functioning were the components most influential to caregiver stress; however, these components were not individually statistically significant (P = 0.08 and 0.10, respectively). For MCS, vitality (energy, pep) was the only component with a significant relationship to caregiver’s life disruption (P <0.05). No relationships were identified between patient SF-36 scores and emotional impact on the caregiver.
Conclusion: Caregivers report high levels of stress related to the patients’ reported physical and mental status. As health care costs and ancillary support services are cut, informal caregivers will have to assume a greater role in convalescent patient care. Understanding the dynamics of this link may be valuable for clinicians and policy makers to better the health outcomes of their elderly patients. Also, understanding the dynamics of the patient/caregiver relationship may be important when evaluating treatment plans. A larger study to further explore these relationships is warranted.
If noted, the author indicates something of value received. The codes are identified as a-research or institutional support; b-miscellaneous funding; c-royalties; d-stock options; e-consultant or employee; n-no conflicts disclosed, and *disclosure not available at time of printing.
• The FDA has not cleared this drug and/or medical device for the use described in this presentation (i.e., the drug or medical device is being discussed for an “off label” use). ◆FDA information not available at time of printing.