Determination of the Burden of Care in Families of Cardiac Surgery Patients

Abstract

"Burden of care" is a term that describes the effects of the multifaceted stressors associated with providing care to an ill family member. Descriptions of burden of care in acute care populations, such as families of patients who have had coronary artery bypass grafting, are very limited. The three purposes of this study were to describe the burden of care in families of coronary artery bypass grafting surgery patients, to compare the burden of care in families grouped by length of stay, and to provide evidence for the validity of the Caregiving Burden Scale in acute care populations. A survey was done using a longitudinal design over the first six weeks following coronary artery bypass grafting surgery. The 124 spouses of coronary artery bypass grafting surgery patients who participated reported a moderate degree of burden in caring for post cardiac surgery family members. Providing emotional support, taking over household tasks, and monitoring patients' conditions created the greatest burden for the participants. Length of stay in hospital did not have an impact on burden of care. The analysis of the data supports the validity of the Care-giving Burden Scale when used in the cardiac surgery population. (Prog Cardiovasc).

Caregiver burden and outcomes of caregiving of spouses of patients who undergo coronary artery bypass graft surgery

“…[37][38][39] Caregivers reported most burden with monitoring clinical progress, managing behavior, providing emotional support, and assuming household tasks. 3,5,6 In one longitudinal study, subjective burden increased after surgery from 1 to 3 months 37 and then slightly diminished at 1 year 38 (the latter change was not significant). These findings suggest that although patient recovery might be progressing, emotional sequelae in caregivers were still evident, even at 1 year after surgery.…”

“…Over the last decade, the typical length of hospital stay after CABG surgery has been dramatically reduced; this change potentially places more burden on the patient's caregiver. [3][4][5][6] Currently, the average age of patients undergoing CABG procedures is estimated at 65 years. 7 This increasing age potentially prolongs the expected recovery course and the length and extent of the caregiving role for an elderly patient's spouse.…”

“…14,[17][18][19][20][21] Although caregiver burden has been well documented across the lifespan in other acute [22][23][24][25][26] and chronically ill populations, [27][28][29][30][31][32][33][34] few studies have examined burden in the context of CABG surgery. 3,5,6,12,35,36 Caregiving may be different after an acute event such as CABG surgery because there is an expectation that the patient will be better both symptomatically and functionally after surgery. Two quantitative CABG studies found caregivers report low-to-moderate objective and subjective burden 1 to 6 weeks 3 and 1, 3, and 12 months after surgery.…”

“…5,6,35,36 Across the initial recovery trajectory, problems include (1) cognitive: lack of information and uncertainty about the patient's physical and emotional needs; (2) physical: concerns of how their own emotional stress and fatigue could interfere with their ability to physically fulfill caregiving demands; (3) psychologic: fears, uncertainties, and vulnerabilities about dealing with emergencies and losing the patient, anger about patient noncompliance, feeling overwhelmed by responsibilities, and depression when their activities are restricted; and (4) behavioral: initially wanting to protect the patient and then reorganizing responsibilities, and dealing with mood swings of the patient. 3,5,6,9,12 Although positive feelings toward the patient-caregiver relationship, often referred to as "mutuality," may mitigate burden in the early phase, such feelings may diminish in the later postoperative period because estrangement may develop from overprotective and distancing patterns. 40 Other than emotional distress, little is known about other outcomes of caregiving (OOC) of spouses who care for their marital partner after CABG surgery.…”

The reliability, validity and feasibility of tools used to screen for caregiver burden: a systematic review

“…An example of this is the "Caregiver Burden Scale". 42,43,57,58 Caregiver burden is a construct that is recognized internationally. However the term caregiver is not used synonymously throughout the world.…”