Experiences of informal caregivers after cardiac surgery: a systematic integrated review of qualitative and quantitative studies

Abstract

ObjectivesTo provide a comprehensive synthesis of informal caregivers’ experiences of caring for a significant other following discharge from cardiac surgery.DesignSystematic integrated review without meta-analysis.Data sourcesA bibliographic search for publications indexed in six databases (Cochrane Library, CINAHL, MEDLINE, EMBASE, AMED and PsycINFO), including a scan of grey literature sources (GreyNet International, Google Scholar, Web of Science, WorldCat and the Clinical Trials Registry) was conducted in October 2018.Eligibility criteria for selecting studiesStudies were included if they described views and perspectives of informal caregivers of cardiac surgery patients (non-intervention studies (qualitative and quantitative)), and the effectiveness of interventions to evaluate support programme for informal caregivers of cardiac surgery patients (intervention studies).ResultsOf the 4912 articles identified in searches, 42 primary research studies were included in a narrative synthesis with 5292 participants, including 3231 (62%) caregivers of whom 2557 (79%) were women. The median sample size across studies was 96 (range 6–734). Three major themes emerged from the qualitative study data: (1) caregiver information needs; (2) caregiver work challenges and (3) caregivers adaption to recovery. Across the observational studies (n=22), similar themes were found. The trend across seven intervention studies focused on caregiver information needs related to patient disease management and symptom monitoring, and support for caregivers to reduce symptoms of emotional distress.ConclusionInformal caregivers want to assist in the care of their significant others after hospital discharge postcardiac surgery. However, caregivers feel insecure and overwhelmed and they lack clear/concise discharge information and follow-up support during the early at-home recovery period. The burden of caregiving has been recognised and reported since the early 1990s, but there remains a limited number of studies that assesses the effectiveness of caregiver interventions.PROSPERO registration numberCRD42018096590.

Comparison of the effectiveness of home visits and telephone follow-up on the self-efficacy of patients having undergone coronary artery bypass graft surgery (CABG) and the burden of their family caregivers: A randomized controlled trial

“…( 32 ) In this regard, the findings of a study showed that even secondary caregivers suffer from physical and psychological problems during the provision of care services and need to be supported. ( 33 ) Although the challenges and problems that family caregivers face decrease over time due to gaining experience,( 34 ) conducting patient-oriented interventions, including educational interventions, as in the present study, are essential in reducing the care burden of family caregivers. ( 23 )…”

Tackling pain after cardiac surgery: It takes a village!

“…Nevertheless, very few studies have examined caregiver-facilitated pain management interventions in hospitalized adults (Yasmeen et al, 2020), as well as interventions focused on support for caregivers when transitioning at home (Bjornnes et al, 2019). Hence, in a systematic review of 42 studies including caregivers of cardiac surgery patients, solely 7 intervention studies were found (Bjornnes et al, 2019). The findings reflected caregivers feel insecure and lack information and support during the recovery at home (Bjornnes et al, 2019).…”

“…Hence, in a systematic review of 42 studies including caregivers of cardiac surgery patients, solely 7 intervention studies were found (Bjornnes et al, 2019). The findings reflected caregivers feel insecure and lack information and support during the recovery at home (Bjornnes et al, 2019). Yet, interventions educating caregivers and involving them in pain management seem promising in contributing to the reduction of pain intensity as well as opioid consumption (Rahmani et al, 2020;Yasmeen et al, 2020) and could even promote the use of positive pain coping strategies (Grondin et al, 2014).…”

Behaviours of older adults and caregivers preparing for elective surgery: a virtually conducted mixed-methods research protocol to improve surgical outcomes

“…Older patients and caregivers report feeling rushed and overwhelmed by information, and admit that they sometimes are too distracted by the excitement of going home to engage with education delivered on day of discharge. [14][15][16][17][18] Importantly, caregivers are not routinely included in the discharge process, potentially leading to informational gaps regarding postoperative instructions. 11 12 15 This is especially problematic for older adults who may have difficulty in understanding postoperative instructions due to pre-existing cognitive impairment and/or postoperative delirium.…”