Postdischarge Caregiver Burden Among Family Caregivers of Older Trauma Patients

Author:

Tabata-Kelly Masami12,Ruan Mengyuan1,Dey Tanujit1,Sheu Christina1,Kerr Emma1,Kaafarani Haytham3,Ornstein Katherine A.4,Kelley Amy5,Gray Tamryn F.6,Salim Ali7,Joseph Bellal8,Cooper Zara17

Affiliation:

1. Center for Surgery and Public Health, Brigham and Woman’s Hospital, Boston, Massachusetts

2. The Heller School for Social Policy and Management, Brandeis University, Waltham, Massachusetts

3. Division of Trauma & Emergency Surgery, Department of Surgery, Massachusetts General Hospital, Boston

4. Johns Hopkins University, School of Nursing, Baltimore, Maryland

5. Brookdale Department of Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, New York

6. Department of Psychosocial Oncology and Palliative Care, Dana-Farber Institute, Boston, Massachusetts

7. Department of Surgery, Brigham and Woman’s Hospital, Boston, Massachusetts

8. Department of Surgery, University of Arizona, Tucson

Abstract

ImportanceCaregiver burden, characterized by psychological distress and physical morbidity, affects more than 50 million family caregivers of older adults in the United States. Risk factors for caregiver burden among caregivers of older trauma patients have not been well characterized.ObjectiveTo characterize postdischarge caregiver burden among caregivers of older trauma patients and identify targets that can inform interventions to improve their experience.Design, Setting, and ParticipantsThis study used a repeated cross-sectional design. Participants were family caregivers for adults 65 years or older with traumatic injury who were discharged from 1 of 2 level I trauma centers. Telephone interviews were conducted at 1 month and 3 months postdischarge with family caregivers (identified by the patient as family or friends who provided unpaid care). Admissions occurred between December 2019 and May 2021, and data were analyzed from June 2021 to May 2022.ExposureHospital admission for geriatric trauma.Main Outcome and MeasuresHigh caregiver burden was defined by a score of 17 or higher on the 12-item Zarit Burden Interview. Caregiver self-efficacy and preparedness for caregiving were assessed via the Revised Scale for Caregiving Self-Efficacy and Preparedness for Caregiving Scale, respectively. Associations between caregiver self-efficacy, preparedness for caregiving, and caregiver burden were tested via mixed-effect logistic regression.ResultsThere were 154 family caregivers enrolled in the study. Their mean (SD) age was 60.6 (13.0) years (range, 18-92 years), 108 of 154 were female (70.6%). The proportion of caregivers experiencing high burden (Zarit Burden Interview score ≥17) was unchanged over time (1 month, 38 caregivers [30.9%]; 3 months, 37 caregivers [31.4%]). Participants with lower caregiver self-efficacy and preparedness for caregiving were more likely to experience greater caregiver burden (odds ratio [OR], 7.79; 95% CI, 2.54-23.82; P < .001; and OR, 5.76; 95% CI, 1.86-17.88; P = .003, respectively).Conclusion and RelevanceThis study found that nearly a third of family caregivers of older trauma patients experience high caregiver burden up to 3 months after the patients’ discharge. Targeted interventions to increase caregiver self-efficacy and preparedness may reduce caregiver burden in geriatric trauma.

Publisher

American Medical Association (AMA)

Subject

Surgery

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