Abstract
BackgroundHealth-care systems nowadays rely on complementary patient care by informal caregivers. The need for, and burden on, informal caregivers will likely increase in the upcoming years. This study aimed to examine the burden on caregivers when providing care for elderly patients undergoing major abdominal surgery.MethodsA single-centre longitudinal cohort study was conducted between November 2015 and June 2018 in the Amphia hospital in Breda, the Netherlands. Patients aged 70+ undergoing elective surgery for colorectal carcinoma (CRC) or an abdominal aortic aneurysm (AAA) were included in this study. Informal caregiver burden was assessed and compared over time using the Caregiver Strain Index (CSI) at the outpatient clinic visit, at discharge, 2 weeks post-discharge and after 6 and 12 months. The effects of patient- and caregiver-related factors on the experienced caregiver strain were examined.ResultsCSI scores of 248 caregivers were significantly increased at discharge (3.5 vs 2.6; p < 0.001) and 2 weeks post-discharge (3.3 vs 2.6; p < 0.001). After 12 months, scores dropped below baseline scores (1.8 vs 2.6; p = 0.012). The highest strain was observed 2 weeks post-discharge for AAA patients and at discharge for CRC patients. Older age, physical or cognitive impairment and burden of comorbidity were associated with an increased caregiver strain at baseline. Type of surgery was independently associated with the change in mean CSI scores over time; a bigger change in caregiver burden is observed after open surgery.ConclusionIn the early postoperative period, perceived caregiver strain was significantly increased. Psychological support for caregivers may be advisable, with timing of this support depending on diagnosis and patient-related factors.Trial registrationThis manuscript was retrospectively registered on 05-04-2016 in the Netherlands Trial Register (NTR5932). http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=5932
Highlights
Health-care systems nowadays rely on complementary patient care by informal caregivers
This study aimed to describe the caregiver strain experienced by informal caregivers when providing care for elderly patients undergoing elective major abdominal surgery for colorectal cancer (CRC) and abdominal aortic aneurysms (AAA) and the factors influencing this strain
Caregiver strain was highest at discharge and 2 weeks post-discharge, emphasizing the importance of informing informal caregivers prior to surgery to prepare them for the care situation at home and of adequate psychological support for both patient and the patients’ informal caregiver during the early postoperative period when desired
Summary
Health-care systems nowadays rely on complementary patient care by informal caregivers. This study aimed to examine the burden on caregivers when providing care for elderly patients undergoing major abdominal surgery. Two diseases that are commonly present in older patients are colorectal cancer (CRC) and abdominal aortic aneurysms (AAA). Both conditions require major abdominal surgery and may both have serious impact on a patient’s physical and mental well-being, thereby possibly requiring additional help of informal caregivers. In CRC patients, an additional mental burden is experienced due to the diagnosis of cancer, with possible psychological problems and decreased quality of life as a consequence [1, 2]. Providing informal care to cancer patients negatively affects psychological health in over 90% of caregivers and physical health in nearly 10% [5, 6]
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