OTA 2006 Posters
Scientific Poster #33 Reconstruction
The Stress of Fracture Care: The Other Side of the Story
Bruce H. Ziran, MD (n); Mary-Kate Barrette-Grischow, MA (n);
Thomas F. Hull, BA (n);
St. Elizabeth Health Center, Youngstown, Ohio, USA
Introduction: Literature regarding the socioeconomic effects of caring
for injured patients is sparse, yet with cuts in social programs, the number
of informal caregivers is growing steadily. This study examines the socioeconomic
impact of caring for orthopaedic patients and attempts to discover the dynamics
of burden associated with caregiving.
Methods: Questionnaires were administered to 99 caregivers of patients
with fractures at a regional Level I trauma center. Caregivers were given
two surveys, including the standardized Caregiver Burden Scale. Variables
included objective burden, subjective demand burden, subjective stress burden,
financial strain, and emotional and social stressors of caregiving. Ages
were coded into three groups: young (Y), 15-39 years; middle age (M), 40-64;
and older adult (O), 65+. Descriptive and inferential statistical analysis
was done using SPSS software.
Results: Regarding objective burden (infringement on daily life),
M caregivers reported higher burden (43%) than their cohorts (Y 35%, O 24%).
M patients were less of a burden (25%) than their cohorts (Y 48%, O 47%).
For subjective demand burden (perception of caregiving demands), more Y
caregivers reported feeling that patient demands were excessive/unfair (eg,
being taken advantage of) compared to cohorts (Y 26%, M 10%, O 5%). In the
subjective stress burden (emotional stress of caregiving), caregiving had
a negative emotional impact (eg, intimate relationships) more on Y (65%)
and M (57%) caregivers compared to the elderly (38%). Regarding financial
impact, O patients were less of a financial burden on their caregivers18%
(O) vs. 30% (M) and 55% (Y). M caregivers reported the most financial burden
(30% = significant, 4% = crisis) compared to cohorts (22% = significant,
0% = crisis). Caregivers of O patients reported less pre/post-injury financial
burden change with ratios: O = 0.8 (CI 98%, 0.60 to 1.05) compared to overall
= 0.5 (CI 98%, 0.42 to 0.57). There was also significant negative correlation
between patient age and financial burden 6 months after injury (P
= 0.03).
Conclusions: We identified previously unknown aspects of fracture
treatment. Middle age patients experience the most disruption and high levels
of stress across all variables but are the easiest to care for. Elderly
patients are less of a burden than other age cohorts. Reasons may include
quicker recovery of young patients, existing support systems for the elderly,
and life stresses during the middle ages. Lower burdens with the elderly
may be due to pre-existing care provided by middle-aged family. As government/social
programs diminish, patients/caregivers may experience more responsibilities
and stresses that may have significant personal, social, and economic impact.
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.