Pain of fracture and stress of caregiving: Links between patient function and caregiver burden

Purpose: The trend in modern healthcare is toward more responsibility being assumed by non-compensated caregivers. This study examines the relationship between older orthopaedic trauma patients' SF-36 scores and the degree of stress upon informal caregivers.

Methods: 45 pairs of patients (>59years) and their caregivers were the basis of this study. Demographic and injury data was collected and patients were given the standardized SF-36V2. Caregivers were administered the standardized Caregiver Burden Scale (disruption of life, emotional stress, and responsibilities too demanding) and an additional survey developed by the authors. SPSS statistical analysis utilized frequency tables and T-tests.

Results: Mean SF-36 scores were more than one standard deviation below the national average (Physical Component Score 32.92, Mental Component Score 35.73). Overall caregiver stress response was high (32% high life disruption, 47% high emotional impact of care responsibilities). Low PCS was associated with high life disruption for the caregiver (p<0.01). Bodily pain and physical functioning were the components most influential to caregiver stress. Regarding the MCS, vitality (energy, pep) was the only component with a significant relationship to caregiver stress (p<0.05). No relationships were identified between patient SF-36 scores and emotional impact on the caregiver.

Discussion: This study suggests an interaction between the health of patients and the stress burden of caregivers. It is interesting that the relationship can be seen with the physical health measurement but not the mental. As caregiver responsibilities evolve to include non-compensated providers, understanding the dynamics of the patient/caregiver relationship may be important when evaluating functional outcomes studies.