Paper
Thursday, 20 July 2006
This presentation is part of : Acute Care Models and Strategies
Caregiver Burden and Health-Related Quality of Life Outcomes of Spouses of Coronary Artery Bypass Patients
Margo A. Halm, RN, PhD, APRN-BC1, Ruth Ann Lindquist, RN, PhD, APRN, BC, FAAN2, and Diane Treat-Jacobson, PhD, RN2. (1) United Hospital, St. Paul, MN, USA, (2) School of Nursing, University of Minnesota, Minneapolis, MN, USA
Learning Objective #1: The learner will be able to describe caregiving and HRQL outcomes of spouse caregivers at 3, 6 and 12 months after their partner's CAB surgery.
Learning Objective #2: The learner will be able to discuss the predictors of caregiver burden for spouses of CAB patients during the first year of recovery after surgery.
Introduction: CAB patients often rely on spouses for support and assistance during their recovery after surgery. While caregiving may be meaningful, it may also be stressful and affect spouse’s health related-quality of life (HRQL) and their ability for caregiving.  However, little is known about the impact of burden on spousal HRQL.
Methods:  This cross-sectional study assessed the hypothesis that total caregiver burden would be reduced at 12 months (versus 3 and 6 month cohorts), and that caregiver burden (total, objective, subjective) would be negatively associated with spousal HRQL.  A convenience sample of CAB spouses (N=166) (power analysis: moderate effect size .5, power .80, alpha .05) was recruited at 3, 6 or 12 months. Spouses completed surveys on patient health status, caregiver burden and other caregiving variables, and HRQL outcomes.
Results:  Caregiver burden was low-to-moderate.  No differences were found between total, objective or subjective burden at 3, 6 or 12 months.  Male caregivers had significantly higher total burden but more positive caregiving outcomes. Caregiver burden was predicted by patient’s gender (female) and poorer health status, lower caregiver mental HRQL, and increased personal gain and caregiver competence; these predictors explained 38% of the variance in burden.  Additionally, burden was significantly associated with poorer life satisfaction, physical and mental HRQL, State anxiety and depression.
Conclusions:  Total, objective and subjective burden were negatively associated with HRQL outcomes in spouse cohorts of all timepoints, but these outcomes were not lower at 12 months as expected.  At-risk caregivers need to be identified so that nurses can link spouses to appropriate hospital and community resources. Longitudinal investigations over the first year after CAB surgery could identify timepoints most burdensome for caregivers, as well as the impact of burden on patient recovery outcomes to lay the foundation for intervention programs to support CAB patients and spouse caregivers. 

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