Caregiver burden and its relationship to health-related quality of life of spouses of coronary artery bypass patients
Margo A. Halm, PhD, RN, NEA-BC attended the University of Iowa (BSN, MA nursing) and the University of Minnesota (PhD Nursing). In her 40+ career, Halm has held staff nurse, clinical nurse specialist, nurse scientist and nursing director positions in large organizations in the U.S. She was certified for 20 years in both critical care nursing (CCRN) and as an adult medical/surgical clinical nurse specialist (ACNS-BC). Currently she is certified as a nurse executive advanced (NEA-BC). As a CNS, Halm developed a love for research, EBP and writing. She blended these interests by pitching the idea for an EBP column in the American Journal of Critical Care, envisioning syntheses of the best available evidence on contemporary health care issues to guide high-acuity and critical care nursing practice. Launched in 2007, ‘Clinical Evidence Review’ has featured over 40 evidence syntheses to date. Dr. Halm’s research has spanned patient-and-family-centered care, women and heart disease, integrative therapies (music therapy, auricular acupressure, essential oils), caregiving after heart surgery, and EBP competency. Her current research focuses on validating the Modified Fresno test, an objective measure to assess EBP knowledge/skills of acute care nurses, and investigating the lived experience of nurses during the COVID-19 pandemic. In addition to her own program of research, Halm has a passion for mentored research experiences where she guides nurses through each step of the research process to generate and disseminate new knowledge for practice. Examples of mentored research topics include identifying characteristics of patients who frequently use emergency department services; evaluating pain and coping scales to determine their impact on women’s perceptions of positive presence during labor; validating a functional pain assessment scale; testing the effectiveness of Lavandin in reducing preoperative anxiety; examining the effects of Peppermint oil in alleviating urinary retention in hospitalized patients; and the lived experience of nurses during a global pandemic.
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Background. With today's aging population and short hospitalizations, patients recovering after coronary artery bypass (CAB) surgery rely on family assistance, usually from their spouse. While caregiving may be meaningful, this experience may be stressful. Very little is known about caregiver burden after CAB surgery. The purpose of this cross-sectional study was to investigate the correlates of caregiver burden in the first year after CAB surgery and its relationship to spousal health-related quality of life (HRQL) outcomes.
Method. Using a comparative design, a convenience sample of 166 spouses of CAB patients was recruited from three Midwestern hospitals. Cohorts completed a survey on patient health status, caregiver burden and HRQL outcomes, and relationship, support and demographic factors at either 3, 6 or 12 months.
Results. Caregiver burden was low-to-moderate—a finding consistent with other studies (Rankin, 1988; Stolarik et al., 2000). No differences were found between total, objective or subjective burden of spouses at 3, 6 or 12 months; male caregivers had significantly higher total burden but more positive outcomes from caregiving. Caregiver burden was predicted by patient's gender (female) and poorer health status, lower mental HRQL, and increased personal gain and caregiver competence; these predictors explained 38% of the burden variance. Additionally, caregiver burden was significantly associated with poorer caregiver HRQL outcomes, impacting physical and mental HRQL, State anxiety, depression, and life satisfaction.
Implications. Caregiver screening tools would be useful for nurses to identify caregivers at risk for burden so they can be linked to resources in the hospital and community. Adequate preparation of spouses regarding what to expect in terms of caregiving demands and difficulties after discharge is imperative. Spouse caregivers need to be informed of the stresses of caregiving and ways to reduce its impact on HRQL outcomes, such as adequate rest and sleep, time for self, and regular medical follow-ups.
Recommendations. Longitudinal investigations over the first year after CAB surgery are essential to identify what timepoints are most burdensome for caregivers, as well as how burden differs based on age, gender and ethnicity. This knowledge is critical to lay the foundation for intervention programs that best support caregivers.
This dissertation has also been disseminated through the ProQuest Dissertations and Theses database. Dissertation/thesis number: 3167683; ProQuest document ID: 305465303. The author still retains copyright.
|Review Type||None: Degree-based Submission|
|Research Approach||Quantitative Research|
|Keywords||Coronary Artery Bypass Surgial Patients;
Quality of Life;
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