Study On Caregiver Burden And Influencing Factors Of Burn Patients

Objective To understand the caregiver burden of burn patients and analyze the relationship between caregiver burden and quality of life and social support;To explore the influencing factors of caregiver burden of burn patients and understand the real experience through semi-structured interviews so that further understand their burden of care.Methods This study adopts a mixed method of quantitative and qualitative research.In the quantitative research part,using convenient sampling method to investigate 220 burn patients and their main caregivers who met the inclusion and exclusion criteria in a certain general hospital in Yinchuan,Ningxia,from October 2017 to November 2018.Assessment tools included the general information questionnaire for caregivers,the general information questionnaire for burn patients,the Zarit Care Burden Scale(ZBI),the Social Support Rating Scale(SSRS),and the MOS 36-Item Short from Health Survey(SF-36).SPSS22.0 statistical software package was utilized to analyze all collected data.The methods included descriptive analysis,t-test,variance analysis or rank sum test(when the variance was uneven),Pearson correlation and multiple linear regression analysis.In the part of qualitative research,from October 2017 to November 2018,the representative subjects were selected by purposeful sampling for face-to-face semi-structured in-depth interviews.Each case was interviewed for 40-50 minutes.Investigators listened carefully,recorded the interviews truthfully,and carefully observed the facial expressions and emotional changes of the interviewees.At the same time,the inner experience expressed bythe subjects was recorded by recording notes.Now,within 24 hours of the end of the interview,transcribed the recorded material into words in order to understand its ideas and refine its theme.Based on the sample inclusion principle of information saturation,the inclusion of new subjects was stopped when no new information appeared.Finally,17 subjects participated in the interview and used Colaizzi seven-step analysis method to analyze the data.Results 1.In this study,220 questionnaires were sent out and recovered.Six invalid questionnaires were excluded.The valid rate of the questionnaires was 97.27%.2.The highest score of the ZBI was 71 points and the lowest was 4 points,and the average score was 34.22 ± 14.68.The caregivers burden was mild in 46 cases(21.5%),moderate in 87 cases(40.7%)and severe in 81 cases(37.9%).3.The average score of subjective social support was 23.86±4.76;the average score of objective support was 9.49±2.33;the average score of social support utilization was 6.82±1.91;the average score of total social support was 39.94±6.98.There were 30(14%)cases with low social support level,133(62%)cases with medium social support level and 51(24%)cases with high social support level.4.The scores of physical function and social function of caregivers were higher than those of domestic norms,and the scores of general health,vitality,emotional function and mental health were lower than those of domestic norms(P < 0.05).5.Univariate analysis showed that the variables of caregivers with statistical differences were monthly income per capita,education level,working status,residence,financial burden,sleeping problems,daily care time and number of assistant caregivers(P<0.05).The variables of burned patients were education level,nature of burns,the degree of burns,the depth of burns,head and neck burns or not(P<0.05).6.The correlation analysis between caregiver burden and social support showed that thehigher the score of subjective support,the lower the score of personal burden and total burden(P<0.05).The higher the total score of social support,the lower the score of role burden,personal burden and total burden(P<0.05).7.The correlation analysis between caregiver burden and quality of life showed that role burden was negatively correlated with bodily pain,general health,vitality,role emotional and mental health(P<0.05).Personal burden was negatively correlated with general health,vitality,social functioning,role emotional and mental health(P<0.05).Total burden was negatively correlated with bodily pain,general health,vitality,social functioning,role emotional and mental health(P<0.05).8.Multivariate analysis showed that the main influencing factors of role burden were vitality,caregiver's age,sleeping difficulty,working condition,residence and medical expenses.The main influencing factors of personal burden were vitality,sleeping difficulty,role emotional,care time,burn TBSA,residence,burn degree,role physical and social functioning.The main influencing factors of total burden were vitality,sleeping,residence,burn TBSA,role emotional,economic,degree of burns and mental health.9.After the analysis of interview data,four themes were extracted: physiological burden,psychological or emotional burden,social burden and economic burden.Conclusion 1.The burden of caregivers of burn patients was at a moderate level,enabling caregivers to have sufficient energy and sleep,and providing financial and emotional support to alleviate the caregiver's burden.2.The social support of caregivers was at a medium level.Good social support to the caregivers can reduce the burden of caregivers.3.The general health,vitality,emotional function and mental health of caregivers of burn patients were lower than the domestic norm.The improvement of caregivers' burden can benefit from the improvement of caregivers' quality of life.4.The negative emotions of caregivers were particularly significant.Full understanding of caregivers and corresponding psychological and emotional support can effectively reduce the burden of caregivers.