Study On The Burden Of Caregiver For Spinal Cord Injury Patients And It’s Influencing Factors

Background:Spinal cord injury (SCI) is a relatively common serious disabling disease. Spinal cord injury can cause damage of body function under the level of the injury, such as loss of feeling, movement disorders, abnormal reflexes, impairment of bowel and bladder control ability and other changes accordingly, spinal cord injury can cause permanent disability, many people are unable to take care of themselves. Most of the patients stay at home during their rehabilitation process after injury, and this will undoubtedly bring heavy burden to the family caregivers. Caregivers’burden includes the influence of the care on the caregiver’s mental, emotional and social life, the time spent on care, costs and care tasks. Family caregivers take the major responsibility to help and support the patients in their rehabilitation process. At home and abroad, there are lack of a comprehensive and in-depth study researches about the caregivers’ burden of spinal cord injury, this study aims to explore the care burden of the care givers of SCI, arouse care workers to concern for the caregivers’ health, provide a theoretical basis for nursing interventions, help caregivers to adapt to the caregivers’ role better and to promote the health level of the patients and their families.Objective:(1)To describe the care burden level of care givers of spinal cord injury patients.(2)To describe the coping status and self-efficacy levels of caregivers of spinal cord injury patients.((3)To analyse the influencing factors of the caregivers’ burden of SCI patients.(4)To explore the caregivers’ care experience and feelings of patients with spinal cord injury.Method:This study includes two parts:the quantitative study and the qualitative research.The quantitative research:A convenience sampling method was used in this study. From December 2011 to December 2012 in the second and third affiliated hospital of Nanchang University, the caregivers of SCI outpatients participated in the investigation.Self-report questionnaires were used to collect the data, including primary family caregivers of patients and the general information, Activity of Daily Living Scale,Simplified Coping Style Questionnaire,General Self-Efficacy Scale Social Support Rating Scale,the ability of caring for SCI patients questionnaire,and the Zarit Caregiver Burden Interview.The qualitative research:A phenomenological research method was used in this study.15 caregivers of spinal cord injury in Jiangxi province participated in the semi-structure interviews. The data was analyzed by Claizzi’s phenomenological procedure.Results:In the quantitative research:1.The score of care burden of 150 caregivers with spinal cord injury were (52.91±11.56) minutes,88% of the burden of caregivers were in the moderate and severe levels.2.The degree of spinal cord injury patients,daily living,health insurance and complications had effect on the care burden,while the patient’sgender, age had no effect.Caregivers’gender,educational level,care time had effect on the care burden,while age, religion had no effect.3.patients used more negative coping styles, and adopted less positive coping styles(P<0.01), the care burden of caregivers of patients with SCI was negatively correlated with positive coping style (r=-0.418), positively correlated with negative coping style (r= 0.613).4.The self-efficacy score of caregiver were (19.63±4.85) points; the score of care burden of caregivers and self-efficacy was highly negative correlation, (r=-0.294) 5.Different ages and caring time of Caregivers had no different care burden;caregivers with higher educaion had higher caring capacity scores, and the difference was statistically significant(P<0.01); Caregiver burden and care ability of caring was significant negative correlation (r=-0.237).6.Social support of caregivers’ total score were(6.83±2.87)minutes,which was lower, caregiver burden caren was negatively correlated with social support (r=-0.244).7.Multiple linear regression analysis showed that care burden of caregivers had some influencing factors:complications (β=0.641), the number of caring days (β=0.431), positive coping styles (β=0.158)、the patient’s self-care ability (β=-0.320), the ability of caring (β=-0.241), self-efficacy (β=-0.285) and negative coping styles (β=-0.082)In the qualitative study:Six themes were derived from the interviews: ①physical and mental exhaustion, physical and mental exhaustion includes physical exhaustion, lifestyle changes, and sadness/helplessness.② more negative response than positive response.③ self-efficacy becomes low.④ inadequate care.⑤ weak social support systems ⑥ heavy economic burden.Conclusion:The caregivers of patients with spinal cord injury bear heavy care burden, including social, physical, psychological aspects, lack of capacity of care. All aspects of the burden of care workers should be concerned about the health of caregivers. Nurses should pay more attention to the caregivers of spinal cord injury, encourage patients to promote self-care ability,enhance social support system, guide them to take an active coping style, avoiding negative coping style, continuously improve self-efficacy and to reduce the burden of care for caregivers. Nurses should help the caregiver adapt to caregiver role better, in order to promote the health level of the patients and their families.