Family caregivers' burden and its influencing factors in elderly patients with hip fracture and cognitive impairment

Objective To investigate the burden level and influencing factors among the family caregivers of elderly hip fracture patients with cognitive impairment, and to provide a theoretical basis for the intervention study on reducing the burden of family caregivers. Methods This study was a cross-sectional survey. A total of 130 elderly hip fracture patients with cognitive impairment who were admitted to a ClassⅢ Grade A hospital in Shanghai from January to November 2018 as well as their family caregivers (n=130) were selected by convenient sampling. Patient and Caregiver General Information Questionnaire, Montreal Cognitive Assessment Scale (MoCA) , Barthel Index Assessment Scale (BI) , Caregiver Burden Inventory (CBI) , Neuropsychiatric Inventory-Questionnaire (NPI-Q) , Simple Coping Style Questionnaire (SCSQ) , Social Support Rating Scale (SSRS) were used in the investigation. Single factor analysis and multiple stepwise regression analysis were used to analyze the influencing factors of caregiver burden. A total of 130 questionnaires were sent out and 121 valid questionnaires were collected, yielding an effective recovery rate of 93.08%. Results The CBI score of family caregivers of elderly hip fracture patients with cognitive impairment was (38.58±16.46) , and the overall level of caregivers was medium. Univariate analysis showed that there were statistically significant differences in the burden level among caregivers of patients in terms of the following 7 factors: different level of cognitive impairment, self-care ability, caregiver's past history, whether living with patients, whether multiple caregivers or not, daily care time and total care time (P<0.05) . Multivariate stepwise regression analysis showed that self-care ability and cognitive impairment, caregiver's NPI-Q pain degree, negative coping style and daily care time were the main influencing factors of family caregiver burden in elderly hip fracture patients with cognitive impairment (R2=0.564, F=29.726, P<0.01) . Conclusions Care burden exists in family caregivers of elderly hip fracture patients with cognitive impairment. Medical workers should provide individual professional support and humanistic care to the caregivers according to the specific conditions of the patients' families, so as to improve the overall burden level of family caregivers. At the same time, it calls on the government, medical institutions and other relevant support policies to improve the care ability of caregivers, shorten their daily care time, reduce their burden, and promote their physical and mental health. Key words: Aged; Hip fracture; Cognition disorders; Caregivers; Burden; Infuencing factors