Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
Divison of Neurosurgery, Department of Surgery, Toronto Western Hospital, University Health Network, University of Toronto, Toronto, Canada.
J Clin Neurosci. 2021 Jun;88:83-87. doi: 10.1016/j.jocn.2021.03.035. Epub 2021 Apr 1.
The objective of this study is to describe the caregiver burden, as well as the financial burden among caregivers after inpatient and outpatient neurosurgical patients. In this single center, observational study, adult patients undergoing elective inpatient or outpatient neurosurgery (supratentorial tumor resection or lumbar microdiscectomy) and his/her caregiver were recruited for the study. Bakas Caregiving Outcome Scale (BCOS) was used to assess caregiver burden and data was collected from preoperative period until post-operative day (POD) 30. Cost burden was assessed by a cost diary from day of surgery till POD 7. Forty-eight patient-caregiver pairs (21 inpatient craniotomies, 7 outpatient craniotomies, and 20 outpatient microdiscectomies) completed the study. BCOS values were in the negative impact range (<60) on POD1 in craniotomy group and improved to positive impact range (>60) after POD3. Median BCOS score remained at 60 in outpatient microdiscectomy. 56% of caregiver had at least 1 day of loss of income and 20% lost income throughout first 8 days. Median Cost (in Canadian dollars) associated with caregiving ranged from C$57 to C$250 amongst different groups. We concluded that caring for patients after craniotomy is psychologically demanding which leads to an increase in caregiver burden. In addition, there is a cost burden for the care givers in the form of missed workdays and additional direct expenses. Further studies are needed to recognize this problem and address the burden among the caregivers in the neurosurgical population.
本研究旨在描述神经外科住院和门诊患者的照顾者负担和经济负担。在这项单中心观察性研究中，招募了接受择期住院或门诊神经外科手术（幕上肿瘤切除术或腰椎微切除术）的成年患者及其照顾者。使用 Bakas 照顾者结局量表（BCOS）评估照顾者负担，并在术前至术后第 30 天（POD）期间收集数据。通过手术日至 POD7 的费用日记评估费用负担。共有 48 对患者-照顾者（21 例住院开颅术、7 例门诊开颅术和 20 例门诊微切除术）完成了研究。BCOS 值在开颅术组的 POD1 处于负面影响范围（<60），并在 POD3 后改善为正影响范围（>60）。门诊微切除术的 BCOS 评分中位数仍为 60。56%的照顾者至少有 1 天收入损失，20%的照顾者在头 8 天内收入损失。不同组间与照顾相关的中位费用（加元）范围为 57 加元至 250 加元。我们得出结论，照顾开颅术后的患者在心理上要求很高，这导致照顾者负担增加。此外，照顾者还面临因错过工作日和额外直接费用而产生的经济负担。需要进一步的研究来认识到这个问题，并解决神经外科患者照顾者的负担。
