Table 1.
Characteristics of included studies: author and country; number of patients; number of caregivers; outcome measures; follow-up; data findings; conclusion; relationship with the patients.
| Author and Country; Number of Patients; Number of Caregivers |
Outcomes Measures; Follow-up |
Outcome Measures *; Follow-up |
Relationship with the Patients |
|---|---|---|---|
| Shen, 2015, China [13]; 492; 539. |
FES-I (p < 0.001); FRS (p < 0.001); VAS 24 months |
75.4% of family caregiver and 70.7% of patients showed FOF; Regular follow-up examinations showed a lower family caregiver FES-I score and a higher patient FRS. |
321 spouses (59.5%), 171 (31.7%) offsprings |
| Patrocinio Ariza-Vega, 2019, Spain [14]; 172; 172. |
CSI (p < 0.001); 1 year |
High level of caregiver difficulties at the hospital, at 1 and 3 months, and at 1 year after surgery; Support and training as strategies of treatment to reduce caregivers’ difficulties. |
Partner/spouse 39 (23%), son 15 (8%), daughter 94 (55%), others 24 (14%) |
| Margaret J. Bull, 2017, US [7]; 39; 39. |
CAM (Sensitivity of 94–100%, Specificity of 90–95%); FAM-CAM (Sensitivity of 87.5, Specificity of 94.2%); BSS; 3 weeks pre-surgery; 2-weeks and 2 months post-hospitalization. Caregivers: 2-days post-surgery |
The caregiver rating is high on the FAM-CAM 2 days after surgery; Recognizing presence or absence of delirium symptoms by caregivers. |
Spouse 24 (62%), daughter 8 (21%), others 7 (17%) |
| Maria Crotty, 2003, Australia [15]; 32; 66. |
MBI (p = 0.738); TUG (p = 0.001) Medical Outcomes; SF-36 (p = 0.689); CSI (p = 0.140); 4 months; 12 months |
Caregiver difficulty reduction is achieved by home-based therapy and rehabilitation for patients; Functionally independent patients, return home earlier, with increased involvement of caregivers. |
NS |
| Cuicui Li, 2018, China [16]; 87; 87. |
ZBI (36.83 ± 13.30); GSE (21.67 ± 7.65); 0 |
Moderate or severe caregiver difficulties; Social support and self-efficacy might be helpful to reduce caregivers’ difficulties. |
Mothers 51 (58.6%), others 36 (41.4%) |
| Rachel L. Difazio, 2016, US [17]; 44; 44. |
CP CHILD (p < 0.001); ACEND (p = 0.26); 1 year |
Children’s HRQOL improved over 12 months after spinal surgery; steady improvement over time after hip surgery, decrease at 6 weeks; Caregivers reported an improvement in HRQOL 1 year after orthopedic surgery. |
NS |
| Mohammad Hossein Ebrahimzadeh, 2013, Iran [18]; 72; 72. |
SF-36 (p < 0.001); 6 months |
Wives worked full time at home. 88.9% of veterans had a paraplegic lesion; The SF-36 scores of the spouses were lower. The caregivers’ challenges can impact the QOL of caregivers. |
Spouse 72 (100%) |
| Jacobi Elliott, 2014, Canada [19]; 8; 11. |
Questionnaire; 0 |
Facilitators and barriers included prior health care experience, trusting relationships, and the rural setting; Effective strategies to improve information sharing and care continuity may be involved. |
Adult children 6 (54.5%), spouses 2 (18.1%) |
| Amit Jain, 2018, US [20]; 251; 251. |
HRQOL (p < 0.001); 2 years post-surgery RNLI (33.3); CBI |
HRQL: 74% of caregivers are a “lot better”; Caregiving in spinal surgery is ranked as the most beneficial intervention in the patients’ lives. Caregiver burden is high at 18 and 24 months post-hip-fracture; |
NS |
| Katherine S. McGilton, 2019, Canada [21]; 76; 76. |
2 years post-hip fracture | There is a need for interventions for patients to enhance their RNLI and to support caregivers in decreasing their difficulties in caring. | Marital status, married or common-law partner 26 (34%) |
| Laura Churchill, 2018, GB [22]; 14; 14. |
Questionaire; 6 months Questionnaire; |
Concerns and challenges are mobility, pain, self-care and caregiver support; Outpatient THA can be implemented with pre-operative education, clarification of recovery processes and expectations. More details are needed from care providers to self-manage symptoms. |
NS |
| Odom-Forren J, 2017, US [3]; 9; 10. |
2 weeks after surgery | Nurses should be focused on preparing patients to manage sustained recovery issues at home. | Spouses 7 (70%), parents 2 (20%) |
| Jung-Ah Lee, 2014, US [11]; 30; 30. |
Questionaire; At hospitalization |
Patients and caregivers take daily injections of heparin. Patients with hip fracture and their caregivers may need further VTE preventive education. |
child or son/daughter-in-law 19 (63.4%), 3 (10%) spouses |
| Pi-Chu Lin, 2007, Taiwan [23]; 95; 95. |
OMFAQ; SERS; FOS; FFRS; FRS; CBI; 1 week and 1 month after discharge |
1 week after hospital discharge the patients’ physical functioning, self-efficacy, and social support contributed to variance in caregivers’ difficulties; A health education and social support program should be designed to improve the primary caregiver’s knowledge and to reduce the burden of care. |
Apouses 30 (31.6%), sons 20 (21.1%), 18 (18.9%) daughters, 17 daughters-in-law (17.9%), grandchildren 7 (7.4%) |
| Hsin-Yun Liu, 2015, Taiwan [24]; 276; 276. |
CBI; CMMSE; PS; MICROFET2; MNA; SF-36; 1-3-6-12 months after discharge |
MCS levels were lower (22.4%), moderate (34.1%) and highest (43.5%); Health care providers could consider family caregivers’ mental well-being while estimating recovery times and health outcomes of patients. |
Spouse 70 (25.3%), son 61 (22.1%), daughter 57 (20.6%), daughter-in-law 71 (25.7%), other 17 (6.1%) |
| Asha Manohar, 2014, US [25]; 44; 44. |
Questionnaire; ADL; Post-operative days; 0-3-7-30 |
Many patients needed more time to resume their ADL. Primary caregivers’ disturbances were emotional and physical; Informal caregiving may be an unrecognized physical and psychological burden and may have a significant societal impact. |
NS |
| Mariana Ortiz-Piña, 2019, Spain [26]; 70; 70. |
FIM; Euro-Qol/EQ-5D; TUG; CBZI; SPPB; ADS; 4 weeks and 12 weeks after discharge |
70 patients with a high pre-fracture functional level were allocated into a telerehabilitation group; Telerehabilitation is an option to promote recovery of the pre-fracture functional level. |
NS |
| Mashfiqul A Siddiqui, 2010, Singapore [27]; 76; 76 |
CSI; 6 months |
To 1 week of admission, and at 6 months, the caregivers were stressed. The stress factor was a financial strain. Adequate resources should be available to caregivers of patients with osteoporotic hip fractures. |
NS |
| Benedict U. Nwachukwu, 2019, NS [28]; 95; 95. |
UCLA Activity Score; HRQoL; Rehabilitation; 2 years post-surgery |
Active adolescents assigned higher utility to achieve a stable return to the same function and lower utility to health states in which they were not fully participating in sport; These findings provide insight into the health-related quality of life impact for acute patella dislocations and their management. |
NS |
| Joshua A. Parry, 2019, NS [29]; 29; 29. |
CBI; DS 6 months |
Caregivers have negative effects on their finances, relationships, work hours, or intent to place the patient in a care facility. Caregivers with high caregiver burdens were more likely to consider the placement of the patient into a long-term care facility. |
NS |
| Sara Elli, 2018, Italy [30]; 147; 147. |
BRASS; At the beginning of the rehabilitation program |
The caregivers assign lower scores than the doctor; Caregivers’ altered perceptions can lead to a general lack of satisfaction with the outcome at the end of the rehabilitation process. |
NS |
| Yea-Ing Lotus Shyu, 2012, Taiwan [31]; 135; 151. |
PRS; MOS; SF-36; CBI; 1-3-6-12 months after discharge |
Caregivers’ mental health was lower at 12 and 1 month after discharge; The home care nurses should develop interventions early after discharge. |
1/3 sons (32.66%), daughters-in-law (26.7%), spouses (20%), daughters (14.1%). |
| Åsa Johansson Stark, 2016, Finland [32]; 306; 306. |
During recovery | If nurses gave information to partners, they experienced a greater quality of recovery; Spouses’ emotional state is important in the patients’ quality of recovery. |
Spouses 306 (100%). |
| Justine Toscan, 2012, Canada [33]; 6; 6. |
Questionnaire; During transition care |
Four factors related to illness were confusion, unclear roles and responsibilities, diluted personal ownership over care, and role strain; Supports the notion of collaborative practice and includes an appropriate, informed role for patients and informal caregivers. |
Children 5 (99%) |
| Cornelis L. P. van de Ree, 2017, Netherland [34]; 123; 123. |
CarerQoL; 7D score; 1-3-6 months |
The average amount of informal care provided per patient per week was 39.5 during the first six months; The Carer QoL was not associated with the intensity of the provided informal care. |
Partners (44.7%), child (43.1%), sibling (5.7%), others (6.5%) |
| Li-Chu Wu, 2013, Taiwan [35]; 116; 116. |
Questionnaire; 1 month after discharge |
Impairments in physical functions were standing up/sitting down and dressing. The care needs were wound care, medical visits, cleaning, maintaining living; The physical function status was improved 1 week and after 1 month after discharge. The care needs and the difficulty of tasks for caregivers were negatively related to physical functional status. |
Daughters or Sons (54.3%), Spouses (34.5%), Foreign workers (11.0%). |
| Jayson D. Zadzilka, 2018, US [36]; 150; 150. |
CSI; KOOS; 4 weeks and 1 year after surgery |
CSI scores at 1 year were lower; The caregivers’ difficulties were high in the early post-operative period. It was close to zero by one year post-operation. |
NS |
ACEND: Assessment of Caregiver Experience with Neuromuscular Disease; BRASS: Blaylock Risk Assessment Screening Score; BSS: Bakas Satisfaction Scale; Carer QoL 7D Score: Carer Quality of Life 7D Score; CAM: Confusion Assessment Method; CBI: Chinese Barthel Index; CBS: Caregiver Burden Rating Scale; CBZI: Caregiver Burden Zarit Intervention; CMMSE: Chinese Mini Mental Status Examination; CP CHILD: Cerebral Plasty Child; CSI: Caregiver Strain Index; DS: Depression Scale; EQoL-5D: Euro Quality of Life 5D; FAM-CAM: Family Confusion Assessment Method; FES-I: Falls Efficacy Scale-International; FFRS: Family Function Rating Scale; FIM: Functional Indipendence Measure; FOS: Filial Obligation Scale; GSE: General Self-Efficacy Scale: HADS: The Hospital Anxiety and Depression Scale; HRQoL: Health Related Quality of Life; HSS-Pedi-FABS: Hospital for Special Surgery Pediatric Functional Activity Brief Scale; IFS: International Fitness Scale; IADL: Instrumental Activities of Dayly Living; KEso: Knowledge Expectations of Significant Other; KOOS: Knee Injury and Osteoarthritis Outcome Score; MBI: Maslach Burnout Inventory; MCI: Mild Cognitive Impairment; MICRO FET2: Micro Force Evaluation Testing 2; MNA: Mini Nutritional Assesment; MOS: Medical Outcome Study; MOS SF-36: Medical Outcome Study Short Form-36; OMFAQ: Multidimensional Functional Assessment Questionnaire; PRS: Performance Related Scale; PS: Pain Scale; QoL: Quality of Life; RKso: Received Knowledge of Significant Other; RNLI: Reintegration to Normal Living Index; SERS: Self Efficacy Rating Scale; SFES-I: Short Falls Efficacy Scale-International; SF-36: Short Form 36; SPPB: Short Physical Performance Battery; TUG: Timed Up and Go Test; UCLA: University of California, Los Angeles Loneliness Scale; VAS: Visual Analog Scale; VTE: Venous Thromboembolism; ZBI: Zarit Burden Interview.