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      Caregiver's Burden in Rehabilitation of Patients with Neurological Deficits following Traumatic Spinal Cord Injury

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          ABSTRACT

          Introduction

          Traumatic spinal cord injury (SCI) is an emerging public health problem reaching epidemic proportions. Reduced functional capacity after SCI not only affects the quality of life (QOL) of the patient, but also creates an added social, financial, and psychological burden on the family. Caregiver is responsible for providing the patient with physical, emotional, and functional support. Therefore, the increasing burden on the caregiver worsens all the domains constituting the QOL of the patient. Thus, the understanding of caregiver burden in terms of demographic profile of caregivers, severity of SCI, cost of care, mode of treatment adopted, and employment and education of the caregiver is important in the rehabilitation of patients with SCI.

          Materials and methods

          A cross-sectional analytical questionnaire survey was performed with 50 SCI patients and their primary caregivers at a tertiary care institution between June and September 2016. The caregiver burden was assessed using the Zarit burden interview scale, and its relation with severity of injury and type of treatment was analyzed using nonparametric statistics. The demographic variables influencing caregiver burden were also studied.

          Results

          About 38% of patients had complete SCI. About 34% of caregivers of patients were their own spouse. The mean age of caregiver was 42.9 ± 1.2 years. The majority (44%) of caregivers had moderate burden. Completeness of SCI significantly influenced caregiver burden (p = 0.02). Type of treatment adopted did not influence the caregiver burden (p = 0.52). Employment status and education of caregiver were found to be significantly associated with caregiver burden (p = 0.001 and p = 0.046 respectively).

          Conclusion

          Caregivers had significant burden of care in terms of severity of SCI. Age, employment status, education, and marital status affect caregiving burden. We hope the results of the study will guide experimental research in this field, motivating the health care professionals in providing early psychological intervention leading to positive belief and attitude change in society. The study will encourage society in focusing on community-based rehabilitation, which can potentially reduce the overall burden.

          How to cite this article

          Gopal VV, Baburaj PT, Balakrishnan PK. Caregiver's Burden in Rehabilitation of Patients with Neurological Deficits following Traumatic Spinal Cord Injury. J Spinal Surg 2017;4(1):9-13.

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          Most cited references9

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          A global map for traumatic spinal cord injury epidemiology: towards a living data repository for injury prevention.

          Literature review. To map traumatic spinal cord injury (TSCI) globally and provide a framework for an ongoing repository of data for prevention. An initiative of the ISCoS Prevention Committee. The results obtained from the search of Medline/Embase using search phrases: TSCI incidence, aetiology, prevalence and survival were analysed. Stratification of data into green/yellow/red quality 'zones' allowed comparison between data. Reported global prevalence of TSCI is insufficient (236-1009 per million). Incidence data was comparable only for regions in North America (39 per million), Western Europe (15 per million) and Australia (16 per million). The major cause of TSCI in these regions involves four-wheeled motor vehicles, in contrast to South-east Asia where two-wheeled (and non-standard) road transport predominates. Southern Asia and Oceania have falls from rooftops and trees as the primary cause. High-fall rates are also seen in developed regions with aged populations (Japan/Western Europe). Violence/self-harm (mainly firearm-related) was higher in North America (15%) than either Western Europe (6%) or Australia (2%). Sub-Saharan Africa has the highest reported violence-related TSCI in the world (38%). Rates are also high in north Africa/Middle East (24%) and Latin America (22%). Developed countries have significantly improved TSCI survival compared with developing countries, particularly for tetraplegia. Developing countries have the highest 1-year mortality rates and in some countries in sub-Saharan Africa the occurrence of a spinal injury is likely to be a fatal condition within a year. Missing prevalence and insufficient incidence data is a recurrent feature of this review. The piecemeal approach to epidemiological reporting of TSCI, particularly failing to include sound regional denominators has exhausted its utility. Minimum data collection standards are required.
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            Causes and costs of spinal cord injury in the United States.

            M DeVivo (1997)
            A cross-sectional multicenter study was conducted to estimate the direct costs for each cause of spinal cord injury in the United States. Random samples of 227 new injuries and 508 persons 2-16 years postinjury were selected. Prospective data were collected during one year on all charges for emergency medical services, hospitalizations, attendant care, equipment, supplies, medications, environmental modifications, physician and outpatient services, nursing homes, household assistance, vocational rehabilitation, and miscellaneous items. In 1995 dollars, first year charges averaged $233,947 for vehicle crashes, $217,868 for violence, $295,643 for sports, $185,019 for falls and $208,762 for other causes. Recurring annual charges for each cause averaged $33,439, $17,275, $27,488, $26,238 and $23,510, respectively. Using average age at time of injury for each cause, a 2% real discount rate, and the most recent survival data from the National Spinal Cord Injury Statistical Center, average lifetime charges for each cause were $969,659, $613,345, $950,973, $630,453 and $673,749, respectively. Given an estimated 10,000 new cases of spinal cord injury occurring each year of which 35.9% are caused by vehicle crashes, 29.5% are caused by violence, 20.3% are caused by falls, 7.3% are caused by sports, and 7% result from other causes, annual aggregate direct costs of traumatic spinal cord injury in the United States are $3.48 billion for vehicle crashes, $1.81 billion for violence, $1.28 billion for falls, $694 million for sports and $472 million for other causes. Total direct costs for all causes of SCI in the United States are $7.736 billion.
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              The psychological and physical health of family members caring for an elderly person with dementia

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                Author and article information

                Contributors
                Role: Associate Professor
                Role: Associate Professor
                Role: Professor and Head
                Journal
                JOSS
                The Journal of Spinal Surgery
                JOSS
                Jaypee Brothers Medical Publishers
                2349-0462
                2348-6031
                January-March 2017
                : 4
                : 1
                : 9-13
                Affiliations
                [1,3 ]Department of Neurosurgery, Government Medical College Kottayam, Kerala, India
                [2 ]Inter University Centre for Disability Studies, School of Behavioural Sciences, Mahatma Gandhi University, Kottayam Kerala, India
                Author notes
                Vinu V Gopal, Associate Professor Department of Neurosurgery, Government Medical College Kottayam, Kerala, India, Phone: +919656769340, e-mail: vinoogopa@ 123456gmail.com
                Article
                10.5005/jp-journals-10039-1117
                89a9ebfd-a791-43af-80ab-f19a1a633d30
                Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.

                Creative Commons Attribution 4.0

                History
                Categories
                ORIGINAL ARTICLE
                Custom metadata
                joss-2017-4-9.pdf

                General medicine,Pathology,Surgery,Sports medicine,Anatomy & Physiology,Orthopedics
                Spinal cord injury,Burden,Caregiver,Traumatic

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