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Table of Contents
Year : 2016  |  Volume : 12  |  Issue : 1  |  Page : 4-6

Burden among the care givers of traumatic brain injured patients admitted in critical care units

1 Nursing Incharge, NIMHANS, Bengaluru, India
2 Formerly Additional Professor, Dept of Nursing NIMHANS, Bengaluru, India

Date of Web Publication17-Jun-2019

Correspondence Address:
Nursing Incharge, NIMHANS, Bengaluru
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/2231-1505.260548

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Traumatic brain injury is a catastrophic and life altering experience which creates major problems to the victims, family and society.This study was conducted to assess the level of burden on care givers of critically ill traumatic brain injury patients hospitalized in critical care units at NIMHANS. Descriptive research design was used for the study. A total of 100 subjects were selected using simple random sampling method. Socio-demographic data schedule and Zarit burden interview was used to collect the information for a period of 3 months.Results showed that the burden mean score and standard deviation was70.26± 5.764. Socio demographic variables showed no influence on burden in the study subjects.The study concluded overall findings of this study showed increased burden scores in care givers of traumatic brain injury patient which suggest that nurses need to conduct motivation and interventional programmes to improve the care giver’s coping and reduce their burden level.

How to cite this article:
Kusuma, Nagarajaiah. Burden among the care givers of traumatic brain injured patients admitted in critical care units. Indian J Psy Nsg 2016;12:4-6

How to cite this URL:
Kusuma, Nagarajaiah. Burden among the care givers of traumatic brain injured patients admitted in critical care units. Indian J Psy Nsg [serial online] 2016 [cited 2023 Apr 2];12:4-6. Available from: https://www.ijpn.in/text.asp?2016/12/1/4/260548

  Introduction Top

TBI’s are leading cause of mortality, morbidity, disability and also socio economic losses in India and other developing countries. Nearly 1.5 to 2 million people are injured and one million people succumb to death every year in India[1]. Road traffic injuries resulted in the death of an estimated 110,000 persons, 2.5 million hospitalizations and eight to nine million minor injuries. Nearly 10%-30% of hospital registrations are due to road traffic injuries and a majority of these people have varying levels of disabilities.[2]

The term care giver refers to anyone who routinely helps others who are limited by acute or chronic conditions, caring for a family member with a TBI is unique and undoubtedly a stressful situation and one that most of the people have not experienced before. The challenges and responsibilities that come in caring for a person with TBI can result in the caregiver experiencing exhaustion and isolation especially when they don’t get proper assistance in the need for support, education and regular breaks.[3] In addition , the unpredictability of TBI can mean that though the patient has survived, for how long the caregiver has to take up the role and to what extent, cannot be foreseen which makes caregivers feel that their role is demanding, burdened and result in stress that can affect the whole family including the person with TBI[9].

  Materials and Methods Top

The present study was conducted in casualty and emergency intensive care unit at NIMHANS which is a multidisciplinary institute in the field of Mental Health and Neurosciences located in Bangalore. Descriptive research design was adopted for the study. A total of 100 samples were included in the study using simple random sampling technique

Informed consent was obtained after explaining the scope and nature of the study. The tools used for the data collection were socio demographic data schedule and Zarit burden interview consists of 22 items measuring the subjective burden faced by the care giver. It is an instrument used to measure the level of burden experienced by the care givers of patients. The 22 items are assessed on a 5-point likert scale, ranging from 0=‘never’ to 4=‘nearly always’. Items scores are added up to give a total score ranging from 0- 88 , with higher scores indicating higher burden, score was interpreted as 0 – 21 little or no burden, 21 – 40 mild to moderate burden, 41 – 60 moderate to severe burden, 61 – 88 severe burden. The questions focus on major areas such as care givers health, psychological well being, finances, social life and the relationship between the care giver and the patient, although burden can be assessed qualitatively, it is beneficial to have an easy – to -use and validated instrument to be able to conveniently quantify the degree of burden. The Zarit burden interview provides a comprehensive assessment of both subjective and objective burden and has been validated in many ethnically or culturally different populations. The cronbach’s alpha value for the Zarit burden interview items was 0.93; the intra class correlation co-efficient for the test-retest reliability of the Zarit burden score was 0.89. It is a valid and reliable instrument for measuring the burden of care givers[7],[8]. Lower scores indicate less burden. Tool was validated and piloted before the study. The data was analyzed, using descriptive and inferential statistics

  Results Top

A total of 100 subjects were enrolled in the study. Most of the subjects were males and were in the age group between 41-50 years. Many of the study subjects were educated up to primary level (47%). Most of the subjects were married (81%) and were Hindus(91%), residing in rural areas, were self employed and had income within 3000 per month.
Table 1: Base line characteristics of the subjects n=100

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The overall mean and SD scores of burden in the care givers was 70.26±5.764 which indicates that the care givers had increased burden score levels.

As given in Table 3 that the association of burden scores with selected socio demographic variables. The outcome was statistically analyzed using ANOVA. The results revealed that there was no statistically significant association between the socio demographic variables such as age, sex domicile, occupation, education, marital status and scores of burden in the care givers,

  Discussion Top

The present study was conducted to assess the level of burden among care givers of traumatic brain injured admitted in critical care units. In this study, the overall burden scorewith standard deviation was70.26± 5.764 showed that burdenlevel was high in the care givers. The study was supported by various research studies which showed that professional intervention is needed to reduce the burden of the family and care givers of the TBI patient’s experience. One of the study conducted assessed social support, reactions and burden on care givers revealed disruption of routine activities, family interaction, subjective burden and objective burden being significantly high in family members of psychiatry and neurosurgery patients[3]

Study conducted at 1 year post injury assessed the burden, psychosocial functioning, and subjective burden revealing significant levels of anxiety and depression evident in over one third of the caregivers. The emotional difficulties, in particular their anger, apathy, and dependency of TBI persons caused the greatest distress for caregivers leading to high burden[4]

Family member close to the patient, spouse, parent or the child usually bearing the strain of illness with the patient was reported emphasising on open and honest communication with both physician and the patient. The effect of illness on family in the physical, social, economic and psychological areas are profound and needs to be looked into modern methods of treatment which extend the life span of certain patients. However, this impose burden on the family, there is anxiety about the patients shortened life expectancy, treatment and the cost of the hospital admission and the effect of illness on other family members. Emergency has been perceived as a crisis which has impact on the patient’s suffering from life threatening illness and condition and the care givers of that patients[5]

Subjective and objective burden was assessed in one of the studywhich assessed TBI individuals with physical, cognitive, emotional, behavioral, and social dysfunction. TBI individuals had severe traumatic brain injury. Caregivers were assessed at 6-months and 1-year post injury. Caregivers reported clinically significant symptoms of anxiety and depression, and poor social adjustment. Over time, the person with TBI’s behavioral and cognitive problems begins to play a larger role in the level of distress experienced by the TBI caregiver[6]
Table 2: Association of burden scores with selected socio demographic variables

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Hence, interventional programmes to care for the caregivers to reduce the burden level are highly recommended by staffs through training and staff educational programmes.

  Conclusion Top

The overall findings of this study showed increased burden scores in care givers of traumatic brain injury patient which suggest that nurses need to conduct motivation and interventional programmes to improve the care giver’s copingand reduce their burden level.

  References Top

Gururaj G. Epidemiology of traumatic brain injuries: Indian scenario. National medical journal of India.2002; 24(1):24-8.  Back to cited text no. 1
Gururaj G. Road traffic deaths, injuries and disabilities in India: current scenario. National medical Journal of India.2008; 21(1):14-20  Back to cited text no. 2
Omman. A study on emergency services at NIMHANS: social work, burden on family members. Dissertation submitted for the award of M.Phil. social work, Bangalore university. 1993 (unpublished)  Back to cited text no. 3
Schulz, R. obtrien, A.T.Bookwala, Psychiatric and physical morbidity effects of dementia care giving- prevalence, correlates and causes, gerontologist.1995; 35(6): 771-791  Back to cited text no. 4
Devereux. Consequences of caring for a spouse with multiple sclerosis. Journal of clinical neuropsychology. 1994;9(!):17- 19  Back to cited text no. 5
Marsh NV, KerselDA, Havill JH, sleigh JW. Caregiver burden at 1 year following severe traumatic brain injury. Brain injury. 2002; 12(12):1045-59  Back to cited text no. 6
Chan TSF, lamlcw, chiu HFK. Validation of the Chinese version of the zaritbrden interview. Hong kong journal of psychiatry: 2006; 9-13  Back to cited text no. 7
Boon khengseng, Nan luo, WaiyeeNG, validity and reliability of the Zaritburden interview in assessing the care giver burden. Annuals academy of medicine. 2010; 39(10)  Back to cited text no. 8
Livingston, M.G. Head injury: The relatives’ response. Brain Injury. 1987; 1(1): 33-39.  Back to cited text no. 9


  [Table 1], [Table 2]


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