title: Stress levels amongst caregivers of patients with osteoporotic hip fractures - a prospective cohort study.
abstract: BACKGROUND
  We evaluated if there was significant stress in caregivers of elderly patients with osteoporotic hip fractures and determine any contributory factors.
  
  
  METHODS
  A prospective cohort study was performed from June 2005 to June 2006 in a single tertiary hospital. Patients admitted during this period and their primary caregivers were interviewed on admission and at 6 months. Information on patient's demographics, comorbidities, functional and mental status, placement post-discharge and financial strain were noted. Caregiver stress was measured using the caregiver strain index (CSI). Relationships between key variables were analysed to derive possible correlations.
  
  
  RESULTS
  The study comprised caregivers of 76 patients with a mean age of 77 years (range, 50 to 95; SD, 11). Within 1 week of admission, 45 of the 76 caregivers (59.2%) were significantly stressed based on the CSI while at 6 months, 30 of the caregivers (50%) were significantly stressed. The mean CSI within 1 week of admission and at 6 months post-admission was 7.18 and 6.25 respectively (P = 0.042). The most significant contributory factor to stress was financial strain (P = 0.01) attributable to medical bills, rehabilitation costs and transport expenses.
  
  
  CONCLUSIONS
  There is a significant amount of stress that is experienced by caregivers of elderly patients with hip fractures which commences from admission of the patient and it remains high at 6-months post-fracture. Financial strain has been found to be the only significant cause on both univariate and multivariate analysis. Adequate resources should be available to caregivers of patients with osteoporotic hip fractures.
authors.affiliation: Department of Orthopaedic Surgery, Singapore General Hospital, Singapore. mohd.mashfi qul@gmail.com
authors.forename: Mashfi Qul
authors.initials: MQ
authors.lastname: Siddiqui
authors.forename: Lynette
authors.initials: L
authors.lastname: Sim
authors.forename: Joyce
authors.initials: J
authors.lastname: Koh
authors.forename: Stephanie
authors.initials: S
authors.lastname: Fook-Chong
authors.forename: Carol
authors.initials: C
authors.lastname: Tan
authors.forename: Tet Sen
authors.initials: TS
authors.lastname: Howe
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000191:economics / Q000523:psychology*; D017281:Cost of Illness; D005260:Female; D006620:Hip Fractures / Q000209:etiology* / Q000534:rehabilitation*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010024:Osteoporosis / Q000150:complications*; D011446:Prospective Studies; D013315:Stress, Psychological