title: Study of factors determining caregiver burden among primary caregivers of patients with intracranial tumors.
abstract: BACKGROUND
  Caregivers of patients with intracranial tumors handle physical, cognitive, and behavioral impairments of patients. The purpose of this study was to assess the magnitude of burden experienced by primary caregivers of patients operated for intracranial tumors and evaluate factors influencing it.
  
  
  METHODS
  Descriptive cross-sectional design was used to assess home-care burden experienced by primary caregivers of patients operated for intracranial tumors. Using purposive sampling, 70 patient-caregiver pairs were enrolled. Modified caregiver strain index (MCSI) was used to assess the caregiver burden. Mini mental status examination (MMSE), Katz index of independence in activities of daily living (ADL), and neuropsychiatric inventory questionnaire (NPI-Q) were used to assess the status of patients.
  
  
  RESULTS
  Of 70 caregivers, 45 had mild, and 22 had moderate MCSI burden. A number of behavioral changes in NPI-Q had a significant correlation with MCSI burden (P < 0.001), whereas MMSE and Katz-ADL of patients did not show significant relation with caregiver burden. In NPI-Q, irritability, agitation, anxiety, depression, and sleep disturbances had a significant impact on MCSI. Among caregiver factors, unemployment, low per capita income, time spent, inability to meet household needs, quitting the job, and health problems had a significant impact on MCSI. In separate multivariate analyses, irritability component (P = 0.004) among behavioral changes of patients and caregivers' inability to meet household needs (P < 0.001) had a significant association with caregiver burden independent of other factors.
  
  
  CONCLUSIONS
  Behavioral changes in patients (especially irritability) and financial constraints had a significant independent impact on the burden experienced by primary caregivers of patients operated for intracranial tumors. Identifying and managing, these are essential for reducing caregiver burden.
authors.affiliation: National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Manju
authors.initials: M
authors.lastname: Dhandapani
authors.affiliation: College of Nursing, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sandhya
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sivashanmugam
authors.initials: S
authors.lastname: Dhandapani
authors.affiliation: National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Prabhjot
authors.initials: P
authors.lastname: Kaur
authors.affiliation: National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Kanwaljit
authors.initials: K
authors.lastname: Samra
authors.affiliation: National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Kirti
authors.initials: K
authors.lastname: Sharma
authors.affiliation: National Institute of Nursing Education, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Kunchok
authors.initials: K
authors.lastname: Dolma
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Manju
authors.initials: M
authors.lastname: Mohanty
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Navneet
authors.initials: N
authors.lastname: Singla
authors.affiliation: Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Sunil K
authors.initials: SK
authors.lastname: Gupta
keywords: Caregiver burden; Katz activities of daily living; intracranial tumors; mini mental status examination; modified caregiver strain index; neuropsychiatric inventory questionnaire