The influence of informal caregivers on the rehabilitation of the elderly in the postoperative period of proximal femoral fracture

Rocha, Suelen Alves; Avila, Marla Andréia Garcia de; Bocchi, Silvia Cristina Mangini

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Sumário

Integrative Review • Rev. Gaúcha Enferm. (Online) 37 (1) • 2016 • https://doi.org/10.1590/1983-1447.2016.01.51069 copy

The influence of informal caregivers on the rehabilitation of the elderly in the postoperative period of proximal femoral fracture

Authorship SCIMAGO INSTITUTIONS RANKINGS

ABSTRACT

Objective

To analyze the influence of informal caregivers on the functional independence of older adults in the postoperative period of proximal femoral fracture due to falls.

Method

It is an integrative review of a corpus for analysis that gathered 23 articles, between 2002 and 2012, from databases “Literatura Latino-Americana e do Caribe em Ciências da Saúde” (Latin-American and Caribbean Health Sciences Literature in Health Sciences), Cumulative Index to Nursing and Allied Health Literature, US National Library of Medicine and Scopus.

Results

There was a predominance of studies by Chinese authors and nurses. The analysis of the studies evidenced that falls followed by fractures lead to dependence of older adults and, consequently, an overload to caregivers. Moreover, older adults and caregivers showed a need for support in the rehabilitation process.

Conclusions

Informal caregivers still need to be included in care planning and to be qualified for such care by health professionals, since they positively influence functional independence in the postoperative period.

Aged; Accidental falls; Femoral fractures; Caregivers; Postoperative period

Country of the Publication of the study	n (%)
China	8 (34.78)
USA	6 (26.09)
Australia	2 (8.70)
Brazil	2 (8.70)
Canada	1 (4.35)
Cuba	1 (4.35)
Scotland	1 (4.35)
Israel	1 (4.35)
Singapore	1 (4.35)
Total	23 (100.00)

First author and type of study	Thematic axis of the journal	Object of the study	Influence of informal caregivers on the functional independence of elderly
Eastwood EA⁽¹³⁾ Quantitative Cohort	gerontology	Association between the characteristics of patients recognized at admission and functional outcomes after six months⁽¹³⁾.	Caregivers can assist in mobility, self-care and transfers⁽¹³⁾.
Megret Caballero A⁽¹⁴⁾ Quantitative Quasi-experimental design	nursing	Educational intervention outcomes for caregivers of elderly⁽¹⁴⁾.	Empower families to provide care may minimize complications⁽¹⁴⁾.
Crotty M⁽¹⁵⁾ Quantitative Randomized Clinical Trial	medicine	The effect of early discharge on home rehabilitation compared to conventional hospital rehabilitation⁽¹⁵⁾.	For the patients there was no difference between early discharge and traditional care (hospital). In a 12 month period, the overload experienced by caregivers was reduced with the assistance provided by family caregivers⁽¹⁵⁾.
Lin P-C⁽¹⁶⁾ Quantitative Cross-sectional	nursing	The overload of caregivers of elderly with PFF during transition from hospital to home⁽¹⁶⁾.	The physical ability of older patients has gradually improved after hospital discharge and was negatively related to overburdened caregivers⁽¹⁶⁾.
Macleod M⁽¹⁷⁾ Qualitative Thematic analysis	interdisciplinary	The role of caregivers in early rehabilitation of elderly patients who suffered PFF⁽¹⁷⁾.	Caregivers provide concrete, practical aid regarding care and psychological support⁽¹⁷⁾.
Jones CA⁽¹⁸⁾ Quantitative Cohort	gerontology	The correlation between the responses of patients and their caregivers to health-related quality of life⁽¹⁸⁾.	Caregivers are considered reliable sources of information on the health status of elderly individuals⁽¹⁸⁾.
Lin P-C⁽¹⁹⁾ Quantitative cross-sectional	nursing	Care needs of elderly who suffered PFF and the challenges posed by post-discharge care⁽¹⁹⁾_.	Caregivers should be inserted in the transition of care to ensure high quality care to elderly at home⁽¹⁹⁾.
Huang H-C⁽²⁰⁾ Quantitative Quasi-experimental design	nursing	The factors associated to adherence to the use of hip protectors⁽²⁰⁾.	Thanks to the use of hip protectors 12 falls did not cause fractures. The reasons for non-adherence to hip protectors were: lack of familiarity with the device, daily use only, discomfort and lack of support of family caregivers⁽²⁰⁾.
Shawler C⁽²¹⁾ Qualitative Grounded Theory	gerontology	Relationship between elderly mother-daughter during and after PFF⁽²¹⁾.	Importance of “empowerment “in the management of a health crisis. In the process of empowerment to manage the crises, the dyad expresses the need for courage and remaining upright to protect the person who is sick⁽²¹⁾.
Li H-J⁽²²⁾ Qualitative Grounded Theory	nursing	The process of coping of Taiwanese families after hospital discharge⁽²²⁾.	Caregivers and elderly individuals made reciprocal adjustments of behaviors, attitudes, expectations (adequate coping styles) to achieve better results in care^(22).
Lin P-C⁽²³⁾ Quantitative, Cohort	nursing	The factors that have impact on the suffering of caregivers in the process of transition from hospital to home⁽²³⁾.	The predictive factors for overload of caregivers: physical ability of the elderly, self-efficacy and social support⁽²³⁾.
Hershkovitz A⁽²⁴⁾ Quantitative Cross-sectional	rehabilitation	Prognostic factors in acute rehabilitation of elderly who suffered PFF⁽²⁴⁾.	At the end of the rehabilitation program, two variables were identified as predictive of discharge of elderly: the presence of a caregiver and the cognitive status of the elderly⁽²⁴⁾.
Kochar J⁽²⁵⁾ Quantitative Cross-sectional	gerontology	Association between depressive symptoms and sleep problems in female caregivers⁽²⁵⁾.	Depressed caregivers report sleep problems, which may interfere with the quality of care delivered⁽²⁵⁾.
Martins JJ⁽²⁶⁾ Qualitative, Collective Subject Discourse	nursing	Home care under the perspective of elderly/family members and professional of a family health unit⁽²⁶⁾.	The professionals must provide guidance on home care, including family caregivers in the process, respecting the autonomy of elderly and cultural family aspects⁽²⁶⁾.
Min WJ⁽²⁷⁾ Quantitative Cross-sectional	gerontology	The preference for a type of caregiver⁽²⁷⁾.	Cultural factors that impact the preference for a type of caregiver; Latin elderly prefer family caregivers⁽²⁷⁾.
Rocha L⁽²⁸⁾ Qualitative Thematic analysis	nursing	Factors that affect the vulnerability of elderly to falls followed by PFF⁽²⁸⁾.	A caregiver who is aware of the vulnerability of elderly to falls may provide guidance on prevention measures⁽²⁸⁾.
Taylor NF⁽²⁹⁾ Qualitative Thematic analysis	rehabilitation	Mobility in the residence and in the neighborhood after PFF⁽²⁹⁾.	Caregivers can help elderly who have difficulty walking⁽²⁹⁾.
Nahm E-S⁽³⁰⁾ Qualitative Phenomenology	gerontology	Experiences and support needs of caregivers of elderly who suffered PFF⁽³⁰⁾.	Caregivers indicate the need for formal support to care for elderly at home⁽³⁰⁾.
Shyu Y-I L⁽³¹⁾ Quantitative, Cohort	nursing	The trend of health outcomes reported by family caregivers of patients who had PFF and the effects of social support⁽³¹⁾.	Elderly whose caregivers reported the need for information were more likely to recover walking ability⁽³¹⁾.
Siddiqui MQA⁽³²⁾ Quantitative Cohort	medicine	Stress experienced by caregivers of elderly patients who had PFF⁽³²⁾.	Financial problems resulting from health problems are a major stress factor for family caregivers⁽³²⁾.
Louie S W-S⁽³³⁾ Quantitative Randomized clinical trial	rehabilitation	The outcomes of a rehabilitation program aimed to empowerment of patients who had PFF⁽³³⁾.	Elderly who participated in the program reported higher rate of adaptation to daily life activities⁽³³⁾.
Shyu Y-I L⁽³⁴⁾ Quantitative Cohort	nursing	The effect of the needs reported by family caregivers on the functional recovery of elderly who had PFF⁽³⁴⁾.	Caregivers who developed abilities to care for elderly, with worsening in their mental status⁽³⁴⁾.
Nahm E-S⁽³⁵⁾ Quantitative, Quasi-experimental design	nursing	The importance of an on-line research center for caregivers of patients with PFF⁽³⁵⁾.	Caregivers with improved knowledge of the care to be provided⁽³⁵⁾.

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[1] Corresponding author: Marla Andréia Garcia de Avila. E-mail: marla@fmb.unesp.br