Experiences of Family Caregivers of Elderly Burned Patients at the Komfo Anokye Teaching Hospital, Ghana

Abstract

The elderly population has been noted to be particularly at risk of being involved in burn injury and outcomes are usually related to significant morbidity and mortality rates resulting in increasing dependence on others. Despite this, there is limited exploration of their caregivers‘ experiences. Thus, this study aimed at exploring and describing the experiences of family caregivers of elderly burned patients at the Komfo Anokye Teaching Hospital. The study was guided by the Stress Process Model and employed a qualitative exploratorydescriptive approach. Purposive sampling approach was used to recruit fourteen (14) family caregivers who rendered care to elderly burned patients from the time of admission until death. All the interviews were audio-taped and transcribed verbatim. Data was analysed using the principles of thematic content analysis as espoused by Miles and Huberman. Six major themes emerged; five of which were consistent with the Stress Process Model (injury and reactions of caregivers, hospitalisation and associated stressors, effects of caregiving, coping strategies and support) and the sixth (expected and real outcome of injury) was an additional theme. Burn injuries were noted to occur suddenly and associated with various emotional responses such as confusion, shock, devastation and anxiety among caregivers. The sudden occurrence of burn injuries was also associated with unplanned and urgent hospitalisation and unprepared entry into the caregiving role. These features represented the context of caregiving to older burned patients. Three males and eleven females were noted to undertake the caregiving role though all males indicated that it was a feminine role. In exploring the primary stressors associated with burns caregiving in the hospital, it was observed that participants faced several physical demands: waking up early so as to arrive at the hospital on time, providing hands on care and running errands (to purchase medications, dressing materials and feeds for the elderly burned patient). Though nurses took over care of the elderly burned patient, participants were still worried as nurses were unable to meet their needs at all times especially at night. As the patient transitioned, they manifested symptoms such as pain, restlessness and impaired verbal communication which were identified to be sources of stress for caregivers. The primary stressors identified in this study led to the development of secondary stressors such as financial constraints and alteration in life patterns for caregivers. Despite these, the existence of various resources such as coping strategies (hope, prayer and adjusting to the new situation) and support from family, neighbours, affiliated religious groups among others were identified as means utilised by caregivers to mitigate the effects of the stress. At the end of the caregiving process, both negative effects (physical and emotional exhaustion) and positive effects (growth, feeling matured and meeting new people) were noted. The additional theme identified described the outcomes that participants had hoped for though the real outcome was recognised as double loss (death of the patient and loss of properties). As symptoms exhibited by the burned patient were reported to be distressing, it was suggested that further studies be done to identify the place of palliative care in burns management. Also, there is a need for a platform to enable caregivers to talk about their experiences. In addition, health professionals need to be aware of the emotional responses evoked by the occurrence of burns and offer assistance as the case may be. Furthermore, the National Health Insurance Scheme may require revision so as to absorb the costs associated with burns management.