Functional Recovery and Caregiver Burden Following Surgery in the Elderly

Completed

Conditions: Activities of Daily Living
Caregivers
Ambulatory Surgical Procedures

Brief Summary: The purpose of this study is to assess the functional recovery of older ambulatory surgical patients and the impact of the current model of care on the caregivers of these patients. This study will provide unique insight into the challenges patients and their families face following surgery.

The primary objective of this study is to:

1. Assess the impact of ambulatory surgery on functional capacity as assessed by the Système de Mesure de l'Autonomie Fonctionnelle (SMAF) one week and one month following surgery in a population of surgical patients 65 years of age and older.

Secondary objectives are to determine if:

2. Changes in the patient's functional capacity result in increased burden of care as assessed by the Zarit Burden Interview (ZBI) in the patient's primary caregiver.

3. Changes in functional capacity are correlated with decrements in quality of life as assessed by the Short Form 12 (SF12).

4. Changes in functional capacity are correlated with inadequate postoperative analgesia as assessed by the Brief Pain Inventory (BPI).

Recruitment & Eligibility

Inclusion Criteria

Patients

aged 65 years and older
elective surgery with a planned discharge to the community on the day of the surgical procedure.
Eligible surgical procedures include: inguinal herniorrhaphy, ventral herniorrhaphy, laparoscopic cholecystectomy,laparoscopic salpingoophorectomy, urethropexy, cystocoele/rectocoele repair, vaginal hysterectomy, arthroscopic debridement (knee, hip, shoulder), arthroscopic repair (knee, hip, shoulder), removal of hardware from lower extremity, foot surgery, and lumbar discectomy.

Caregiver

spouses, family members, or friends identified as the patient's primary source of support in the community.

Exclusion Criteria

Patients

Reside in a nursing home providing professional support services;
Are unable to complete the study instruments due to cognitive (MMSE <24) or physical impairment;
Are unable to speak English or French

Caregiver

Professional caregivers (nurse, personal care assistant, etc) hired to care for the patient;
Unable to complete the study instruments due to physical impairment;
Unable to Speak English or French

Primary Outcome Measures

Name	Time	Method
Functional Autonomy Measurement System (SMAF)	Baseline, one week, and one month following surgery	29-item scale, each item graded on a four-point scale. 0= independent, 1= needs supervision,2 = needs help, 3 = dependent. Total score ranges from 0 to 87 with higher scores indicating increased disability

Secondary Outcome Measures

Name	Time	Method
Brief Pain Inventory (BPI) Functional Interference Score.	Baseline, one week, and one month following surgery	Comprised of seven questions in which the subject is asked to describe the extent to which pain interferes with activity. Scores are anchored at 0 for "does not interfere" and 10 for "completely interferes." The seven resulting scores are averaged and reported as a single value (0 - 10) with higher scores indicating greater interference with function.
Zarit Burden Interview (ZBI)	Baseline, one week, and one month following surgery	A 22-item questionnaire in which subjects rate how often they experience negative feelings associated with caregiving. Each item rated on a 5 point scale anchored at 0 for "never" and 4 for "nearly always." Scores range from 0-88 with higher scores indicating increased burden of care.
Short Form 12	Baseline, one week, and one month following surgery	A validated measure of health related quality of life comprised of 12 questions regarding participant experience over the preceding week. Generate Physical And Mental Component scores ranging from 0-100 with higher scores indicating better quality of life.