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Caregiver Patient Reported Outcomes Measurement Information System (PROMIS) profiles in patients undergoing total joint arthroplasty and spine surgery: a prospective observational cohort study
  1. Michael L Kent1,
  2. Kalyn Jannace2,
  3. Krista B Highland2,
  4. Maria Dimarzio2,
  5. Julie Tran2,
  6. Sara Gonzalez2 and
  7. Chester C Buckenmaier2
  1. 1 Anesthesiology, Duke University Hospital, Durham, North Carolina, USA
  2. 2 Defense and Veterans Center for Integrative Pain Management, Rockville, Maryland, USA
  1. Correspondence to Dr Michael L Kent, Anesthesiology, Duke University Hospital, Durham, North Carolina, USA; michael.kent{at}duke.edu

Abstract

Background/Objective The role of caregiver psychosocial characteristics and their relation to postsurgical caregiving capability remains unclear. The objective of this study was to explore caregiver psychosocial variables following surgery of patients undergoing total joint arthroplasty and spine surgery.

Methods A prospective observational study was conducted where questionnaires were administered to caregivers preoperatively and 1 week/2 weeks/1 month postoperatively. Measures included demographics, caregiver activities and National Institutes of Health Patient Reported Outcomes Measurement Information System (NIH PROMIS) item banks. Bivariate analysis assessed differences between participants reporting baseline pain and those reporting no baseline pain. Generalized estimating equation models examined PROMIS T-scores across time.

Results 190 caregivers were enrolled and completed surveys. 18% of caregivers reported experiencing a painful condition where they experienced pain during most days of the week. Across all time points, the majority of caregivers reported no worse than mild impairment across PROMIS scores. Compared with baseline, caregivers reported lower PROMIS satisfaction with social roles across all postoperative time points (p<0.001) and higher depression and fatigue at postoperative day 7 (p=0.002) and 14 (p=0.006). PROMIS sleep disturbance was only higher at day 7 (p=0.01). Caregivers reporting a baseline pain condition reported PROMIS scores indicative of higher anxiety (p=0.02), depression (p=0.003), sleep disturbances (p<0.001) and fatigue (p<0.001) and lower levels of satisfaction with social roles (p=0.002) compared with those caregivers without baseline pain.

Conclusion While there were transient worsening in PROMIS scores, it is unclear whether these were clinically meaningful. Postsurgical caregivers reporting baseline pain were characterized by worse functioning across all PROMIS scales.

  • caregiver
  • acute pain
  • PROMIS
  • postoperative
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Footnotes

  • Twitter @KentmlSd

  • Presented at Meetings where work has been presented: American Society of Regional Anesthesia and Pain Medicine Spring 2017 Meeting.

  • Contributors MK: conceived and designed the study, collected the data, contributed to data analysis and prepared the manuscript. KJ: designed and performed the analysis, prepared the manuscript. KBH: designed and performed the analysis, prepared the manuscript, assisted in study design. MD: collected the data, participated in manuscript preparation. JT: collected the data, participated in manuscript preparation. SG: collected the data, participated in manuscript preparation. CCB: conceived and designed the study, and prepared the manuscript.

  • Funding Funding for this study was by the Department of the Army, Telemedicine and Advanced Technology Research Center, US Army Medical and Material Command and conducted through the Henry M. Jackson Foundation for the Advancement of Military Medicine under Cooperative Agreement #W81XWH-11-2-0201.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This prospective longitudinal observational cohort study was approved by the Walter Reed National Military Medical Center institutional review board (IRB#: 500115-1b).

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request.

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