1. Lindsey, Heather

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According to this study:


* Inguinal hernia and its repair significantly affect lay caregivers.


* Such caregivers assume the heaviest burden two weeks after surgery.



Inguinal hernia and its repair may significantly affect lay caregivers, especially patients' significant others and family members. A recently published study revealed that they assumed the greatest burden in time and effort two weeks after hernia repair and expended greater effort when there were complications after the procedure. "In general, people are usually not prepared for the amount of care patients may require after surgery," said the principal study author Whitney Perkins Witt, in an interview with AJN.


Researchers analyzed data pertaining to 1,983 men participating in a U.S. Department of Veterans Affairs Cooperative Study, a trial involving men with inguinal hernia at 14 of its medical centers, to compare the level of burden among caregivers before surgery and afterward. Caregivers (n = 837) identified by patients responded to a questionnaire at baseline and to at least one of two follow-up self-administered questionnaires at two weeks and at three months after treatment. Most caregivers were wives (73%); others included sons, daughters, sisters, brothers, and friends, and 88% of them lived with the patient. Whether the surgery was open or laparoscopic did not determine the degree of either the caregiver's burden or level of concern about the patient's level of functioning.


Wives and girlfriends reported concern about a patient's ability to work or engage in social or recreational activities more often than other caregivers did, and family members expressed "extreme concern" about a patient's ability to engage in recreational activities-specifically, about three times more often than did other caregivers. Caregivers of patients who had complications of surgery more often expressed concern about all activities of the patient, and caregivers of patients with severe systemic disease nearly twice as often reported extreme concern about activities in the home than caregivers of healthier patients did. The researchers also found that caregivers spent more than five hours at additional household chores more than four times as often at two weeks after surgery than at baseline; three months after surgery that time spent had decreased significantly.


According to Witt, nurses can help such caregivers prepare for the possible burdens of attending to patients after surgery for inguinal hernia by being involved in discharge planning. This might include, for example, education directed toward family members and wives specifically, as they are the most likely to have significant concerns.


In the Society for Surgery of the Alimentary Tract Patient Care Guidelines for Surgical Repair of Groin Hernias, it's noted that a rapid return to normal activities can be achieved after the procedure, but that "lifting and exercise are commonly discouraged for four to six weeks following inguinal hernia repair, although patients can typically resume any physical activity that is comfortable to them and progress at their own pace."




Witt WP, et al. Arch Surg 2006;141(9):925-30; Society for Surgery of the Alimentary Tract. SSAT patient care guidelines: surgical repair of groin hernias. 2006 Apr.