Work-Caregiving strain among family caregivers of burn survivors: Occupational sacrifice and positive occupational appraisal

BackgroundFamily caregivers are often working adults whose unpaid care responsibilities can disrupt paid work, yet occupational impact is rarely examined beyond employment status or financial burden. Burn caregiving provides a high-demand traumatic-injury context in which prolonged rehabilitation, family reorganization, and support needs may conflict with caregivers' work lives.ObjectiveTo examine the occupational impact of burn caregiving over a 24-month recovery period and characterize two theory-informed patterns of caregiver occupational experience: occupational sacrifice and positive occupational appraisal.MethodsWe analyzed baseline and 24-month occupational follow-up data from 256 family caregivers in a burn survivor-caregiver cohort. Follow-up outcomes captured work participation, job change, caregiving-attributed workforce detachment, perceived career impact, and work-related barriers and facilitators post-baseline. Occupational sacrifice was operationalized as caregiving-attributed workforce detachment or adverse career appraisal among employed caregivers; positive occupational appraisal was defined as favorable perceived career impact. Baseline demographic, survivor-injury, and psychosocial characteristics were examined descriptively and in logistic regression models.ResultsAt 24 months, 71.5% reported ongoing work participation, 20.7% caregiving-attributed workforce detachment, and 7.8% other changes. Among employed caregivers, 32.2% reported job change, of whom 42.4% reported negative career appraisal. Occupational sacrifice was identified in 35.2% and was accompanied by functional, appearance-related, family-caregiving, workplace, rehabilitation-support, and financial barriers. Positive occupational appraisal was reported by 31.3% and was associated with lower baseline distress and higher posttraumatic growth.ConclusionsThese findings extend injury-related occupational health to family caregivers and support a theory-informed framework for studying work-caregiving strain, occupational sacrifice, and positive appraisal prospectively.