Beyond pain relief: a thematic exploration of informal caregiver experiences and needs following SPING block treatment in geriatric hip fracture patients

PURPOSE: To explore informal caregivers' experiences and preferences regarding decision-making and care processes following the Spinal Phenol IN Glycerol (SPING) block as non-operative pain management in frail older care recipients with a hip fracture. The aim is to improve the care process of the SPING block and improving communication with and support for informal caregivers. METHODS: A single-center qualitative study was conducted at Amphia Hospital (the Netherlands) using semi-structured interviews. Informal caregivers of frail, older patients with hip fracture treated with SPING block were purposively sampled until saturation was reached. Interviews were audio-recorded and transcribed verbatim for thematically analysis. RESULTS: Four dominant themes were identified: (1) Pain relief as a core treatment priority; (2) Complex decision-making and the caregiver's moral burden; (3) Emotional toll and coping with witnessing decline; and (4) Shifting roles and long-term caregiving burden. SPING block was viewed as an acceptable, often preferred non-operative pain management. Informal caregivers valued rapid analgesia and the possibility of early discharge yet described insufficient communication and uncertainty around long-term effects. The caregiving burden extended beyond hospital discharge, with many reporting distress and role conflict. CONCLUSION: Informal caregivers prioritize effective analgesia, compassionate communication and continuity of care when navigating decisions about SPING block in the context of frailty and end-of-life care. These findings underscore the importance of integrated, multidisciplinary protocols that facilitate timely decision-making, align with patient goals and address caregiver needs across care settings. Prospective studies are warranted to evaluate patient-centered outcomes of SPING block and its long-term analgesic effects.