*Limitations*

There were several limitations to this study. Further research is needed to examine how the intervention described would be successful with a larger sample. The study lacked a control group: future research is needed using a design that randomly assigns participants to intervention and control groups. Despite these limitations, the interventions were successful in increasing knowledge of caregivers' importance in orthopedic disease.

## **5. Conclusions**

Despite the challenges in studying the role of caregivers in orthopedic diseases and family caregiver strain and challenges when caring for orthopedic patients, the literature indicates that not only the increase in caregivers' stress levels but also the decrease in quality of life was less severe in caregivers who received appropriate behavioral interventions including health care advice, such as medication advice or psychological tips. To improve the quality of health care, stressors should be considered for caregivers due to the high strain, especially in the post-discharge period.

Clinicians should consider the importance of caregiver interventions, not only for the orthopedic patient but also for the spouse, child, or friend who will be providing care for that individual. Further studies should focus on the important physical and mental role of the informal caregiver for patients who receive orthopedic surgery and the importance of psychological sphere for the patient–caregiver dyad. Focusing on caregivers' welfare rather than only on patient well-being could radically improve both caregivers' performance and patients' recovery.

**Author Contributions:** Conceptualization, M.M. and U.G.L.; methodology, V.A. (Valeria Arcangeli); software, V.A. (Viviana Alciati); validation, V.C., and M.M.; formal analysis, G.F.; investigation, A.M.; resources, M.G.D.M.; data curation, V.C.; writing—original draft preparation, writing—review and editing, A.M.; visualization, M.M.; supervision, V.D.; project administration, U.G.L. All authors have read and agreed to the published version of the manuscript.

**Funding:** This research received no external funding.

**Acknowledgments:** This research did not receive any specific gran<sup>t</sup> from funding agencies in the public, commercial, or not-for-profit sectors.

**Conflicts of Interest:** The authors declare no conflict of interest. *J. Clin. Med.* **2020**, *9*, 1497

#### **Appendix A. List of Search Terms Used for Systematic Review**

*Search terms for Medline Complete (via EBSCO Host): 1971 to 27 January 2019*


## **269. records found**

*Search terms for PubMed: 1971 to 27 January 2019*


*J. Clin. Med.* **2020**, *9*, 1497


## **233. records found**

*Search terms for CINHAL (via EBSCO Host): 1995 to 27 January 2019*


## **169. records found**

*Search terms for Embase: 1971 to 27 January 2019*


## **135. records found**
