A Holistic Approach to Expressing the Burden of Caregivers for Stroke Survivors: A Systematic Review

Tziaka, Eftychia; Tsiakiri, Anna; Vlotinou, Pinelopi; Christidi, Foteini; Tsiptsios, Dimitrios; Aggelousis, Nikolaos; Vadikolias, Konstantinos; Serdari, Aspasia

doi:10.3390/healthcare12050565

Cited by 4 publications

(6 citation statements)

References 56 publications

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“…While we intended to recruit support people, only one such person participated, so we could not do any meaningful analyses. However, the inclusion of support people was noted to be important during the co-design, so future studies or programs should include this group to potentially assist with the high burden they experience [39]. The main strengths of the study were the use of co-design and the leveraging of an existing model of health care within the hospital system.…”

Section: Discussionmentioning

confidence: 99%

Co-Designed Cardiac Rehabilitation for the Secondary Prevention of Stroke (CARESS): A Pilot Program Evaluation

Rehman,

Barker,

Jose

et al. 2024

Healthcare

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Structured health system-based programs, such as cardiac rehabilitation, may reduce the risk of recurrent stroke. This study aimed to co-design and evaluate a structured program of rehabilitation, developed based on insights from focus groups involving stroke survivors and health professionals. Conducted in Tasmania, Australia in 2019, the 7-week program comprised one hour of group exercise and one hour of education each week. Functional capacity (6 min walk test), fatigue, symptoms of depression (Patient Health Questionnaire), and lifestyle were assessed pre- and post-program, with a historical control group for comparison. Propensity score matching determined the average treatment effect (ATE) of the program. Key themes from the co-design focus groups included the need for coordinated care, improved psychosocial management, and including carers and peers in programs. Of the 23 people approached, 10 participants (70% men, mean age 67.4 ± 8.6 years) completed the program without adverse events. ATE analysis revealed improvements in functional capacity (139 m, 95% CI 44, 234) and fatigue (−5 units, 95% CI −9, −1), with a small improvement in symptoms of depression (−0.8 units, 95% CI −1.8, 0.2) compared to controls. The co-designed program demonstrated feasibility, acceptability, and positive outcomes, suggesting its potential to support stroke survivors.

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Section: Discussionmentioning

confidence: 99%

Co-Designed Cardiac Rehabilitation for the Secondary Prevention of Stroke (CARESS): A Pilot Program Evaluation

Rehman,

Barker,

Jose

et al. 2024

Healthcare

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“…A hospital-based study indicated that a factor responsible for major stress among caregivers was anxiety [47]. A recent systematic review suggested that anxiety and depression could increase caregiver burden [48]. 4.1.2.…”

Section: Discussionmentioning

confidence: 99%

“…Providing caregivers with stress relief options can be vital for reducing the burden on stroke caregivers in all stages. Mental health professionals may play an important role in emotional support, stress management, and interventions for depression and anxiety [48]. Reducing the caregiving hours, especially in the initial months, may help reduce caregiver burden [46].…”

Section: Strategies To Reduce Caregiver Burdenmentioning

confidence: 99%

Predictors of Burden for First-Ever Stroke Survivor’s Long-Term Caregivers: A Study of KOSCO

Lee,

Sohn,

Lee

et al. 2024

Medicina

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Long-term changes in caregiver burden should be clarified considering that extended post-stroke disability can increase caregiver stress. We assessed long-term changes in caregiver burden severity and its predictors. This study was a retrospective analysis of the Korean Stroke Cohort for Functioning and Rehabilitation. Patients with an acute first-ever stroke were enrolled from August 2012 to May 2015. Data were collected at 6 months and 6 years after stroke onset. The caregiver burden was measured with a subjective caregiver burden questionnaire based on the Korean version of the Caregiver Burden Inventory. The caregivers’ characteristics and patients’ clinical and functional status were also examined at each follow-up. A high caregiver burden, which suggests a risk of burnout, was reported by 37.9% and 51.7% of caregivers at 6 months and 6 years post-stroke, respectively. Both the caregiver burden total score and proportion of caregivers at risk of burnout did not decrease between 6 months and 6 years. The patients’ disability (OR = 11.60; 95% CI 1.58–85.08; p = 0.016), caregivers’ self-rated stress (OR = 0.03; 95% CI 0.00–0.47; p = 0.013), and caregivers’ quality of life (OR = 0.76; 95% CI 0.59–0.99; p = 0.042) were burden predictors at 6 months. At 6 years, only the patients’ disability (OR = 5.88; 95% CI 2.19–15.82; p < 0.001) and caregivers’ psychosocial stress (OR = 1.26; 95% CI 1.10–1.44; p = 0.001) showed significance. Nearly half of the caregivers were at risk of burnout, which lasted for 6 years after stroke onset. The patients’ disability and caregivers’ stress were burden predictors in both subacute and chronic phases of stroke. The findings suggest that consistent interventions, such as emotional support or counseling on stress relief strategies for caregivers of stroke survivors, may reduce caregiver burden. Further research is needed to establish specific strategies appropriate for Korean caregivers to alleviate their burden in caring for stroke patients.

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“…Stroke is the second leading cause of death and a major contributor to global disability [1,2], with ischemic stroke accounting for approximately 85% of all cases [3,4]. Due to its high prevalence, therapeutic measures supported by robust scientific evidence, such as intravenous thrombolysis up to 4.5 h from symptom onset [5][6][7][8], endovascular treatment for proximal occlusion stroke [9][10][11][12], decompressive craniectomy for malignant edema resulting from extensive stroke [13,14], and the establishment of geographically delimited stroke units (SU) dedicated to stroke treatment [15], are now in place.…”

Section: Introductionmentioning

confidence: 99%

“…Data presented as medians (interquartile ranges) or absolute and relative frequencies; Abbreviations: GW, general ward; SU, stroke unit; RS, Rio Grande do Sul; TIA, transient ischemic attack; DVT, deep vein thrombosis; 1 Mann-Whitney Test,2 Chi-Square Test.…”

mentioning

confidence: 99%

Length of Hospitalization and Mortality among Stroke Patients before and after the Implementation of a Specialized Unit: A Retrospective Cohort Study Using Real-World Data from One Reference Hospital in Southern Brazil

Poll,

Martins,

Anschau

et al. 2024

Healthcare

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Stroke constitutes a significant global cause of mortality and disability. The implementation of stroke units influences hospital quality indicators, guiding care management. We aimed to compare hospital length of stay (LOS), in-hospital mortality, and post-discharge mortality between stroke patients admitted in the pre- and post-implementation periods of a stroke unit in a public hospital in southern Brazil. This retrospective cohort study used real-world data from one reference hospital, focusing on the intervention (stroke unit) and comparing it to the general ward (control). We analyzed the electronic medical records of 674 patients admitted from 2009 to 2012 in the general ward and 766 patients from 2013 to 2018 in the stroke unit. Admission to the stroke unit was associated with a 43% reduction in the likelihood of prolonged hospitalization. However, there was no significant difference in the risk of in-hospital mortality between the groups (Hazard ratio = 0.90; Interquartile range = 0.58 to 1.39). The incidence of death at three, six and twelve months post-discharge did not differ between the groups. Our study results indicate significant improvements in care processes for SU patients, including shorter LOS and better adherence to treatment protocols. However, our observations revealed no significant difference in mortality rates, either during hospitalization or after discharge, between the SU and GW groups. While SU implementation enhances efficiency in stroke care, further research is needed to explore long-term outcomes and optimize management strategies.

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A Holistic Approach to Expressing the Burden of Caregivers for Stroke Survivors: A Systematic Review

Cited by 4 publications

References 56 publications

Co-Designed Cardiac Rehabilitation for the Secondary Prevention of Stroke (CARESS): A Pilot Program Evaluation

Co-Designed Cardiac Rehabilitation for the Secondary Prevention of Stroke (CARESS): A Pilot Program Evaluation

Predictors of Burden for First-Ever Stroke Survivor’s Long-Term Caregivers: A Study of KOSCO

Length of Hospitalization and Mortality among Stroke Patients before and after the Implementation of a Specialized Unit: A Retrospective Cohort Study Using Real-World Data from One Reference Hospital in Southern Brazil

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