Burden and Perceived Health Status Among Caregivers of Stroke Patients

Abstract

Objective: To identify the main determinants of burden and perceived health status in caregivers of Brazilian stroke survivors. Methods: Cross-sectional study. Caregivers answered the Hospital Anxiety and Depression Scale (HADS), Zarit caregiver burden interview (ZCBI) and EuroQol. Patients were assessed with the National Institute of Health Stroke Scale, Barthel index (BI), modified-Rankin scale (m-RS), Mini Mental State Examination and HADS. Results: 200 caregiver-patient dyads were assessed. Caregivers were significantly younger (42 vs. 57.7 years) and had more years of formal education (10 vs. 7.8 years); p < 0.0001. Seventy-seven percent of caregivers were females, and 41% were spouses. The prevalence of anxiety disorders was significantly higher in female caregivers than in males (26.1 vs. 10.9%; p = 0.04). ZCBI mean score was 27.2, and female caregivers had significantly worse scores (28.7 vs. 22.3, p = 0.003). ZCBI mean score significantly increased (worsened) as the severity of the disease, based on m-RS, increased. ZCBI mean scores were significantly higher in wives than in other relatives (31.4 vs. 22.6; ANOVA, p < 0.0001). The EuroQol-5D and EuroQol-Visual Analog Scale mean scores were 0.7 (range: 0.04–0.85) and 75.2 (range: 1–100), respectively. Adequate convergent validity (r = –0.38 to –0.40) between EuroQol and ZBCI mean scores was observed. Patient´s disability (as measured by the BI) and caregiver’s factors (female sex, depression as measured by HADS-depression) were independent predictors of caregiver’s burden (r² adjusted = 0.48; p < 0.0001) in the multivariate regression analysis. Conclusions: Caregiver’s mood was the most consistent factor influencing caregiver burden and perceived health in stroke caregivers.

Level of Caregiver Burden in Jamaican Stroke Caregivers and Relationship between Selected Socio-Demographic Variables

“…In addition to this, the unemployment status and low income levels would have been a significant barrier to the majority of the caregivers in this study being able to employ other full-time care providers. This distribution was similar to that reported by other researchers who also found that the largest percentage of caregivers was females and spouses (5,14,15).…”

“…Similar findings were reported in a Brazilian population (14). The majority of caregivers were females who were significantly younger than the stroke patients and had more years of formal education.…”

“…Caregiver burden was also significantly higher in wives who were the primary caregivers compared to other relatives. Patient's disability and caregiver factors such as female gender and depression were found to be independent predictors of caregiver burden (14).…”

Factors affecting the burden on caregivers of stroke survivors in Turkey

“…Similarly, in a study conducted by Mollaoglu et al (6) significantly high scale scores were observed on the part of caregivers whose patients are dependent according to the BI and who meet all patients' needs. Parallel to the results of our study, Carod-Artal et al (37) indicated a negative relationship between the functional status of stroke patient caregivers and caregiver burden.…”

Validation of a stroke symptom questionnaire for epidemiological surveys

“…[1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The impact of cerebrovascular diseases matters not only because of the burden of death [1][2][3][4][5][6][7][8] and the costs of hospitalizations, 9 but also because of the late effects from the disease, such as the degree of motor disabilities, post-stroke depression, reduced cognitive function and, consequently, the reduced quality of life among stroke survivors and their caregivers. [10][11][12] However, mortality data has a natural limitation; classical prevalence surveys 13 are relatively expensive; and incidence-based population studies [14][15][16] are only suitable for small and middle-size towns. Recently, in parallel with cross-sectional studies using the traditional multistage cluster approach, new technologies for gauging the frequencies of diseases and disabilities have emerged, such as telephone surveys 17 and household inquiries conducted by community health workers within primary care settings.…”