Does Caregiver Well-Being Predict Stroke Survivor Depressive Symptoms? A Mediation Analysis

Grant, Joan S.

doi:10.1310/tscir2001-44

Cited by 7 publications

(9 citation statements)

References 17 publications

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“…The TASK II intervention is unique in that it is delivered completely by telephone, trains caregivers how to assess and address their own needs, and is applicable to a wide variety of stroke caregivers (e.g., spouses, adult children, others). Screening for and addressing caregiver depressive symptoms, as in the TASK II program, not only have the potential to improve caregiver outcomes, 10, 12, 19, 20 but may improve the survivors’ recovery 15 and reduce the potential for their long-term institutionalization. 9, 17, 18 …”

Section: Discussionmentioning

confidence: 99%

“…8, 9, 11–13 Furthermore, the caregiver’s emotional well-being can influence the stroke survivor’s depressive symptoms. 14–16 In addition, the caregiver’s depressive symptoms can affect the stroke survivor’s recovery, 15 communication, social participation, and mood. 16 Finally, caregiver stress is a leading cause of institutionalization for stroke survivors and other older adults.…”

Section: Introductionmentioning

confidence: 99%

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Telephone Assessment and Skill-Building Kit for Stroke Caregivers

Bakas

Austin

Habermann

et al. 2015

Stroke

149

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Background and Purpose There are few evidence-based programs for stroke family caregivers post-discharge. The purpose of this study was to evaluate efficacy of the Telephone Assessment and Skill-Building Kit (TASKII), a nurse-led intervention enabling caregivers to build skills based on assessment of their own needs. Methods A total of 254 stroke caregivers (primarily female TASK II/ISR 78.0%/78.6%; white 70.7%/72.1%; about half spouses 48.4%/46.6%) were randomized to the TASKII intervention (n=123) or to an Information, Support, and Referral (ISR) group (n=131). Both groups received 8 weekly telephone sessions, with a booster at 12 weeks. General linear models with repeated measures tested efficacy, controlling for patient hospital days and call minutes. Pre-specified 8 week primary outcomes were depressive symptoms (with Patient Health Questionnaire Depressive Symptom Scale PHQ-9≥5), life changes, and unhealthy days. Results Among caregivers with baseline PHQ-9≥5, those randomized to the TASK II intervention had a greater reduction in depressive symptoms from baseline to 8, 24, and 52 weeks and greater improvement in life changes from baseline to 12 weeks compared to the ISR group (p<.05); but not found for the total sample. Although not sustained at 12, 24, or 52 weeks, caregivers randomized to the TASK II intervention had a relatively greater reduction in unhealthy days from baseline to 8 weeks (p<.05) Conclusions The TASK II intervention reduced depressive symptoms and improved life changes for caregivers with mild to severe depressive symptoms. The TASK II intervention reduced unhealthy days for the total sample, although not sustained over the long term.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Telephone Assessment and Skill-Building Kit for Stroke Caregivers

Bakas

Austin

Habermann

et al. 2015

Stroke

149

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“…In particular, the presence of depressive symptoms is an important factor to assess when considering caregivers' abilities to provide care at home for the stroke survivor because of the potential negative impact on the caregiver as well as the survivor. 16,17 …”

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confidence: 99%

Task Difficulty and Life Changes Among Stroke Family Caregivers: Relationship to Depressive Symptoms

McLennon

Bakas

Jessup

et al. 2014

Archives of Physical Medicine and Rehabilitation

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OBJECTIVE To investigate differences in stroke caregiver task difficulty and life changes based on level of caregiver depressive symptoms, and to estimate probabilities among task difficulty and life change items. DESIGN Descriptive analysis of baseline data from an ongoing stroke caregiver intervention trial. SETTING Caregivers recruited from 10 mid-western hospitals and rehabilitation facilities. PARTICIPANTS Caregivers (N=242; 78.6% female; 47.7% spouses; 71.8% white; mean age 54.2±12.1) caring for stroke survivors within 8 weeks of discharge to home. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES Baseline measures for task difficulty (Oberst Caregiving Burden Scale) and life changes (Bakas Caregiving Outcomes Scale) were compared based on level of depressive symptoms (PHQ-9 scores < 5 = no depressive symptoms, n=126; PHQ-9 scores ≥ 5 = mild to severe depressive symptoms, n=116). Mean scores were analyzed using general linear modeling, with item analyses using logistic regression and the Benjamini-Hochberg method to control Type I error inflation. RESULTS Caregivers with mild to severe depressive symptoms had greater difficulty with tasks and worse life changes than those with no depressive symptoms (p<.001). Odds ratios were highest for the task of arranging care while away, and highest for negative life changes such as addressing self-esteem, coping with stress, and physical health. CONCLUSION Findings underscore the importance of depressive symptom screening for stroke caregivers during or shortly after discharge. Assisting caregivers with depressive symptoms to arrange for respite care and addressing negative physical and psychological changes may be priority areas for future interventions.

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“…Findings from a study of 146 couples suggested that psychological well-being of family caregivers influences the well-being of relatives with stroke (Grant et al, 2013). Similarly, Barskova and Wilz (2007) found that family caregiver attitudes and emotional health contribute to cognitive and psychological recovery of their relatives with stroke.…”

mentioning

confidence: 99%

Family Caregiving for Husbands with Stroke: An Occupational Perspective on Leisure in the Stress Process

Kniepmann¹

2014

OTJR: Occupational Therapy Journal of Research

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This study adapted the Stress Process Model with occupational assessments to identify stress, leisure changes, burden levels, and health-related quality of life in 20 caregivers of working-age husbands with mild to moderate stroke in the past 2 years. Primary stress was based on participants' perceptions of their husbands' functional behavior skills. Secondary strain was indicated by reduction of leisure activities that the caregivers wished to still do or do more-a phenomena labeled Leisure Loss. Outcomes were burden and health-related quality of life. Wives whose husbands had more functional behavior difficulties experienced significantly more Leisure Loss. Wives with Leisure Loss had significantly higher burden scores than those who continued their leisure participation, but health-related quality of life scores were not different. These findings suggest that leisure participation is important as health promotion for family caregivers, with potential to enhance health of the relative with stroke and the entire family.

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Does Caregiver Well-Being Predict Stroke Survivor Depressive Symptoms? A Mediation Analysis

Cited by 7 publications

References 17 publications

Telephone Assessment and Skill-Building Kit for Stroke Caregivers

Telephone Assessment and Skill-Building Kit for Stroke Caregivers

Task Difficulty and Life Changes Among Stroke Family Caregivers: Relationship to Depressive Symptoms

Family Caregiving for Husbands with Stroke: An Occupational Perspective on Leisure in the Stress Process

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