Relationship Consensus and Caregiver Burden in Adults with Cognitive Impairments 6 Months Following Stroke

Abstract

Background: Caregiver burden is commonly experienced in caregivers of adults with cognitive impairment after stroke. This burden can be associated with caregiver-centered factors, including caregiver-perceived relationship quality. Objective: To examine the role of caregiver-perceived relationship quality on caregiver burden at 6 months following stroke. Design: Prospective observational study. Setting: Community settings. Participants: Adults enrolled in two randomized controlled trials after stroke (n = 60) and their caregivers (n = 60). Methods: Three constructs of relationship quality (relationship consensus, cohesion, and satisfaction) were examined as predictors of caregiver burden (the Abbreviated Dyadic Adjustment Scale). A hierarchical logistic regression and a Poisson regression with robust standard errors were used to examine the effect of relationship quality on caregiver burden while controlling for characteristics of stroke survivors and caregivers. Main Outcome Measurements: Caregiver burden was measured with the abridged version of the Zarit Burden Interview. Results: Poor relationship consensus (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.06-2.07; P = .02) increased the odds of high caregiver burden after controlling for characteristics of stroke survivors (age, comorbidity, cognitive fluency) and caregivers (gender, self-reported health). Relationship cohesion (OR = 1.03; 95% CI = .84-1.25; P = .81) and relationship satisfaction (OR = 1.53; 95% CI = .75-3.10; P = .24) did not predict caregiver burden. Conclusion: Meaningful and agreeable goals and expectations between dyads are essential to reduce caregiver burden after stroke. Collaborative goal-setting between stroke survivors and their caregivers may be a promising intervention strategy to increase relationship consensus and reduce caregiver burden.

The Effects of Patients’ and Caregivers’ Characteristics on the Burden of Families Caring for Stroke Survivors

“…It is notable that in all studies, including the present one, the typical primary caregiver was female (spouse/partner/daughter) [ 23 , 24 , 27 , 28 , 29 , 30 , 31 , 34 , 35 , 36 ]. Women are the primary caregivers in the family setting.…”

“…Partners ( n = 183) of stroke patients in the Netherlands experienced a high care burden, anxiety, and depressive symptoms that were associated with partner variables (younger age, relationship satisfaction, proactive coping, self-efficacy, everyday social support, burden, anxiety, and depressive symptoms) and patient variables (stroke severity and depressive symptoms) [ 28 ]. Patients’ age, comorbidities, and cognitive function, as well as the gender and self-reported health of caregivers, were correlated with caregiver burden at 6 months following stroke [ 29 ]. In a study by Olai et al [ 30 ] in Sweden, caregiver burden increased with low informal caregiver support, patient’s age, and with low functional capacity/BI.…”

A newly designed intensive caregiver education program reduces cognitive impairment, anxiety, and depression in patients with acute ischemic stroke

“…However, the majority of education care programs focus on motor recovery, and there are insufficient studies concerning cognitive and psychological complications, such as cognitive impairment, anxiety, and depression (11). Furthermore, caregivers often experience emotional challenges as well as burden due to the lack of AIS rehabilitation-related knowledge, hence some caregiver education programs are designed to promote the satisfaction of caregivers regarding rehabilitation education (12 –15). For example, one caregiver education program promotes caregiving competence as well as working satisfaction in caregivers by establishing caregiving rehabilitation training (16).…”

Assessing the Structural Characteristics of the Japanese Version of the Adult Social Care Outcomes Toolkit for Carers

“…A RMSEA value close to .06 and a CFI of above .95 represented good fit. 29 A SRMR value less than .05 represented a well-fitting model. 29 For the second research question, an IRT approach was employed to investigate the response system of the J-ASCOT-Carer with maximum likelihood estimation and robust standard errors.…”

“…29 A SRMR value less than .05 represented a well-fitting model. 29 For the second research question, an IRT approach was employed to investigate the response system of the J-ASCOT-Carer with maximum likelihood estimation and robust standard errors. An advantage of the IRT approach is the fact that the question items and response options' properties are not sample dependent.…”