The associations between caregivers’ psychosocial characteristics and caregivers’ depressive symptoms in stroke settings: a cohort study

Abstract

Background Studies have found that caregivers can influence stroke survivors’ outcomes, such as mortality. It is thus pertinent to identify significant factors associated with caregivers’ outcomes. The study objective was to examine the associations between caregivers’ psychosocial characteristics and caregivers’ depressive symptoms. Methods The analysis obtained three-month and one-year post-stroke data from the Singapore Stroke Study, which was collected from hospital settings. Caregivers’ depressive symptoms were assessed via the Center for Epidemiologic Studies Depression instrument. Psychosocial characteristics of caregivers included subjective burden (Zarit Burden Interview), quality of care-relationship (a modified 3-item scale from the University of Southern California Longitudinal Study of Three-Generation Families) and expressive social support (an 8-item scale from Pearlin et al.). Mixed effect Tobit regressions were used to examine the associations between these study variables. Results A total of 214 caregivers of stroke patients hospitalized were included in the final analysis. Most caregivers were Chinese women with secondary school education, unemployed and married to the patients. Caregivers' subjective burden was positively associated with their depressive symptoms (Partial regression coefficient: 0.18, 95% CI 0.11–0.24). Quality of care-relationship (Partial regression coefficient: − 0.35, 95% CI − 0.63 to − 0.06) and expressive social support (partial regression coefficient: − 0.28, 95% CI − 0.37 to − 0.19) were negatively associated with caregivers’ depressive symptoms. Caregivers’ depressive symptoms were higher at three-month post-stroke than one-year post-stroke (Partial regression coefficient: − 1.00, 95% CI − 1.80 to − 0.20). Conclusion The study identified subjective burden, quality of care-relationship and expressive social support as significantly associated with caregivers’ depressive symptoms. Caregivers’ communication skills may also play a role in reducing caregivers’ depressive symptoms.

Relationships between care burden, resilience, and depressive symptoms among the main family caregivers of stroke patients: A cross-sectional study

“…Notably, the results of the present study showed that there is a statistically significant and inverse relationship between care burden and depressive symptoms in family caregivers. Our findings support previous research ( 64 , 65 ) suggesting that caregivers who score high care burden have also high depression. Despite these similar findings in the literature, we don't see a ready explanation for this association.…”

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

“…Researchers report that caregivers with moderate to high levels of subjective burden experience or are at high risk for developing depressive symptoms [ 34 , 41 , 51 ] and exhibit emotional changes [ 19 ]. In addition, a cohort study by Koh and his colleagues [ 48 ] showed that caregivers who mentioned that were burdened by their caregiving responsibilities had high depression scores when their depressive symptoms were measured three months after the patient’s stroke. These scores appeared to decrease statistically significantly when assessed one year after stroke.…”

“…For instance, it was found that caregivers’ high level of benefit finding could predict low levels of anxiety, depression, and burden [ 57 ]. Additionally, a study by Koh et al [ 48 ] found that levels of depression decreased statistically significantly over a 9-month period. As previously mentioned for this study, caregivers’ depressive symptom assessments were conducted at 3 and 12 months after the patient’s stroke.…”

“…This reduction was attributed to caregivers becoming more familiar with their role and receiving more support from their relatives [ 58 ]. Furthermore, they noticed that if the caregiver, despite their burden, had a good relationship with the patient and had extra support, their depressive symptomatology was low [ 48 ]. Finally, in a qualitative study, all participants, despite their burden level, reported benefits from caring for the stroke survivor.…”

“…This indicates that countries with comprehensive medical insurance coverage or robust healthcare systems may alleviate some financial burdens on caregivers. Moreover, the discussion on the impact of caregiver burden on psychological health, as evidenced by studies like those by Koh et al [ 48 ] and Mei et al [ 57 ], underscores the importance of support mechanisms. Koh et al [ 48 ] found that depressive symptomatology decreased over time, attributing it to caregivers becoming more familiar with their role and receiving support from relatives.…”