Burden in caregivers of long-term stroke survivors: Prevalence and determinants at 6 months and 5 years after stroke

Jaracz, Krystyna; Grabowska-Fudala, Barbara; Górna, Krystyna; Jaracz, Jan; Moczko, Jerzy; Kozubski, Wojciech

doi:10.1016/j.pec.2015.04.008

Cited by 96 publications

(112 citation statements)

References 44 publications

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“…As such, stroke survivors commonly suffer limits in functional recovery (Cumming, Marshall, & Lazar, 2013;LuengoFernandez et al, 2013) and significant difficulties performing activities of daily living (Mayo, WoodDauphinee, Côté, Durcan, & Carlton, 2002). Subsequently, continued support is often required (Kelly-Hayes et al, 2003), commonly provided by informal caregivers, such as family members, within the home (Jaracz et al, 2015;Sumathipala, Radcliffe, Sadler, Wolfe, & McKevitt, 2012).…”

Section: Introductionmentioning

confidence: 99%

“…The provision of informal care to stroke survivors within the community can be challenging (Jaracz et al, 2015), and can be associated with significant emotional consequences including sleep difficulties (Rittman, Hinojosa, & Findley, 2009); loss of relationships with family and friends (Rochette, Desrosiers, Bravo, Tribble, & Bourget, 2007); withdrawal from social activities (Mausbach et al, 2011) and poor quality of life (Godwin, Ostwald, Cron, & Wasserman, 2013). Further, caregivers may experience poor physical health (Carretero, Garcés, Ródenas, & Sanjosé, 2009;Legg, Weir, Langhorne, Smith, & Stott, 2013) and reduced energy (Parag et al, 2008).…”

Section: Introductionmentioning

confidence: 99%

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”I Don’t Believe in Leading a Life of My Own, I Lead His Life”: A Qualitative Investigation of Difficulties Experienced by Informal Caregivers of Stroke Survivors Experiencing Depressive and Anxious Symptoms

Woodford

Farrand

Watkins

et al. 2017

Clinical Gerontologist

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Objectives: Health and social care services are increasingly reliant on informal caregivers to provide long-term support to stroke survivors. However, caregiving is associated with elevated levels of depression and anxiety in the caregiver that may also negatively impact stroke survivor recovery. This qualitative study aims to understand the specific difficulties experienced by caregivers experiencing elevated symptoms of anxiety and depression. Methods: Nineteen semi-structured interviews were conducted with caregivers experiencing elevated levels of depression and anxiety, with a thematic analysis approach adopted for analysis. Results: Analysis revealed three main themes: Difficulties adapting to the caring role; Uncertainty; and Lack of support. Conclusions: Caregivers experienced significant difficulties adapting to changes and losses associated with becoming a caregiver, such as giving up roles and goals of importance and value. Such difficulties persisted into the long-term and were coupled with feelings of hopelessness and worry. Difficulties were further exacerbated by social isolation, lack of information and poor long-term health and social care support. Clinical Implications: A greater understanding of difficulties experienced by depressed and anxious caregivers may inform the development of psychological support targeting difficulties unique to the caring role. Improving caregiver mental health may also result in health benefits for stroke survivors themselves.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

”I Don’t Believe in Leading a Life of My Own, I Lead His Life”: A Qualitative Investigation of Difficulties Experienced by Informal Caregivers of Stroke Survivors Experiencing Depressive and Anxious Symptoms

Woodford

Farrand

Watkins

et al. 2017

Clinical Gerontologist

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“…4 Given the severe disability and limitations in activities of daily living present in stroke, caregivers have been found to experience high levels of burden (ie, the overall impact of the physical, psychological, and social demands of caregiving) 5 and unpreparedness. [5][6][7][8] Caregivers experiencing high levels of burden report lower QOL. 9 Although research has found that QOL of survivors and their caregivers is interdependent in stroke, 10,11 to our knowledge, only one study 10 has used a statistical approach that controls for this interdependence within stroke dyads.…”

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confidence: 99%

Roles of Changing Physical Function and Caregiver Burden on Quality of Life in Stroke

Pucciarelli

Vellone

Savini

et al. 2017

Stroke

115

117

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Background and Purpose-The purpose of this study was to examine changes in stroke survivor and caregiver quality of life (QOL) and to determine whether changes in survivor physical functioning and caregiver burden (ie, the impact of the physical, psychological, and social demands of caregiving) influence changes in QOL. Methods-Longitudinal design with 226 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivor physical functioning, caregiver burden, and QOL (physical, psychological, social, and environmental) in both survivor and caregiver. Multilevel modeling was used to control for the interdependence of the data. Results-Survivors (50% male sex) and caregivers (66% female sex) were 70.8 (SD=11.9) and 52.4 (SD=13.1) years old, respectively. Over the 12 months, stroke survivor's physical (γ=1.59; P<0.001) and psychological (γ=0.86; P<0.05) QOL significantly improved; social and environmental QOL did not P>0.05. Caregiver QOL, on average, did not significantly change over time P>0.05. Improvements in survivor physical functioning were associated with increases in survivor and caregiver physical and psychological QOL and survivor environmental QOL. Decreases in caregiver burden were significantly associated with improvements in caregiver physical, psychological, and environmental QOL but not with survivor QOL. Conclusions-QOL of stroke survivors and caregivers covaries and is greatly impacted by the physical function changes of the survivor. Dyadic approaches to stroke rehabilitation that acknowledge the interdependence of dyads are needed.

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“…2 For this reason, the global stroke-related burden is huge and continues to rise. 3 Therefore, it is necessary to explore the predictors of poor prognosis after stroke.…”

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confidence: 99%

Association of Oxidized Low-Density Lipoprotein With Prognosis of Stroke and Stroke Subtypes

Wang

Yang

et al. 2017

Stroke

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Background and Purpose-The association between oxidized low-density lipoprotein (oxLDL) and the long-term prognosis of stroke is unclear. The aim of this study is to investigate whether oxLDL levels contribute to the prognosis of stroke and stroke subtypes. Methods-All patients with ischemic stroke were recruited from the SOS-Stroke (Study of Oxidative Stress in Patients WithAcute Ischemic Stroke) and classified into 5 different subtypes, according to the TOAST criteria (Trial of Org 10172 in Acute Stroke Treatment). We measured oxLDL levels and followed up with patients at 1 year after stroke onset. We analyzed the association between oxLDL and the clinical outcomes of death and poor functional outcome (modified Rankin Scale score of 3-6) of stroke and different stroke subtypes. Results-Among the 3688 patients included in this study, 293 (7.94%) were deceased at the 1-year follow-up and 1020 (27.66%) had a poor functional outcome. Patients in the highest oxLDL quartile had a higher risk of 1-year stroke mortality (hazard ratio, 1.61; 95% confidence interval, 1.10-2.33; P<0.001) and a poor functional outcome (odds ratio, 1.48; 95% confidence interval, 1.15-1.89; P<0.001) compared with the lowest oxLDL quartile. In the subgroup analyses, oxLDL was only significantly associated with death and poor functional outcome in the large-artery atherosclerosis subgroup (P<0.05) and small-artery occlusion subgroup (P<0.05). Conclusions-High levels of oxLDL were associated with the high risk of death and poor functional outcome within 1 year after stroke onset, especially in large-artery atherosclerosis and small-artery occlusion stroke subtypes. Therefore, in this prospective cohort study, we investigated the associations between oxLDL and the long-term prognosis of stroke and stroke subtypes. Methods Study Design and PopulationThe study population was recruited from the SOS-Stroke (Study on Oxidative Stress in Patients with Acute Ischemic Stroke ), a nationwide multicenter prospective registry. 13 The SOS-Stroke study enrolled 4164 consecutive patients with stroke from 43 designated hospitals in China from January to October 2014. Patients with a diagnosis of acute ischemic stroke within 7 days after the onset of stroke were included in this study. The inclusion criteria for SOSStroke were as follows: (1) age >18 years; (2) diagnosis of acute ischemic stroke by a neurologist and confirmation of such with brain computed tomography or magnetic resonance imaging; (3) time from onset of stroke to diagnosis was <1 week; and (4) the patient provided informed consent. Standard Protocol Approvals, Registrations, and Patient ConsentsThe study was sponsored by the China Stroke Prevention Project of the National Health and Family Planning Commission and was approved by the Ethics Committee of Beijing Tiantan Hospital, Xuanwu Hospital Capital Medical University, and Peking Union Medical College Hospital and was in compliance with the Declaration of Helsinki. All participants provided written informed consent. Baseline Data Collection ...

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Burden in caregivers of long-term stroke survivors: Prevalence and determinants at 6 months and 5 years after stroke

Cited by 96 publications

References 44 publications

”I Don’t Believe in Leading a Life of My Own, I Lead His Life”: A Qualitative Investigation of Difficulties Experienced by Informal Caregivers of Stroke Survivors Experiencing Depressive and Anxious Symptoms

”I Don’t Believe in Leading a Life of My Own, I Lead His Life”: A Qualitative Investigation of Difficulties Experienced by Informal Caregivers of Stroke Survivors Experiencing Depressive and Anxious Symptoms

Roles of Changing Physical Function and Caregiver Burden on Quality of Life in Stroke

Association of Oxidized Low-Density Lipoprotein With Prognosis of Stroke and Stroke Subtypes

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