Caring for Stroke Survivors: Baseline and 1-Year Determinants of Caregiver Burden

Rigby, Heather; Gubitz, Gord; Eskes, Gail A.; Reidy, Yvette; Christian, Christine; Grover, Vaneeta Kaur; Phillips, Stephen J.

doi:10.1111/j.1747-4949.2009.00287.x

Cited by 70 publications

(69 citation statements)

References 39 publications

(48 reference statements)

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“…Predictors of the mental domains on the other hand were depressive symptoms, cognitive impairment, and global disability of the stroke survivor, as well as lack of social support for the spouses of stroke survivors. The results are consistent with previous studies indicating that the functional status, 22 depressive symptoms, and neurological deficits 23 of the stroke survivor are determinants and predictors of the caregivers' experienced burden during the first year after stroke onset. The amount of available social support may also be an important factor in lowering the psychological distress of the informal caregiver.…”

Section: Discussionsupporting

confidence: 82%

Spouses of Stroke Survivors Report Reduced Health-Related Quality of Life Even in Long-Term Follow-Up

Persson

Holmegaard

Karlberg

et al. 2015

Stroke

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Data on stroke survivors, controls, and spouses were collected from the 7-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). 8 The database covers 600 consecutively recruited patients diagnosed with ischemic stroke before the age of 70 within 4 stroke units in western Sweden between 1998 and 2003 and 600 ageand sex-matched controls who were selected randomly from a group of participants in a population-based health survey. For both stroke cases and controls, recurrent stroke and deaths between SAHLSIS baseline and follow-up have been identified using the Swedish Cause of Death Register and the National Patient Register.9 For the 7-year follow-up,Background and Purpose-The consequences for the family of stroke survivor are generally studied in a short-term perspective. The aim of this study was to assess long-term aspects of health-related quality of life among spouses of stroke survivors. Methods-Data on stroke survivors, controls, and spouses were collected from the 7-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). The health-related quality of life of spouses was assessed by the Short Form-36, and the characteristics of stroke survivors were assessed using the National Institutes of Health Stroke Scale, the Mini-Mental State Examination, the Hospital Anxiety and Depression Scale, the Barthel Index, and the modified Rankin Scale. Results-Dyads of 248 stroke survivors aged <70 at stroke onset and 245 dyads of matched controls were included. Spouses of stroke survivors and spouses of controls had a median age of 64 and 65, respectively; proportion of men was 35% and 34%, respectively. The spouses of stroke survivors reported lower scores in all the mental domains (P=0.045; P<0.001), as well as in the domains of general health (P=0.013) and physical role (P=0.006), compared with the spouses of controls. Predictors of poor physical health of the spouses were their own age and the level of global disability of the stroke survivor. Predictors of poor mental health of the spouses were depressive symptoms, cognitive impairment, and global disability among the stroke survivors. Conclusions-The

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Section: Discussionsupporting

confidence: 82%

Spouses of Stroke Survivors Report Reduced Health-Related Quality of Life Even in Long-Term Follow-Up

Persson

Holmegaard

Karlberg

et al. 2015

Stroke

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“…4 The consequences of stroke for caregivers have been extensively investigated with a focus on emotional wellbeing; it has also been argued that studies in this area suffer from heterogeneity and methodological limitations and are largely atheoretical. 31 Nevertheless, estimates of caregiver burden range from 25% to 54% 32 and stroke disability appears to be associated with caregiver outcomes. 31 In this study, just over one fourth of national sample and one fifth of the population registers sample reported experiencing negative changes in their family relationships.…”

Section: Discussionmentioning

confidence: 99%

Self-Reported Long-Term Needs After Stroke

McKevitt

Fudge

Redfern

et al. 2011

Stroke

404

392

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Background and Purpose— Development of interventions to manage patients with stroke after discharge from the hospital requires estimates of need. This study estimates the prevalence of self-reported need in community-dwelling stroke survivors across the United Kingdom. Methods— We conducted a survey of stroke survivors 1 to 5 years poststroke recruited through Medical Research Council General Practice Research Framework general practices and 2 population-based stroke registers. Levels and type of need were calculated with comparisons among sociodemographic groups, disability level, and cognitive status using the χ 2 test or Fisher exact test, as appropriate. Results— From 1251 participants, response rates were 60% (national sample) and 78% (population registers sample) with few differences in levels of reported need between the 2 samples. Over half (51%) reported no unmet needs; among the remainder, the median number of unmet needs was 3 (range, 1 to 13). Proportions reporting unmet clinical needs ranged from 15% to 59%; 54% reported an unmet need for stroke information; 52% reported reduction in or loss of work activities, significantly more from black ethnic groups ( P =0.006); 18% reported a loss in income and 31% an increase in expenses with differences by age, ethnic group, and deprivation score. In multivariable analysis, ethnicity ( P =0.032) and disability ( P =0.014) were associated with total number of unmet needs. Conclusions— Multiple long-term clinical and social needs remain unmet long after incident stroke. Higher levels of unmet need were reported by people with disabilities, from ethnic minority groups, and from those living in the most deprived areas. Development and testing of novel methods to meet unmet needs are required.

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“…Neurological deterioration was also more frequently developed in patients with prestroke dementia than in those without pre-stroke dementia ( Table 2 ). In addition, patients with pre-stroke dementia showed higher mRS at 3 months after stroke onset than those without pre-stroke dementia (median [interquartile range] 3 [2][3][4] vs. 1 [0-3], p < 0.01), resulting in a higher prevalence of poor functional outcome in patients with pre-stroke dementia (63.7%) than in those without pre-stroke dementia (27.1%, p < 0.01; Table 2 ; online suppl. Fig.…”

Section: Pre-stroke Dementia and Clinical Outcomes In All Participantsmentioning

confidence: 99%

“…Dementia and stroke are major causes of functional disability in the elderly [1] , causing increased impact and burden on caregivers as well as on the society [2][3][4] . Because the prevalence of dementia is expanding rapidly worldwide [5] and also because dementia is a known risk factor for stroke [6,7] , an increase in the number of acute stroke patients with preexisting dementia is expected [8] .…”

Section: Introductionmentioning

confidence: 99%

Adverse Influence of Pre-Stroke Dementia on Short-Term Functional Outcomes in Patients with Acute Ischemic Stroke: The Fukuoka Stroke Registry

Wakisaka¹,

Matsuo²,

Hata

et al. 2016

Cerebrovasc Dis

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Background: Dementia and stroke are major causes of disability in the elderly. However, the association between pre-stroke dementia and functional outcome after stoke remains unresolved. We aimed to determine this association in patients with acute ischemic stroke. Methods: Among patients registered in the Fukuoka Stroke Registry from June 2007 to May 2015, 4,237 patients with ischemic stroke within 24 h of onset, who were functionally independent before the onset, were enrolled in this study. Pre-stroke dementia was defined as any type of dementia that was present prior to the index stroke. Primary and secondary study outcomes were poor functional outcome (modified Rankin Scale 3-6) at 3 months after the stroke onset and neurological deterioration (≥2-point increases on the National Institutes of Health Stroke Scale score during hospitalization), respectively. For propensity score (PS)-matched cohort study to control confounding variables for pre-stroke dementia, 318 pairs of patients with and without pre-stroke dementia were also selected on the basis of 1:1 matching. Multivariable logistic regression models and conditional logistic regression analysis were used to quantify associations between pre-stroke dementia and study outcomes. Results: Of all 4,237 participants, 347 (8.2%) had pre-stroke dementia. The frequencies of neurological deterioration and poor functional outcome were significantly higher in patients with pre-stroke dementia than in those without pre-stroke dementia (neurological deterioration, 16.1 vs. 7.1%, p < 0.01; poor functional outcome, 63.7 vs. 27.1%, p < 0.01). Multivariable analysis showed that pre-stroke dementia was significantly associated with neurological deterioration (OR 1.67; 95% CI 1.14-2.41; p < 0.01) and poor functional outcome (OR 2.91; 95% CI 2.17-3.91; p < 0.01). In the PS-matched cohort study, the same trends were observed between the pre-stroke dementia and neurological deterioration (OR 2.60; 95% CI 1.17-5.78; p < 0.01) and between the dementia and poor functional outcome (OR 3.62; 95% CI 1.89-6.95; p < 0.01). Conclusions: Pre-stroke dementia was significantly associated with higher risks for poor functional outcome at 3 months after stroke onset as well as for neurological deterioration during hospitalization in patients with acute ischemic stroke.

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Caring for Stroke Survivors: Baseline and 1-Year Determinants of Caregiver Burden

Cited by 70 publications

References 39 publications

Spouses of Stroke Survivors Report Reduced Health-Related Quality of Life Even in Long-Term Follow-Up

Spouses of Stroke Survivors Report Reduced Health-Related Quality of Life Even in Long-Term Follow-Up

Self-Reported Long-Term Needs After Stroke

Adverse Influence of Pre-Stroke Dementia on Short-Term Functional Outcomes in Patients with Acute Ischemic Stroke: The Fukuoka Stroke Registry

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