Mediating effects of burden on quality of life for caregivers of first-time stroke patients discharged from the hospital within one year

Abstract

BackgroundCaregiver burden may be either a predictor or an outcome of caregiver quality of life (QoL). Patient or caregiver factors that directly affect caregiver QoL, predictors that are simultaneously shared with caregiver burden and QoL, and factors that affect caregiver QoL through caregiver burden are not well understood. This study explored predictors of caregiver QoL and identified whether caregiver burden is a mediator for caregivers of first-time stroke patients.MethodsThis is a cross-sectional study. We recruited first-time stroke patients who had been discharged from the hospital within 1 year. We screened caregivers with two major inclusion criteria: age > 20 years old and being the family member who provides the most patient-care hours out of all family caregivers. Caregiver burden (Caregiver Strain Index, CSI), QoL (Caregiver Quality of Life Index, CQLI), and patient and caregiver characteristics were assessed with structured questionnaires. Multiple-regression and bootstrap analysis were conducted for data analysis.ResultsA total of 126 caregivers completed the questionnaires. Higher caregiver burdens, lower caregiver education level, lower self-rated health, lower monthly family income, and spouses who were responsible for medical fees were significant predictors of lower caregiver QoL. Poor self-rated health and monthly family income of $ 666 USD or below were the strongest predictors of caregiver QoL. Spouses who were responsible for medical fees and lower monthly family income had direct negative effects on caregiver QoL, but these factors exhibited no indirect mediating effect between caregiver characteristics and QoL through caregiver burden as a mediator. Caregiver education level at or below elementary school and poor or fair self-rated-health had direct negative effects on caregiver QoL, which were mediated by caregiver burden.ConclusionsOur study indicated predictors of caregiver QoL and the relationships with caregiver burden among first-time stroke survivors in the early stage. Caregivers’ financial factors affected caregiver QoL directly. Caregivers’ poor self-rated health and lower education level negatively affected caregiver QoL indirectly through caregiver burden as a mediator. Interventions to make appropriate policies for financial subsidies, to enhance caregivers’ health and to provide tailored stroke-related education through multidisciplinary cooperation may effectively promote caregiver QoL.

Fatores associados à ideação suicida em cuidadores de sobreviventes de acidente vascular encefálico

“…Pesquisas revelaram a influência negativa do cuidado para vida do cuidador, interferindo na rotina diária, na renda individual e familiar, no trabalho e/ou estudos, no lazer e nos relacionamentos afetivos (1,(5)(6)12) . Os prejuízos decorrentes desse cuidado prolongado não se restringem apenas à esfera individual do cuidador, podendo interferir na qualidade das ações executadas e na própria integridade física do paciente, haja vista que a sobrecarga representa importante fator de risco para violência e negligência (6) .…”

Relationship between Care Burden, Social Support and Quality of Life in Caregivers of Individual with Stroke

“…Literatürde bu hastalık ile ilgili yapılan birçok çalışmada bakım vericilerin yaşam kalitelerinin düşük olduğu bulunmuştur. Çalışmadan elde edilen bu sonuç, literatürdeki çalışma bulgularıyla uyumludur (13,(37)(38)(39) . Bununla birlikte, inmeli bireye bakım verenlerin yaşam kalitesinin orta düzeyde olduğunu gösteren çalışmalar da vardır (28,38) .…”

“…(47) inmeli bireyin bakımının bakım verene yük getirdiğini ve bu yükün yaşam kalitesini azalttığını saptamışlardır. Bakım yükü ile yaşam kalitesi arasında ilişkinin değerlendirildiği başka çalışmalarda da bakım vericilerin bakım yükünün artarken yaşam kalitesinin düştüğü bulunmuştur (28,38,39) .…”

“…Batı toplumlarına kıyasla, doğu toplumlarında aile ve sosyal ilişkiler daha ön plandadır (50) . Doğu toplumlarından olan Türk toplumu sosyal destek sistemleri güçlü olan bir toplumdur ve sosyal destek sistemi de bakım verenin yükünü azaltan önemli bir kaynaktır (39,41) . Çalışma bulguları bu bilgileri desteklemektedir.…”

The association of stroke severity with health-related quality of life in survivors of acute cerebrovascular disease and their informal caregivers during the first year post stroke: a survey study

“…With increased focus on earlier discharge and re-integration of patients into the community, the role of family and other informal caregivers is becoming more important. Accordingly, there are a growing number of studies addressing the quality of life (QoL) of informal caregivers of stroke survivors [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. While QoL is a broad assessment of an individual's subjective well-being or life satisfaction, this study investigates the narrower concept of health-related quality of life (HRQoL).…”