Quality of Life and Mood Disorders of Acute Stroke Survivors and their Caregiver Burden: A Cross-sectional Study
Syed Aftab Husain Rizvi1, Anand Kumar2, Deepika Joshi2, Varun Singh2, Abhishek Pathak2, Rameshwar Chaurasia2, Vijaya Mishra2, Neha Lall3, Amit Nandan Dhar Dwivedi4
1MBBS, 2Neurology, 3Radiotherapy and Radiation Medicine, 4Radiodiagnosis and Imaging, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India
Objective:
This study evaluated the impact of patient clinical and psycho-social variables like post-stroke mood disorders and quality of life (QoL) on caregiver burden and stress.
Background:
The stress between patients and families is interrelated and can have grave consequences including poor patient recovery and caregiver burnout.
Design/Methods:
In this prospective, cross-sectional study, 127 patient-caregiver dyad of mild-moderate stroke survivors within 7 days of onset were assessed by several scales. Stroke Specific-Quality of Life (SS-QOL), Generalized Anxiety Disorder (GAD-7) and Hospital Anxiety and Depression (HADS) to patient while Caregiver Strain Index (CSI), Burden Scale for Family Caregivers (BSFC) and Sleep Quality Scale (SQS) to caregiver.
Results:
Nearly 43% patients had anxiety while 78% had depression. Mean caregiver age was about 21 years lesser than patients. About 18% caregivers were moderately burdened while 59% reported increased stress. Higher CSI was observed when caregiver had to stop working (RR=1.359), post-stroke change in family income (RR=1.551) and post-stroke seizure (RR=1.387) in the patient. Caregivers from rural background (p=.035) and middle-lower socioeconomic status (p=0.012) had higher CSI. Young adolescent caregivers reported higher strain (p=0.045). CSI was associated with intraventricular involvement for hemorrhagic stroke (p=0.048). Degree of disability was also associated with caregiver burden (p=0.025). Higher burden was found among the caregivers who had higher self-reported anxiety (RR=1.614) and who had to assist the patient in urination (RR=2.068). Caregivers with evidence of emotional support reported lesser burden (RR=0.310). Caregivers with poor SQS felt more burdened (RR=5.784) and had greater strain (RR=2.557). However, no association was found between post-stroke survivor’s anxiety, depression and QoL with the caregiver strain or burden.
Conclusions:
The above results emphasize that a large number of caregivers suffer from increased strain and burden. Hence, it is important to address the patient-caregiver as a unit and focus on a “recovering together” approach by early intervention at initial hospitalization.
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