Qiu Yanru, Li Sijian
Department of Oncology, Renmin Hospital, Wuhan University, Wuhan, China.
J Clin Nurs. 2008 Jun;17(12):1563-73. doi: 10.1111/j.1365-2702.2007.02156.x.
aims and objectives: The main aim of this study was to identify the coping strategies of stroke caregivers, to identify the factors associated with caregivers' depression and to identify predictors of caregivers' depression.
Stroke has a high incidence in China. Most stroke survivors are accompanied by family caregivers during hospitalisation. However, little is known about these informal caregivers' coping strategies to the consequences brought on by stroke and their depressive symptoms.
A correlation and cross-sectional design was used and a purposive sample of 92 stroke survivors and their caregivers completed the questionnaires, which were used to describe the demographic of both the caregiver and stroke survivor, coping strategies (the Brief COPE Inventory) and depression of caregivers (the Center for Epidemiologic Studies Depression Scale). Spearman's correlation and multiple stepwise regression analysis were used in data analyses.
Several coping strategies (planning, positive reframing, acceptance, active coping, use of instrumental support and humour) were most commonly used by stroke caregivers. The length of hospital stay, stroke survivor's cognitive status and functional status, family income and coping strategies such as (i) denial, (ii) self-blame, (iii) planning and (iv) religion had significant correlations with caregiver's depression. The best predictors of caregiver's depression were denial, planning and stroke survivor's functional status.
This study contributes to our knowledge about the coping strategies and depression level of stroke caregivers on the Chinese mainland. The depression rate is very high during hospitalisation, although these caregivers often had positive coping responses to the stroke event. Many factors were associated with caregivers' depression.
Nurses should not only pay attention to stroke survivors but also to their caregivers. To help them adjust well from the stroke consequences and avoid depression, nurses should implement effective interventions.
目的与目标：本研究的主要目的是确定中风患者照料者的应对策略，确定与照料者抑郁相关的因素，并确定照料者抑郁的预测因素。
中风在中国发病率很高。大多数中风幸存者在住院期间由家庭照料者陪伴。然而，对于这些非正式照料者应对中风带来的后果及其抑郁症状的策略知之甚少。
采用相关性和横断面设计，对92名中风幸存者及其照料者进行了有目的抽样，他们完成了问卷，这些问卷用于描述照料者和中风幸存者的人口统计学特征、应对策略（简易应对方式问卷）以及照料者的抑郁情况（流行病学研究中心抑郁量表）。数据分析采用斯皮尔曼相关性分析和多元逐步回归分析。
中风照料者最常用的几种应对策略包括计划、积极重新评价、接受、积极应对、利用工具性支持和幽默。住院时间、中风幸存者的认知状态和功能状态、家庭收入以及诸如（i）否认、（ii）自责、（iii）计划和（iv）宗教等应对策略与照料者的抑郁有显著相关性。照料者抑郁的最佳预测因素是否认、计划和中风幸存者的功能状态。
本研究有助于我们了解中国大陆中风照料者的应对策略和抑郁水平。尽管这些照料者通常对中风事件有积极的应对反应，但住院期间的抑郁率很高。许多因素与照料者的抑郁有关。
护士不仅应关注中风幸存者，还应关注他们的照料者。为帮助他们从中风后果中良好调整并避免抑郁，护士应实施有效的干预措施。
