Teel C S, Duncan P, Lai S M
School of Nursing, University of Kansas Medical Center, Kansas City, Kansas 66160-7502, USA.
Nurs Res. 2001 Jan-Feb;50(1):53-60. doi: 10.1097/00006199-200101000-00008.
Stroke is a major cause of disability in the United States. Over half a million Americans suffer strokes each year, and many of the 75% who survive are cared for in home settings, by family caregivers. The caregiving experience is often stressful and can result in negative physical and mental health outcomes for the family caregiver.
The purpose of this longitudinal study was to examine relationships between patient characteristics, characteristics of the caregiver, and caregiver coping resources with caregiver physical and mental health outcomes at 3 and 6 months after the loved one's stroke. A secondary aim was to compare family members' assessments of patient disability with ratings by clinicians.
The caregiver study was conducted in collaboration with a study of patient outcome after stroke. Both studies used the same cohort of stroke patients and their primary caregivers. Detailed clinical assessment of patient status was conducted 1, 3, and 6 months after stroke. Caregivers (N = 83) completed mailed questionnaires 1, 3, and 6 months after the patient's stroke. The survey included quantification of fatigue and energy, assessment of mood disturbance, stress, spirituality, and reactions to the caregiving situation, which provided a detailed assessment of caregiver characteristics, coping resources, and physical and mental health status.
Caregivers reported stable perceptions of fatigue, vigor, recurrent sorrow, perceived stress, finances, family support, physical health, and depressive state symptoms at 1, 3, and 6 months after the loved one's stroke. The relationship between physical health and depressive symptoms was reciprocal at 3 and 6 months. Perceived stress was related to mental health at 3 and 6 months. Caregiver ratings of disability at 1 month paralleled clinical assessments using the Orpington Prognostic scale.
Part of a comprehensive approach to stroke after-care should include comprehensive assessment of caregiver functioning soon after the loved one's stroke. Early assessment might identify persons at greater risk for physical and mental health problems in a continuing caregiving role.
在美国，中风是导致残疾的主要原因。每年有超过50万美国人中风，其中75%的幸存者中有许多是由家庭照顾者在家中照顾。照顾经历往往压力很大，可能会给家庭照顾者带来负面的身心健康后果。
这项纵向研究的目的是考察在亲人中风后3个月和6个月时，患者特征、照顾者特征以及照顾者应对资源与照顾者身心健康后果之间的关系。第二个目的是比较家庭成员对患者残疾程度的评估与临床医生的评级。
照顾者研究是与一项中风后患者结局研究合作进行的。两项研究使用了同一组中风患者及其主要照顾者。在中风后1个月、3个月和6个月对患者状况进行详细的临床评估。照顾者（N = 83）在患者中风后1个月、3个月和6个月完成邮寄问卷。该调查包括疲劳和精力的量化、情绪障碍、压力、精神性以及对照顾情况的反应的评估，这些提供了对照顾者特征、应对资源以及身心健康状况的详细评估。
照顾者报告称，在亲人中风后1个月、3个月和6个月时，他们对疲劳、活力、反复悲伤、感知压力、财务状况、家庭支持、身体健康和抑郁状态症状的认知保持稳定。在3个月和6个月时，身体健康与抑郁症状之间的关系是相互的。在3个月和6个月时，感知压力与心理健康有关。照顾者在1个月时对残疾程度的评级与使用奥平顿预后量表的临床评估结果相似。
中风后护理综合方法的一部分应包括在亲人中风后不久对照顾者功能进行全面评估。早期评估可能会识别出在持续照顾角色中面临更大身心健康问题风险的人。
