Northwestern University Feinberg School of Medicine, Chicago, IL, USA.
Top Stroke Rehabil. 2010 Jul-Aug;17(4):308-17. doi: 10.1310/tsr1704-308.
Little is known about mediators of stroke caregiver outcomes or patterns of relationships of outcome predictors. We examined relationships between the variable sets of caregiver and stroke survivor characteristics, coping (proposed mediators), and caregiver outcomes.
We assessed 253 dyads prior to discharge from acute rehabilitation. Outcomes were depression, anxiety, preparedness, life change, and family functioning. Coping included problem solving, caregiver appraisal, and unmet resource needs. Multivariate canonical correlation analyses were computed between the sets of variables to identify unique patterns of relationships.
Six patterns of significant relationships were found (R =.30 to .84, Ps <.01 to .02). The strongest relationship was that between greater threat appraisal and negative life change, greater anxiety, and lower caregiving preparedness (P < .01). Caregiver characteristics (nonwhite, spousal caregivers) were related significantly to several outcomes (positive life change, lower anxiety, and less healthy family functioning) (R = .43, P <.01) and remained significant after controlling for the effect of mediators (R = .32, P < .02).
Findings suggest various patterns of relationships that provide guidance for individualizing early caregiver intervention. Clinicians can build on caregivers' strengths while identifying threats to adaptation to tailor interventions that promote healthy outcomes.
对于中风照顾者结局的中介因素或结局预测因素的关系模式,我们知之甚少。我们研究了照顾者和中风幸存者特征、应对方式(拟议的中介因素)以及照顾者结局的变量集之间的关系。
我们在急性康复治疗出院前评估了 253 对患者和照顾者。结局包括抑郁、焦虑、准备程度、生活变化和家庭功能。应对方式包括解决问题、照顾者评估和未满足的资源需求。我们对变量集之间进行多元典型相关分析,以确定关系的独特模式。
发现了 6 种具有显著关系的模式(R=.30 至.84,P<.01 至.02)。最强的关系是威胁评估较高与负面生活变化、较高焦虑和较低照顾准备程度之间的关系(P<.01)。照顾者特征(非白人、配偶照顾者)与多种结局显著相关(生活变化积极、焦虑降低和家庭功能更健康)(R=.43,P<.01),并在控制中介因素的影响后仍然显著(R=.32,P<.02)。
研究结果表明存在各种关系模式,为个性化早期照顾者干预提供了指导。临床医生可以在识别适应威胁的同时利用照顾者的优势,定制促进健康结局的干预措施。