Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India.
J Neurol Sci. 2013 Sep 15;332(1-2):97-101. doi: 10.1016/j.jns.2013.06.026. Epub 2013 Jul 26.
Stroke leaves at least 60% of the survivors with moderate to severe disability limiting their employment status and social functioning leading to high levels of caregiver burden.
We sought to study the employment status and level of change of social functioning of stroke survivors and their principal caregiver and correlate it with severity of stroke, functional disability, and anxiety and depression scores.
One hundred and fifty stroke survivors and principal caregivers (3 months-2 years post-stroke) were recruited for the study. The employment status pre- and post-stroke was assessed. The social function of the patient and caregiver was analyzed using a 6 item social function scale developed for the study, encompassing culturally relevant questions. A 20 point scale adapted from Burden assessment schedule was used to assess the caregiver burden.
Mean age of the study group was 54.37±12.072 (range 22-75 years), with 116 males and 34 females. Spouse was the principal caregiver for 142/150 patients (94.6%). In the stroke survivors, compared to the pre-stroke employment status of 62.7%, only 20.7% were employed post-stroke with half having change of job. But the employment status of caregiver was not reduced post-stroke (34.7% vs 33.3%). Employment loss in stroke survivors had a statistically significant association with severity of functional disability, male gender and presence of limb weakness (p values 0.037, 0.0001 and 0.043 respectively). There was an overall decline in social functions among the 6 parameters assessed in both the stroke survivors and caregivers. Of the caregiver burden, financial burden was more among female and older caregivers. The functional status and motor weakness of the stroke survivors did not tend to worsen the overall caregiver burden.
Loss of occupation among stroke survivors is high. The decline in social function among stroke survivors and caregivers was significant. Even though functional disability contributed to employment loss and social function decline among stroke survivors, it did not have a significant impact on caregiver burden.
我们旨在研究脑卒中幸存者及其主要照顾者的就业状况和社会功能变化，并将其与脑卒中严重程度、功能残疾、焦虑和抑郁评分相关联。
本研究共纳入 150 例脑卒中幸存者及其主要照顾者（脑卒中后 3 个月至 2 年）。评估脑卒中幸存者发病前后的就业状况。采用专门为研究设计的 6 项社会功能量表评估患者和照顾者的社会功能，该量表包含了与文化相关的问题。采用改编自负担评估量表的 20 分量表评估照顾者负担。
研究组的平均年龄为 54.37±12.072（范围 22-75 岁），男性 116 例，女性 34 例。142/150 例患者（94.6%）的主要照顾者为配偶。与发病前的就业状况（62.7%）相比，脑卒中幸存者发病后的就业率仅为 20.7%，其中一半人更换了工作。但脑卒中后照顾者的就业状况并未减少（34.7%比 33.3%）。脑卒中幸存者的就业丧失与功能残疾严重程度、男性性别和肢体无力具有统计学显著关联（p 值分别为 0.037、0.0001 和 0.043）。在脑卒中幸存者和照顾者评估的 6 个参数中，社会功能整体下降。在女性和年龄较大的照顾者中，经济负担更为突出。脑卒中幸存者的功能状态和运动无力并未使整体照顾者负担恶化。
脑卒中幸存者丧失职业的情况较为常见。脑卒中幸存者和照顾者的社会功能下降明显。尽管功能残疾导致脑卒中幸存者就业丧失和社会功能下降，但对照顾者负担没有显著影响。
