Haley William E, Roth David L, Hovater Martha, Clay Olivio J
From the School of Aging Studies (W.E.H.), University of South Florida, Tampa; the Center on Aging and Health (D.L.R.), Division of Geriatric Medicine and Gerontology, Department of Medicine, Johns Hopkins University, Baltimore, MD; and the Department of Biostatistics, School of Public Health (M.H.), and the Department of Psychology (O.J.C.), University of Alabama at Birmingham.
Neurology. 2015 Mar 31;84(13):1323-9. doi: 10.1212/WNL.0000000000001418. Epub 2015 Mar 4.
Three-year changes in well-being were studied among family caregivers of an epidemiologically derived sample of stroke survivors from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study and compared to matched noncaregivers.
Family caregivers of REGARDS participants who experienced a stroke event completed telephone interviews assessing depressive symptoms, mental and physical health quality of life (QOL), life satisfaction, and leisure satisfaction at approximately 9, 18, 27, and 36 months after the stroke (n = 235). For each stroke caregiver, a family member of a stroke-free REGARDS participant was enrolled as a matched noncaregiving control (n = 235) and completed similar interviews.
Multilevel longitudinal models found that caregivers showed poorer well-being at 9 months poststroke than controls on all measures except physical health QOL. Significant differences were sustained for 22 months after the stroke event for depressive symptoms, 31 months for mental health QOL, and 15 months for life satisfaction. For leisure satisfaction, differences were still significant at 36 months poststroke. Caregiving effects were similar across race and sex.
Stroke caregiving is associated with persistent psychological distress, but life satisfaction, depression, and mental health QOL became comparable to noncaregivers by 3 years after stroke. Caregiver leisure satisfaction was chronically lower than in noncaregivers. Intervention for stroke caregivers should recognize both the strains faced by caregivers and their capacity for successful coping over time.
在卒中地理和种族差异原因（REGARDS）研究中，对源自流行病学样本的卒中幸存者的家庭照料者的幸福感进行为期三年的变化研究，并与匹配的非照料者进行比较。
经历卒中事件的REGARDS参与者的家庭照料者在卒中后约9、18、27和36个月完成电话访谈，评估抑郁症状、心理健康和生活质量（QOL）、生活满意度和休闲满意度（n = 235）。对于每位卒中照料者，招募一名未患卒中的REGARDS参与者的家庭成员作为匹配的非照料对照（n = 235），并完成类似访谈。
多层次纵向模型发现，除身体健康QOL外，照料者在卒中后9个月时在所有指标上的幸福感均低于对照组。卒中事件后，抑郁症状的显著差异持续22个月，心理健康QOL持续31个月，生活满意度持续15个月。对于休闲满意度，卒中后36个月时差异仍显著。照料的影响在种族和性别上相似。
卒中照料与持续的心理困扰有关，但卒中后3年时，生活满意度、抑郁和心理健康QOL与非照料者相当。照料者的休闲满意度长期低于非照料者。对卒中照料者的干预应认识到照料者面临的压力及其随着时间推移成功应对压力的能力。
