Malhotra Rahul, Chei Choy-Lye, Menon Edward Balan, Chow Wai-Leng, Quah Stella, Chan Angelique, Ajay Shweta, Matchar David Bruce
a Health Services and Systems Research , Duke-NUS Medical School , Singapore , Singapore.
b Centre for Ageing Research and Education, Duke-NUS Medical School , Singapore , Singapore.
Top Stroke Rehabil. 2018 May;25(4):261-268. doi: 10.1080/10749357.2018.1455369. Epub 2018 Mar 26.
Objective To delineate positive aspects of caregiving trajectories among family caregivers of stroke-survivors and determine the impact of stroke-survivor disability, a time-varying factor, on the delineated trajectories. Methods In a longitudinal study, family caregivers of 173 stroke-survivors in Singapore were administered the Positive Aspects of Caregiving scale (PAC scale) thrice (baseline/3 months/6 months). Group-based trajectory modeling delineated positive aspects of caregiving trajectories and identified the impact of stroke-survivor disability on the trajectories. Results Two distinct positive aspects of caregiving trajectories, Persistently Low and Persistently High were delineated. Increase in stroke-survivor disability was associated with a significant downward shift (reduction in positive aspects of caregiving) of the Persistently Low trajectory and a significant upward shift (increase in positive aspects of caregiving) of the Persistently High trajectory. Older caregivers were more likely to follow the Persistently High trajectory. Conclusions Care professionals should be mindful of the heterogeneity in the longitudinal pattern of positive feelings resulting from care provision among family caregivers of stroke-survivors, and the differential impact of stroke-survivor disability on the pattern of positive feelings. Younger caregivers as well as family caregivers who have low positive feelings at the start of their caregiver journey and experience worsening functional disability of their care recipient (stroke-survivor) require greater attention and support.
目的 描绘中风幸存者家庭照顾者的照顾轨迹中的积极方面，并确定中风幸存者残疾这一随时间变化的因素对所描绘轨迹的影响。方法 在一项纵向研究中，对新加坡173名中风幸存者的家庭照顾者进行三次“照顾的积极方面量表”（PAC量表）测评（基线/3个月/6个月）。基于组的轨迹模型描绘了照顾轨迹的积极方面，并确定了中风幸存者残疾对轨迹的影响。结果 描绘出了两种不同的照顾轨迹积极方面，即持续低水平和持续高水平。中风幸存者残疾程度的增加与持续低水平轨迹的显著向下偏移（照顾积极方面的减少）以及持续高水平轨迹的显著向上偏移（照顾积极方面的增加）相关。年长的照顾者更有可能遵循持续高水平轨迹。结论 护理专业人员应注意中风幸存者家庭照顾者因提供护理而产生的积极情感纵向模式的异质性，以及中风幸存者残疾对积极情感模式的不同影响。年轻的照顾者以及在照顾旅程开始时积极情感较低且其照顾对象（中风幸存者）功能残疾恶化的家庭照顾者需要更多关注和支持。
