Rohde Daniela, Gaynor Eva, Large Margaret, Conway Orla, Bennett Kathleen, Williams David J, Callaly Elizabeth, Dolan Eamon, Hickey Anne
a Population Health Sciences , Royal College of Surgeons in Ireland , Dublin , Ireland.
b Department of Medicine , Royal College of Surgeons in Ireland , Dublin , Ireland.
Top Stroke Rehabil. 2019 Apr;26(3):180-186. doi: 10.1080/10749357.2019.1590972. Epub 2019 Mar 23.
Family members frequently provide long-term care for stroke survivors, which can lead to psychological strain, particularly in the presence of cognitive decline.
To profile anxious and depressive symptoms of family caregivers at 5 years post-stroke, and to explore associations with stroke survivor cognitive decline.
As part of a 5-year follow-up of the Action on Secondary Prevention Interventions and Rehabilitation in Stroke (ASPIRE-S) cohort of stroke survivors, family members completed a self-report questionnaire. Symptoms of anxiety and depression were assessed using the HADS-A and CES-D. Cognitive decline in stroke survivors was assessed from the caregiver's perspective using the IQCODE, with cognitive performance assessed by the MoCA. Data were analyzed using logistic regression models.
78 family members participated; 25.5% exhibited depressive symptoms, 19.4% had symptoms of anxiety. Eleven stroke survivors (16.7%) had evidence of cognitive decline according to both the IQCODE and MoCA. Family members of stroke survivors with cognitive decline were significantly more likely to report symptoms of depression [age-adjusted OR (95% CI): 5.94 (1.14, 30.89)] or anxiety [age-adjusted OR (95% CI): 5.64 (1.24, 25.54)] than family members of stroke survivors without cognitive decline.
One-fifth of family caregivers exhibited symptoms of anxiety and one-quarter symptoms of depression at 5 years post-stroke. Stroke survivor cognitive decline was significantly associated with both depressive and anxious symptoms of family caregivers. Family members play a key role in the care and rehabilitation of stroke patients; enhancing their psychological wellbeing and identifying unmet needs are essential to improving outcomes for stroke survivors and families.
家庭成员经常为中风幸存者提供长期护理，这可能导致心理压力，尤其是在存在认知衰退的情况下。
描述中风后5年家庭照顾者的焦虑和抑郁症状，并探讨与中风幸存者认知衰退的关联。
作为中风幸存者二级预防干预与康复行动（ASPIRE-S）队列5年随访的一部分，家庭成员完成了一份自我报告问卷。使用医院焦虑抑郁量表-焦虑（HADS-A）和流调中心抑郁量表（CES-D）评估焦虑和抑郁症状。从照顾者的角度使用智商变化临床评定量表（IQCODE）评估中风幸存者的认知衰退，用蒙特利尔认知评估量表（MoCA）评估认知表现。使用逻辑回归模型分析数据。
78名家庭成员参与；25.5%表现出抑郁症状，19.4%有焦虑症状。根据IQCODE和MoCA，11名中风幸存者（16.7%）有认知衰退的证据。与没有认知衰退的中风幸存者的家庭成员相比，有认知衰退的中风幸存者的家庭成员更有可能报告抑郁症状[年龄调整后的比值比（95%置信区间）：5.94（1.14，30.89）]或焦虑症状[年龄调整后的比值比（95%置信区间）：5.64（1.24，25.54）]。
中风后5年，五分之一的家庭照顾者表现出焦虑症状，四分之一表现出抑郁症状。中风幸存者的认知衰退与家庭照顾者的抑郁和焦虑症状均显著相关。家庭成员在中风患者的护理和康复中起着关键作用；提高他们的心理健康水平并识别未满足的需求对于改善中风幸存者及其家庭的结局至关重要。
