Byun Eeeseung, Evans Lois, Sommers Marilyn, Tkacs Nancy, Riegel Barbara
a Department of Biobehavioral Nursing and Health Informatics, School of Nursing , University of Washington , Seattle , WA , USA.
b School of Nursing , University of Pennsylvania , Philadelphia , PA , USA.
Top Stroke Rehabil. 2019 Apr;26(3):187-194. doi: 10.1080/10749357.2019.1590950. Epub 2019 Apr 1.
Caregivers of stroke survivors often suffer depressive symptoms that interfere with their own health. Early recognition may lead to attenuation of symptoms and better health and well-being for caregivers.
We examined characteristics of caregivers and stroke survivors associated with caregivers' depressive symptoms in the early poststroke period.
We conducted a prospective, longitudinal exploratory observational study with a convenience sample of 63 caregivers of older adult (≥ 65 years) stroke survivors recruited from urban acute-care settings. We enrolled caregivers by 2 weeks poststroke (T1) and revisited them 4 weeks later (T2). Depressive symptoms were measured using the Patient Health Questionnaire-9. A separate unadjusted linear mixed model was computed to explore significant associations between each caregiver or stroke-survivor characteristic and depressive symptoms.
Caregivers, on average, reported mild depressive symptoms at T1 and T2. Each of the following characteristics was independently associated with caregiver depressive symptoms over the first 6 weeks poststroke: caregiver uncertainty (p < 0.001), perceived stress (p < 0.001) but not cortisol levels (p = 0.858 on waking, p = 0.231 evening), coping (p < 0.001), social support (p = 0.006), race (p = 0.022), income (p = 0.001), time spent on care (p = 0.039), and stroke-survivor race (p = 0.033) and functional status (p = 0.003). At T2, caregiver depressive symptoms were correlated with evening cortisol level (p = 0.001).
Caregiver and stroke-survivor characteristics may help identify caregivers at highest risk for early depressive symptoms and guide interventions aimed at their resolution.
中风幸存者的照料者常常出现抑郁症状,这会影响他们自身的健康。早期识别可能会减轻症状,并使照料者的健康状况和幸福感得到改善。
我们研究了中风后早期与照料者抑郁症状相关的照料者及中风幸存者的特征。
我们进行了一项前瞻性、纵向探索性观察研究,从城市急症护理机构招募了63名老年(≥65岁)中风幸存者的照料者作为便利样本。我们在中风后2周(T1)招募照料者,并在4周后(T2)再次回访他们。使用患者健康问卷-9来测量抑郁症状。计算了一个单独的未调整线性混合模型,以探索每个照料者或中风幸存者特征与抑郁症状之间的显著关联。
照料者在T1和T2时平均报告有轻度抑郁症状。在中风后的前6周,以下每个特征都与照料者的抑郁症状独立相关:照料者的不确定性(p<0.001)、感知压力(p<0.001),但不包括皮质醇水平(醒来时p = 0.858,晚上p = 0.231)、应对方式(p<0.001)、社会支持(p = 0.006)、种族(p = 0.022)、收入(p = 0.001)、护理时间(p = 0.039),以及中风幸存者的种族(p = 0.033)和功能状态(p = 0.003)。在T2时,照料者的抑郁症状与晚上的皮质醇水平相关(p = 0.001)。
照料者和中风幸存者的特征可能有助于识别早期抑郁症状风险最高的照料者,并指导旨在解决这些症状的干预措施。