Center of Excellence in Rehabilitation Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, and De Hoogstraat Rehabilitation, Utrecht, the Netherlands.
Department of Rehabilitation, Physical Therapy Science & Sports, UMC Utrecht Brain Center, University Medical Center Utrecht, the Netherlands.
Top Stroke Rehabil. 2023 Sep;30(6):533-542. doi: 10.1080/10749357.2022.2098898. Epub 2022 Jul 19.
Partners of patients with stroke are at high risk for burden, anxiety and depressive symptoms. Previous studies have reported contradictory results and did not investigate these three courses simultaneously. In this study we comprehensively studied the courses and predictors of burden, anxiety and depressive symptoms in partners of patients with stroke during the first two years after stroke. They were analyzed as outcomes as well as predictors for each other.
Six general hospitals recruited 215 patients with stroke and their partners for a longitudinal cohort study. Mixed model analyses were performed for burden (CSI), anxiety (HADS-A) and depressive symptoms (HADS-D) as time-varying outcome variables, measured at four time points during two years after stroke.
Burden and depressive symptoms did not significantly change over time, whereas anxiety symptoms initially decreased followed by an increase. Higher burden was predicted by partners' younger age, higher education, more symptoms of anxiety and depression, and by patients' greater stroke severity, lower cognitive functioning and more symptoms of anxiety and depression. More anxiety symptoms were predicted by higher burden, more depressive symptoms, and lower self-efficacy of the partner. More depressive symptoms were predicted by older age, higher burden, more symptoms of anxiety, less proactive coping strategies of the partner, and more depressive symptoms of the patients.
Burden, anxiety and depressive symptoms are interrelated and become chronic in partners of patients with stroke. It is important to screen partners early after stroke to identify partners who are at risk for negative outcomes.
脑卒中患者的伴侣存在较高的负担、焦虑和抑郁症状风险。既往研究报告的结果存在矛盾，且并未同时对这三种情况进行研究。本研究综合分析了脑卒中患者发病后 2 年内其伴侣的负担、焦虑和抑郁症状的变化轨迹及其预测因素，分析了彼此之间的结果和预测因素。
6 家综合医院招募了 215 名脑卒中患者及其伴侣，进行了一项前瞻性队列研究。采用混合模型分析了发病后 2 年内的 4 个时间点，作为时间相关的结果变量，评估了负担（CSI）、焦虑（HADS-A）和抑郁症状（HADS-D）。
负担和抑郁症状无显著的时间变化，而焦虑症状先下降后上升。较高的负担与伴侣年龄较小、教育程度较高、焦虑和抑郁症状较多、患者卒中严重程度较高、认知功能较低以及焦虑和抑郁症状较多有关。较高的负担、较多的焦虑和抑郁症状、以及伴侣自我效能感较低可预测更多的焦虑症状。年龄较大、负担较高、焦虑症状较多、伴侣的积极应对策略较少以及患者的抑郁症状较多可预测更多的抑郁症状。
脑卒中患者伴侣的负担、焦虑和抑郁症状相互关联，呈慢性化。因此，在卒中后早期对伴侣进行筛查，以识别出处于不良结局风险中的伴侣非常重要。
