Kumar Anand, Yadav Ajay Kumar, Singh Varun Kumar, Pathak Abhishek, Chaurasia Rameshwar Nath, Mishra Vijaya Nath, Joshi Deepika
Department of Neurology, Banaras Hindu University, Institute of Medical Sciences, Varanasi, Uttar Pradesh, India.
Ann Indian Acad Neurol. 2022 Nov-Dec;25(6):1092-1098. doi: 10.4103/aian.aian_318_22. Epub 2022 Nov 21.
A principal caregiver (CG) is directly affected by the patient's health problems leading to CG strain. In the present study, we evaluated the different factors related to increased CG burden in stroke survivors and assessed the relationship between patient's personal and clinical characteristics and CG's stress.
In this prospective, follow-up study, a total of 141 principle CGs of 164 First-ever stroke (FES) survivors were subjected to the Caregivers Strain Index (CSI) and Oberst Caregiving Burden Scale (OCBS) at 30 days (n = 141), 90 days (n = 129), and 6 months (n = 119) after informed consent. Patients were subjected to modified Rankin Scale (mRS) and Barthel index score assessment at the end of 30 days.
The mean age of CG was 49.8 ± 21.0 years, approximately 20 years lesser than that of the patients. 102 (72.34%) CGs were females. Urinary incontinence (p < 0.006) morbidity at 30 days, mRS (p = 0.004), and moderate to the severe neurological deficit on admission (p = 0.003) were the patient factors in FES cases leading to significant CGs stress. CG factors responsible for major stress were long caregiving hours (P < 0.001), anxiety (P < 0.001), disturbed night sleep (P < 0.001), financial stress (P < 0.001), younger age (P = 0.002), and CGs being daughters-in-law (P = 0.039).
CG burden increases with increased severity of stroke. Integrated stroke rehabilitation services should also address CGs issues along with patients.
主要照顾者（CG）会直接受到患者健康问题的影响，从而导致照顾者压力。在本研究中，我们评估了与中风幸存者照顾者负担增加相关的不同因素，并评估了患者的个人和临床特征与照顾者压力之间的关系。
在这项前瞻性随访研究中，164例首次中风（FES）幸存者的141名主要照顾者在获得知情同意后，于30天（n = 141）、90天（n = 129）和6个月（n = 119）时接受照顾者压力指数（CSI）和奥伯斯特照顾负担量表（OCBS）评估。患者在30天结束时接受改良Rankin量表（mRS）和Barthel指数评分评估。
照顾者的平均年龄为49.8±21.0岁，比患者年龄小约20岁。102名（72.34%）照顾者为女性。30天时的尿失禁（p < 0.006）发病率、mRS（p = 0.004）以及入院时中度至重度神经功能缺损（p = 0.003）是FES病例中导致照顾者显著压力的患者因素。导致主要压力的照顾者因素包括照顾时间长（P < 0.001）、焦虑（P < 0.001）、夜间睡眠障碍（P < 0.001）、经济压力（P < 0.001）、年龄较小（P = 0.002）以及照顾者为儿媳（P = 0.039）。
照顾者负担随着中风严重程度的增加而增加。综合中风康复服务在关注患者的同时，也应解决照顾者的问题。
