The objective was to describe the psychosocial burden experienced by informal carers of elderly stroke victims, and to identify its predictors among baseline characteristics of the patients. From a prospective study of 171 elderly stroke patients admitted to a geriatric ward for rehabilitation in the acute phase, 68 patients living at home with a primary caregiver were identified 6 months after the stroke. At baseline, all the patients were assessed with respect to motor function, cognitive function, global handicap and activities of daily living, and after 6 months the caregivers were assessed, using the Relatives' Stress Scale. According to this, the most frequent impacts were worries that an accident might befall their relatives, that they had to reorganise their household routines and further, that their social life and ability to take holidays had been reduced. Impaired cognitive function was the only baseline patient characteristic that predicted a subsequent psychosocial burden on the carer. Special attention should be paid to elderly stroke patients initially assessed with impaired cognitive function and their caregivers.
"They may be summarized as it follows: (1) factors from a patient's side: low functional status [27, 30], the presence of depression [30, 31], the presence of behavioral and cognitive disturbances [25, 26, 32], being a male [25, 33], older age , and the presence of comorbidities ; (2) factors from a caregiver's side: older age , being a female , not being employed , being the care receipment's daughter– in– law , the amount of surveillance time [29, 30], the presence of depression [19, 35], the presence of disability , sense of coherence  and non informal social support of the caregiver [28, 32, 37]. "
[Show abstract][Hide abstract] ABSTRACT: With improvements in health care, more people survive stroke but many have to cope with the physical, psychological, social and functional sequelae, resulting in increased personal and public costs. Cerebral stroke causes a significant deterioration of the patient's functioning and worsening of her/his quality of life. Long–term disability caused by stroke is a common problem in all countries and its incidence increases markedly with advancing age.
The assessment of the Quality of Life could be as well the evaluator of sequelae of stroke as an indicator of the effectiveness of the post–stroke rehabilitation. In this review article, the contemporary state of art in assessment of the post–stroke Quality of Life has been presented. The emphasis was placed on participation in terms of personal factors and environmental factors of post–stroke persons and their caregivers.
"Although both items in the subscale 'Social isolation' had a lower percentage of respondents answering with one of the response options 1–3 (19AE1% and 22AE3%, respectively), we have chosen to keep the items in the LISS-questionnaire because of the fact that social isolation is a major problem reported in other studies with this population. One-fifth of the spouses in our study felt isolated and withdrew from their social lives, which supports the findings of a study by Thommessen et al. (2001), on which 19% of the relatives stated that their social life had been affected. "
[Show abstract][Hide abstract] ABSTRACT: This paper reports a study to validate and test the reliability of a questionnaire constructed to evaluate the life situation of spouses after their partners have had a stroke.
Stroke is a disease with great consequences for survivors and their families. Most survivors return home after the hospitalization and rehabilitation due to the stroke event. Relatives, primarily spouses, often feel obligated to care for the survivor at home, providing emotional support or assisting the person in activities of daily living. More specific information is needed about the spouse's life situation after the stroke event in order to develop effective supportive strategies.
Psychometric testing of the Life Situation Questionnaire was undertaken with 99 spouses of stroke survivors. The 13-item questionnaire consists of four subscales: 'Worries', 'Powerlessness', 'Personal adjustment' and 'Social isolation'.
Item analysis showed that each item correlated with its own subscale (r = 0.63-0.78). The instrument had high internal consistency, with Cronbach's alphas of 0.80-0.86 and reasonable high congruent validity when correlated with a Wellbeing instrument, with a correlation of 0.59 (P = 0.001). Exploratory factor analysis confirmed the subscales, accounting for 77% of the variance.
The Life Situation Questionnaire is a valid and reliable instrument, and could serve as an assessment tool after a stroke event to identify family caregivers who have problems in their life situations and need support from healthcare services.
"This might lead to tensions, decline in family communication, decrease in marital satisfaction, deterioration in the family's ability to solve problems and increased problems as family members struggle to adopt their new roles and responsibilities (Anderson et al. 1995, Bethoux et al. 1996, Clark & Smith 1999). In a study concerning stroke and caregiver burden, one-third of the caregivers reported that household routines had been upset a great deal after the stroke event (Thommessen et al. 2001). "
[Show abstract][Hide abstract] ABSTRACT: The aim of the present study was to determine the impact of a nurse-led support and education programme for improving the spouses' perceived general quality of life, life situation, general well-being and health state.
Stroke is a disease with great consequences for the patients and their families. The spouses often feel obligated to care for the patient, providing psychological and physical support and having to cope with the patient's physical and cognitive impairments. This might lead to increased problems, as family members struggle to adapt to their new roles and responsibilities.
Longitudinal, randomized controlled trial. One hundred spouses were randomly assigned to intervention or control groups, 50 in each group. The intervention group participated in a support and education programme, six times during six months, led by stroke specialist nurses. Both groups were followed for 12 months.
No significant differences were found, between intervention and control groups, over time. In the sub analyses, we found that the group attending 5-6 times had a significant decrease in negative well-being and increased quality of life over time, while the group attending fewer times had a significant decrease in positive well-being and health state, similar to the control group, which also had a significant decrease in negative and general well-being.
A support and education programme might have a positive effect on spouses' well-being, on condition that they attend at least five times.
To facilitate the spouses' role as informal caregivers to the stroke patients, further development of the support and education programme used in the present study is needed, including empowerment approach and implementation of coping strategies.
H. Elbi, S. Rahman, S. Altan, F. Nazik, A. Kaplan, E. Özmen, F. Sırrı Çam
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