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Life situation among informal caregivers to stroke patients
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Family Medicine and Clinical Epidemiology.
(English)Manuscript (preprint) (Other academic)
Abstract [en]

Background and Purpose Stroke related problems may affect the life situation of not only stroke patients but also their informal caregivers. The objective of this study was to assess life situation aspects in stroke patients and their informal caregivers during the first post-stroke year.

Methods 377 patients surviving a stroke event were followed during the first post stroke year with interviews 1 week after discharge from hospital and three and twelve months after the index stroke admission. Their informal caregivers answered questionnaires in connection to the interviews. In both groups information based on the Hospital Anxiety and Depression Scale (HAD), the Nottingham Health Profile (NHP), and GQL-Activity Scale was obtained. Additional information was sought among patients on their health situation and Mini Mental State Examination (MMSE) score, and among informal caregivers on the nature and amount of assistance provided, measured as support score and number of hours per week and perceived caregiver burden (CB) score.

Results Before index admission 85% of informal caregivers provided on average five hours’ care per week and 8-10 support score. The corresponding numbers after discharge were 91%, 10 hours per week and 13-15 support score. Support determinants were patient’s functional ability, distance to patient’s home, relation to patient, municipality social service support given. CB score determinants were municipality support given, relation to patient, functional ability, and patient age. The caregivers had higher anxiety and depression scores than the patients. Significant associations between caregiver and patient responses were found for HAD anxiety, NHP emotional and social, and GQL activity score.

Conclusions The informal caregivers reported a significant caregiver burden. There was a parallel situation between patients’ and caregivers’ situation.

Keyword [en]
stroke, elderly, informal caregiver, life situation
National Category
Family Medicine
Research subject
Caring Sciences
Identifiers
URN: urn:nbn:se:uu:diva-112873OAI: oai:DiVA.org:uu-112873DiVA: diva2:288651
Available from: 2010-01-21 Created: 2010-01-21 Last updated: 2010-01-22Bibliographically approved
In thesis
1. Life After a Stroke Event: With Special Reference to Aspects on Prognosis, Health and Municipality Care Utilization, and Life Satisfaction Among Patients and Their Informal Caregivers
Open this publication in new window or tab >>Life After a Stroke Event: With Special Reference to Aspects on Prognosis, Health and Municipality Care Utilization, and Life Satisfaction Among Patients and Their Informal Caregivers
2010 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Objectives. The aim of this thesis was to study the prognosis, health care utilization and health situation in stroke patients, and informal caregiver burden during the first post-stroke year.

Material and methods. 390 patients, 65 years or older, discharged from hospital after a stroke, were followed with repeated patient interviews, patient record and register data, and hospital staff and informal caregiver questionnaires.

Results. Prognosis assessments performed by hospital staff at discharge regarding the course of events during the following year were highly accurate and were mainly influenced by the patient’s pre- and post-morbid state. The risk of dying or having a new stroke decreased rapidly during the early post-morbid phase. Health care utilization, in hospitals as well as in primary health care, and municipal social service support was considerably higher after the stroke than before, but the utilization of services was lower than previously reported. Health problem prevalence according to interview and record scrutiny was modest, peaked early after discharge and then declined. Support from informal caregivers increased significantly after discharge and remained high during the first post-stroke year. The support given was mainly determined by patient functional ability, distance to patient, relation to patient, municipal social service support provided, and patient sex. The informal caregivers reported considerable strain and burden, with significantly higher levels of anxiety and depression than the stroke patients. Moreover, there was a parallel between the patient’s and the caregiver’s situation regarding anxiety, emotional and social situation, and home, social and outdoor activities.

Conclusion. Hospital staff prognosis assessments of patient outcomes during the next year were highly accurate. Risk of recurrence and mortality, and health problem prevalence was high in the early post-stroke period, and than declined. Health care utilization and municipality social support increased over time. Informal caregivers reported considerable strain and burden.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2010. 78 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 517
Keyword
stroke, older age, prognosis, care utilization, life situation, informal caregiver, health problems, survival, hazard, nursing
National Category
Family Medicine
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-112875 (URN)978-91-554-7711-0 (ISBN)
Public defence
2010-03-06, Föreläsningssalen, Falu lasarett, Falun, 13:15 (Swedish)
Opponent
Supervisors
Available from: 2010-02-12 Created: 2010-01-21 Last updated: 2010-02-12Bibliographically approved

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