Caring for stroke survivors: baseline and 1-year determinants of caregiver burden

Background Caregiver burden following stroke can have significant adverse health consequences for caregivers and threatens the recovery and successful rehabilitation of patients. Our objective was to identify patient factors that contribute to higher levels of caregiver burden. Methods We prospectively studied patients admitted to our stroke unit over a 2-year period (2001-2002). Data were collected at baseline and at 1 year. Caregiver burden was measured at 1 year using the Relatives Stress Scale (completed by 155 caregivers) and the Bakas Caregiver Outcomes Scale (143 caregivers). Explanatory patient factors at baseline included sociodemographic status, stroke severity, stroke sub-type, functional disability (Barthel Index), functional handicap (Oxford Handicap Scale and Modified Rankin Scale), and cognitive status (orientation, clock drawing). At 1 year, mental health and health-related quality of life were assessed using the Fatigue Impact Scale, Geriatric Depression Scale, Global Deterioration Scale, and 36-item Short Form Health Survey. Results The baseline patient factors predictive of caregiver burden by multiple regression analysis were older patient age (P < 0 center dot 01), male gender (P < 0 center dot 05), ischemic stroke (P < 0 center dot 05), urinary incontinence (P < 0 center dot 0001), and impaired clock drawing (P < 0 center dot 05). At 1 year, significant correlates of caregiver burden were older patient age (P < 0 center dot 05), male gender (P < 0 center dot 01), poor mental health (P < 0 center dot 05), functional handicap (P < 0 center dot 05), and functional disability (P < 0 center dot 001). Conclusions The functional status of patients can be used to identify caregivers at risk of caregiver burden. Patient demographic variables, cognitive function, and mental health status may further expose vulnerable caregivers. These factors should be considered in the development of strategies to offset caregiver burden.