Structural equation modeling of the relationship between caregiver psychosocial variables and functioning of individuals with stroke

Purpose/Objective: Stroke is a leading cause of disability worldwide. Informal caregivers are essential in the survival of most individuals with stroke and may even aid in their recovery. Yet caregivers experience high levels of burnout, depression, burden, and physical illness. Research Method/Design: With structural equation modeling and canonical correlation analysis, links were identified between caregiver psychosocial variables and specific aspects of the functioning of individuals with stroke in 135 care recipient-caregiver dyads. Results: Initial analyses uncovered a medium-sized correlation between caregiver variables and care recipients' functioning. Follow-up analyses pinpointed specific links between caregivers' sense of coherence and care recipients' basic engagement with life and between caregivers' levels of burden and depression and care recipients' cognitive deficits and depression. Conclusions/Implications: On the basis of these findings, the authors propose a feedback loop wherein caregivers' psychosocial functioning, their quality of caregiving, and stroke severity and recovery are causally interconnected. Findings are consistent with the use of cognitive-behavioral interventions for caregivers, which may improve caregivers' sense of coherence, reducing their levels of burden and depression and leading to improved informal care and better recovery from stroke.