Determinants of caregiving burden and quality of life in caregivers of stroke patients

Background and Purpose - A large proportion of disabled stroke survivors live at home and are supported by informal caregivers. Identification of determinants of caregiver burden will help to target caregiver interventions. Methods - Data on patient, caregiver, and health and social support characteristics were collected prospectively over 1 year in 232 stroke survivors in a randomized trial of caregiver training. The contribution of these variables to caregiver burden score (CBS) and quality of life (QOL) measures at 3 months and 1 year was analyzed using regression models. Results - Stroke patients had a mean age of 74 +/- 11 years, and 120 (52%) were men. The mean age of caregivers was 65.7 +/- 12.5 years, 149 (64%) were females, and 116 (50%) had received caregiver training. The mean CBS was 48 +/- 13 and 38 +/- 11 (score range of bad to good 88 to 22) and QOL score was 75 +/- 16 and 75 +/- 15 (score range of bad to good 0 to 100) at 3 months and 1 year, respectively. CBS and QOL correlated with each other and with patient (age, dependency, and mood), caregiver (age, gender, mood, and training), and support (social services and family networks) variables. Of these, only patient and caregiver emotional status, caregiver age and gender, and participation in caregiver training were independent predictors of either outcome at 3 months. Patient dependency and family support were additional independent predictors at 1 year. Social services support predicted institutionalization but not caregiver outcomes. Conclusion - Advancing age and anxiety in patients and caregivers, high dependency, and poor family support identify caregivers at risk of adverse outcomes, which may be reduced by caregiver training.