Chao-Yi Wu1, Elizabeth R Skidmore2, Juleen Rodakowski3. 1. Department of Occupational Therapy, University of Pittsburgh, 5055 Forbes Tower, Pittsburgh, PA 15260. 2. Department of Occupational Therapy, Clinical and Translational Institute, Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA. 3. Department of Occupational Therapy, Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA.
Abstract
BACKGROUND: Caregiver burden is commonly experienced in caregivers of adults with cognitive impairment after stroke. This burden can be associated with caregiver-centered factors, including caregiver-perceived relationship quality. OBJECTIVE: To examine the role of caregiver-perceived relationship quality on caregiver burden at 6 months following stroke. DESIGN: Prospective observational study. SETTING: Community settings. PARTICIPANTS: Adults enrolled in two randomized controlled trials after stroke (n = 60) and their caregivers (n = 60). METHODS: Three constructs of relationship quality (relationship consensus, cohesion, and satisfaction) were examined as predictors of caregiver burden (the Abbreviated Dyadic Adjustment Scale). A hierarchical logistic regression and a Poisson regression with robust standard errors were used to examine the effect of relationship quality on caregiver burden while controlling for characteristics of stroke survivors and caregivers. MAIN OUTCOME MEASUREMENTS: Caregiver burden was measured with the abridged version of the Zarit Burden Interview. RESULTS: Poor relationship consensus (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.06-2.07; P = .02) increased the odds of high caregiver burden after controlling for characteristics of stroke survivors (age, comorbidity, cognitive fluency) and caregivers (gender, self-reported health). Relationship cohesion (OR = 1.03; 95% CI = .84-1.25; P = .81) and relationship satisfaction (OR = 1.53; 95% CI = .75-3.10; P = .24) did not predict caregiver burden. CONCLUSION: Meaningful and agreeable goals and expectations between dyads are essential to reduce caregiver burden after stroke. Collaborative goal-setting between stroke survivors and their caregivers may be a promising intervention strategy to increase relationship consensus and reduce caregiver burden. LEVEL OF EVIDENCE: III.
BACKGROUND: Caregiver burden is commonly experienced in caregivers of adults with cognitive impairment after stroke. This burden can be associated with caregiver-centered factors, including caregiver-perceived relationship quality. OBJECTIVE: To examine the role of caregiver-perceived relationship quality on caregiver burden at 6 months following stroke. DESIGN: Prospective observational study. SETTING: Community settings. PARTICIPANTS: Adults enrolled in two randomized controlled trials after stroke (n = 60) and their caregivers (n = 60). METHODS: Three constructs of relationship quality (relationship consensus, cohesion, and satisfaction) were examined as predictors of caregiver burden (the Abbreviated Dyadic Adjustment Scale). A hierarchical logistic regression and a Poisson regression with robust standard errors were used to examine the effect of relationship quality on caregiver burden while controlling for characteristics of stroke survivors and caregivers. MAIN OUTCOME MEASUREMENTS: Caregiver burden was measured with the abridged version of the Zarit Burden Interview. RESULTS: Poor relationship consensus (odds ratio [OR] = 1.48; 95% confidence interval [CI] = 1.06-2.07; P = .02) increased the odds of high caregiver burden after controlling for characteristics of stroke survivors (age, comorbidity, cognitive fluency) and caregivers (gender, self-reported health). Relationship cohesion (OR = 1.03; 95% CI = .84-1.25; P = .81) and relationship satisfaction (OR = 1.53; 95% CI = .75-3.10; P = .24) did not predict caregiver burden. CONCLUSION: Meaningful and agreeable goals and expectations between dyads are essential to reduce caregiver burden after stroke. Collaborative goal-setting between stroke survivors and their caregivers may be a promising intervention strategy to increase relationship consensus and reduce caregiver burden. LEVEL OF EVIDENCE: III.
Authors: Elizabeth R Skidmore; Deirdre R Dawson; Ellen M Whyte; Meryl A Butters; Mary Amanda Dew; Emily S Grattan; James T Becker; Margo B Holm Journal: Clin Rehabil Date: 2013-10-10 Impact factor: 3.477
Authors: Christine J McPherson; Keith G Wilson; Livia Chyurlia; Charles Leclerc Journal: Health Qual Life Outcomes Date: 2011-05-09 Impact factor: 3.186