Background and Purpose
Caregivers of patients with stroke are central in providing for the patient‟s needs, facilitating participation of the patient in their daily functional ability, maintaining functional improvements gained in rehabilitation and the long-term well-being of stroke survivors. The strain and ultimate decrease in quality of life of the caregiver can lead to breakdown in the support they provide to the patient. The well-being and quality of life of the caregiver is therefore of vital importance in the rehabilitation of the patient with stroke. It is therefore necessary to evaluate relevant factors in the South African context that affect the quality of life of the caregiver, so as to foresee and prevent possible breakdown in the support provided by the caregiver to the patient with stroke. The objectives of the study are to establish the functional level of patients six to 36 months post-stroke, the level of strain and quality of life of the caregiver six to 36 months post-stroke, and the influence of demographic factors, caregiver strain and patient‟s functional ability on quality of life of the caregiver.
Method
A cross-sectional study was performed on 35 patients six to 36 months post-stroke and their primary caregiver, obtained from a sample of convenience from six local clinics/hospitals in the Johannesburg area. Demographic information was gathered from both patient and caregiver by means of a questionnaire. The Barthel Index (BI) was used to assess the patients‟ functional ability at the point of interview. Caregiver strain and caregiver quality of life were measured using the Caregiver Strain Index (CSI) and EQ-5D and EQ-5D VAS respectively.
Results
Of the 35 patients with stroke, 19 (54.3%) were male, and 16 (45.7%) were female, with the mean age of 55.9 years. Of the 35 primary caregivers, 6 (17.1%) were male, and 29 (82.9%) were female, with the mean age of 50.7 years. Sixty percent of patients ranged from being independent in functional ability to being moderately dependent on the caregiver for their functional ability. Seventy seven percent of caregivers reported severe strain as a result of caring for the patient with stroke. Thirty one percent of caregivers reported midrange (50/100) quality of life using the EQ-5D VAS. No association was established between patient‟s functional ability and caregiver quality of life (Pearson x²=0.59). Negative association was established between caregiver strain and quality of life (Kendall‟s Tau-b=-0.23), however it was of marginal significance (Pearson x²=0.06). Logistic regression showed caregivers under severe strain were 1.6 times of higher odds to experience a decrease in quality of life than caregivers with less strain. Caregiver age showed a negative correlation with caregiver quality of life (Kendall‟s Tau-b=-0.48; Pearson x²=0.009). Logistic regression showed older caregivers were 0.19 times of higher odds to experience a decrease in quality of life than younger caregivers.
Conclusion
There is no association between the patient‟s functional ability and the quality of life of the caregiver six to 36 months post-stroke. A negative association is shown between caregiver strain and caregiver age, and caregiver quality of life. The realm of caregiver quality of life is both dynamic and contextual. Knowledge of the effects of the contextual factors enables the health services and professionals to respond appropriately to assist in foreseeing and alleviating those factors that negatively affect caregiver quality of life. As it is understood that caregivers provide support for the patient with stroke, promoting the caregiver‟s well-being in turn will promote patient care and their ultimate well-being.
| Identifer | oai:union.ndltd.org:netd.ac.za/oai:union.ndltd.org:wits/oai:wiredspace.wits.ac.za:10539/11169 |
| Date | 25 January 2012 |
| Creators | Hilton, Jessica |
| Source Sets | South African National ETD Portal |
| Language | English |
| Detected Language | English |
| Type | Thesis |
| Format | application/pdf |
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