title: Risk factors for burn-out in caregivers of stroke patients, and possibilities for intervention.
abstract: OBJECTIVE
  To identify which caregivers of stroke patients living at home experience the highest levels of strain and are at risk of burn-out, and to investigate how support for caregivers of stroke patients could best be organized, and when this support should be offered.
  
  
  METHODS
  Caregivers of stroke patients were recruited in four regions of the Netherlands. A total of 212 caregivers were interviewed. Multiple stepwise regression analysis was performed to determine the effects of patient and caregiver characteristics, resources, coping strategies and duration of the caregiver role on caregiver strain, mental well-being and vitality.
  
  
  METHODS
  The majority of the caregivers were female spouses. Their mean age was 64 years, and their socioeconomic status middle class. Stroke had occurred about 3.5 years ago on average.
  
  
  METHODS
  The following main outcome measures were used: the Caregiver Strain Index, and two scales of the Short Form-36 to measure caregivers' mental well-being and vitality.
  
  
  RESULTS
  Severe cognitive, behavioural and emotional changes in the patient constitute the main risk factors for caregiver burn-out. Women, younger caregivers and caregivers in poor physical health were also identified as risk groups. Caregivers with high perceived self-efficacy, satisfied with social support, and frequently using the coping strategy confronting, experience less strain, higher mental well-being and greater vitality. Duration of the caregiver role does not influence caregivers' strain, mental well-being or vitality.
  
  
  CONCLUSIONS
  Women, younger caregivers, caregivers in poor physical health, and caregivers of patients with severe changes are at risk of burn-out. Support programmes should focus on self-efficacy, social support, and the coping strategy confronting. No specific moment could be identified at which support programmes should be offered.
authors.affiliation: Department of General Practice, University of Groningen, The Netherlands.
authors.forename: E T
authors.initials: ET
authors.lastname: van den Heuvel
authors.forename: L P
authors.initials: LP
authors.lastname: de Witte
authors.forename: L M
authors.initials: LM
authors.lastname: Schure
authors.forename: R
authors.initials: R
authors.lastname: Sanderman
authors.forename: B
authors.initials: B
authors.lastname: Meyboom-de Jong
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D020380:Needs Assessment; D009426:Netherlands; D012044:Regression Analysis; D012307:Risk Factors; D012720:Severity of Illness Index; D012944:Social Support; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000517:prevention & control* / Q000523:psychology; D020521:Stroke