Training carers of stroke patients: randomised controlled trial.
BACKGROUND
Informal care givers support disabled stroke patients at home but receive little training for the caregiving role.


OBJECTIVE
To evaluate the effectiveness of training care givers in reducing burden of stroke in patients and their care givers.


METHODS
A single, blind, randomised controlled trial.


METHODS
Stroke rehabilitation unit.


METHODS
300 stroke patients and their care givers.


METHODS
Training care givers in basic nursing and facilitation of personal care techniques.


METHODS
Cost to health and social services, caregiving burden, patients' and care givers' functional status (Barthel index, Frenchay activities index), psychological state (hospital anxiety and depression score), quality of life (EuroQol visual analogue scale) and patients' institutionalisation or mortality at one year.


RESULTS
Patients were comparable for age (median 76 years; interquartile range 70-82 years), sex (53% men), and severity of stroke (median Barthel index 8; interquartile range 4-12). The costs of care over one year for patients whose care givers had received training were significantly lower (10,133 pounds sterling v 13,794 pounds sterling (18,087 dollars v 24,619 dollars; 15,204 euros v 20,697 euros); P = 0.001). Trained care givers experienced less caregiving burden (care giver burden score 32 v 41; P = 0.0001), anxiety (anxiety score 3 v 4; P = 0.0001) or depression (depression score 2 v 3; P = 0.0001) and had a higher quality of life (EuroQol score 80 v 70; P = 0.001). Patients' mortality, institutionalisation, and disability were not influenced by caregiver training. However, patients reported less anxiety (3 v 4.5; P < 0.0001) and depression (3 v 4; P < 0.0001) and better quality of life (65 v 60; P = 0.009) in the caregiver training group.


CONCLUSIONS
Training care givers during patients' rehabilitation reduced costs and caregiver burden while improving psychosocial outcomes in care givers and patients at one year.
Kalra
Lalit
L
Department of Medicine, Guy's, King's and St Thomas's School of Medicine, London SE5 9PJ. lalit.kalra@kcl.ac.uk
Evans
Andrew
A
Perez
Inigo
I
Melbourn
Anne
A
Patel
Anita
A
Knapp
Martin
M
Donaldson
Nora
N
D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000193:education*; D017046:Cost Savings; D005260:Female; D006701:Home Nursing / Q000191:economics / Q000193:education*; D006801:Humans; D008297:Male; D016037:Single-Blind Method; D020521:Stroke / Q000191:economics / Q000451:nursing*