title: Factors associated with strain in informal caregivers of stroke patients.
abstract: BACKGROUND
  Stroke is one of the most prevalent causes of adult disability and handicap. Informal caregivers play an important role in poststroke care. However, informal caregivers may experience strain, which threatens the recovery of stroke subjects. This study aimed to describe changes in strain experienced by informal caregivers from 3 to 6 months after the stroke, and identify the predicting factors.
  
  
  METHODS
  We recruited pairs of inpatients with ischemic stroke and informal caregivers from a tertiary referral hospital and interviewed them at 3 and 6 months after the stroke. Caregiver strain was evaluated using the Caregiver Strain Index (CSI), with a CSI ≥ 7 indicating considerable caregiver strain. Various factors associated with caregiver strain were analyzed using generalized estimating equations.
  
  
  RESULTS
  Eighty-nine stroke patients and caregivers completed the study. Considerable strain was reported in 46% and 43% of the caregivers at the 3rd and 6th month, respectively. Patient factors such as severe disabilities (Barthel Index ≤ 60), poor cognition (Mini-Mental State Examination ≤ 23), depression (Beck Depression Inventory [BDI] ≥ 10), and recurrent stroke were predictors for caregiver strain. Caregiver factors, such as changed employment status, help from formal caregivers, and depression (BDI ≥ 10) were also associated with considerable caregiver strain.
  
  
  CONCLUSIONS
  Nearly 50% of caregivers experienced considerable strain. Interventions aimed at reducing the caregivers' strain should focus on enhancing the functional and emotional status of stroke subjects, prevention of recurrent stroke, and efficient management of depression symptoms in caregivers.
authors.affiliation: Department of Rehabilitation, Kaohsiung Chang Gung Memorial Hospital, Taiwan.
authors.forename: Jen-Wen
authors.initials: JW
authors.lastname: Hung
authors.forename: Yu-Ching
authors.initials: YC
authors.lastname: Huang
authors.forename: Jin-Hua
authors.initials: JH
authors.lastname: Chen
authors.forename: Li-Na
authors.initials: LN
authors.lastname: Liao
authors.forename: Chun-Ju
authors.initials: CJ
authors.lastname: Lin
authors.forename: Chia-Ying
authors.initials: CY
authors.lastname: Chuo
authors.forename: Ku-Chou
authors.initials: KC
authors.lastname: Chang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D013315:Stress, Psychological / Q000209:etiology*; D020521:Stroke / Q000451:nursing*