title: Employment status, social function decline and caregiver burden among stroke survivors. A South Indian study.
abstract: Stroke leaves at least 60% of the survivors with moderate to severe disability limiting their employment status and social functioning leading to high levels of caregiver burden.
  
  
  OBJECTIVE
  We sought to study the employment status and level of change of social functioning of stroke survivors and their principal caregiver and correlate it with severity of stroke, functional disability, and anxiety and depression scores.
  
  
  METHODS
  One hundred and fifty stroke survivors and principal caregivers (3 months-2 years post-stroke) were recruited for the study. The employment status pre- and post-stroke was assessed. The social function of the patient and caregiver was analyzed using a 6 item social function scale developed for the study, encompassing culturally relevant questions. A 20 point scale adapted from Burden assessment schedule was used to assess the caregiver burden.
  
  
  RESULTS
  Mean age of the study group was 54.37±12.072 (range 22-75 years), with 116 males and 34 females. Spouse was the principal caregiver for 142/150 patients (94.6%). In the stroke survivors, compared to the pre-stroke employment status of 62.7%, only 20.7% were employed post-stroke with half having change of job. But the employment status of caregiver was not reduced post-stroke (34.7% vs 33.3%). Employment loss in stroke survivors had a statistically significant association with severity of functional disability, male gender and presence of limb weakness (p values 0.037, 0.0001 and 0.043 respectively). There was an overall decline in social functions among the 6 parameters assessed in both the stroke survivors and caregivers. Of the caregiver burden, financial burden was more among female and older caregivers. The functional status and motor weakness of the stroke survivors did not tend to worsen the overall caregiver burden.
  
  
  CONCLUSIONS
  Loss of occupation among stroke survivors is high. The decline in social function among stroke survivors and caregivers was significant. Even though functional disability contributed to employment loss and social function decline among stroke survivors, it did not have a significant impact on caregiver burden.
authors.affiliation: Comprehensive Stroke Care Centre, Department of Neurology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Kerala, India.
authors.forename: Sapna Erat
authors.initials: SE
authors.lastname: Sreedharan
authors.forename: J P
authors.initials: JP
authors.lastname: Unnikrishnan
authors.forename: M G
authors.initials: MG
authors.lastname: Amal
authors.forename: B S
authors.initials: BS
authors.lastname: Shibi
authors.forename: Sankara
authors.initials: S
authors.lastname: Sarma
authors.forename: P N
authors.initials: PN
authors.lastname: Sylaja
mesh_terms: D000328:Adult; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D004651:Employment; D005260:Female; D006801:Humans; D007194:India; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012920:Social Behavior Disorders / Q000209:etiology*; D020521:Stroke / Q000150:complications / Q000401:mortality / Q000523:psychology; D011795:Surveys and Questionnaires; D017741:Survivors; D055815:Young Adult
keywords: Anxiety; Caregiver burden; Depression; Disability; Employment status; Social function; Stroke survivors