Correlation Between Poststroke Patients’ Independence and Cognition,and Their Family Caregivers’ Burden and Quality of Life

PURPOSE: Stroke is a chronic disease that generates impairments in functional capacity. The required patient care is commonly provided by family members, which may cause burden and threaten their quality of life. The objectives of this study were (1) to examine the correlation between level of independence and cognition in stroke patients and between burden and quality of life in caregivers; (2) to detect whether stroke patients’ independence and cognition are correlated with caregivers’ burden and quality of life; and (3) to identify if stroke patient’s age, family caregiver’s age, injury time, rehabilitation time, and time giving care correlate with independence, cognition, burden, and quality of life.

METHOD: This is a cross-sectional and correlational study. The nonprobability sample consisted of 30 patients with a diagnosis of stroke and 30 family caregivers, who complied with the following inclusion criteria: Stroke patients were male, were age 18 to 90 yr, had suffered a single stroke at least 6 mo previously with no other associated neurological or disabling diseases, and had undergone a rehabilitation process, and caregivers were a family relative of the stroke patient, were age 18 yr or over, and had been monitoring the stroke patient for more than 6 mo.

The following instruments were used to collect data about the stroke patients: (1) the Mini-Mental State Examination, for the cognitive screening test, and (2) the Functional Independence Measure, for the evaluation of level of independence in activities of daily living. With the family caregivers of stroke patients, the following instruments were used: (1) the Zarit Burden Interview Scale, used to assess the impact of care activities, and (2) the World Health Organization Quality of Life–BREF, for the evaluation of quality of life. The collected data were subjected to a quantitative analysis approach using Pearson’s product–moment correlation coefficient.

RESULTS: The stroke patients were predominantly elderly and married, while their caregivers were adult, female, and stroke patients’ spouse. Although there were no correlations between stroke patient and caregiver variables, independence was correlated with cognition (r = .882) and rehabilitation time (r = –.398), and burden was correlated with quality of life (r = –.414). There was a moderate negative correlation between independence and rehabilitation time in stroke patients (r = –.398) and an absence of correlations between all the other variables. This study found that a greater level of independence was correlated with better cognitive levels and longer rehabilitation in male stroke patients; these findings demonstrate the importance of the cognitive components of patients’ rehabilitation and functional recovery after a stroke. It was also found that higher burden levels were correlated with lower quality of life in caregivers of male stroke patients.

CONCLUSION: These findings highlight the importance of interventions for families who care for stroke patients, which should be aimed at reducing the levels of burden and improving the quality of life of caregivers. These data suggest the necessity to take action and create services in occupational therapy focused on stroke patients and family caregivers.

References

Baumann, M., Lurbe-Puerto, K., Alzahouri, K. & Aïach, P. (2011). Increased residual disability among poststroke survivors and the repercussions for the lives of informal caregivers. Topics in Stroke Rehabilitation, 18, 162–171. http://dx.doi.org/10.1310/tsr1802-162

Morimoto, T., Schreiner, A. S., & Asano, H. (2003). Caregiver burden and health-related quality of life among Japanese stroke caregivers. Age and Ageing, 32, 218–223. http://dx.doi.org/10.1093/ageing/32.2.218