A longitudinal study of burden among spouse and non-spouse caregivers of older adults with stroke-induced-dependency

Day, Carolina Baltar; Bierhals, Carla Cristiane Becker Kottwitz; Pizzol, Fernanda Laís Fengler Dal; Low, Gail; Santos, Naiana Oliveira dos; Paskulin, Lisiane Manganelli Girardi

doi:10.1590/0034-7167-2023-0052

Carolina Baltar Day Corresponding author: Carolina Baltar Day, E-mail: carolina.day@pucrs.br

conception or design of the study/research

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Pontifícia Universidade Católica do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil

https://orcid.org/0000-0002-5998-5735

Carla Cristiane Becker Kottwitz Bierhals

conception or design of the study/research

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Universidade Federal do Rio Grande do Sul. Porto Alegre, Rio Grande do Sul, Brazil

https://orcid.org/0000-0002-6956-1549

Fernanda Laís Fengler Dal Pizzol

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

University of Alberta. Edmonton, Alberta, Canada

https://orcid.org/0000-0002-6790-0121

Gail Low

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

University of Alberta. Edmonton, Alberta, Canada

https://orcid.org/0000-0002-5004-3549

Naiana Oliveira dos Santos

conception or design of the study/research

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Universidade Franciscana. Santa Maria, Rio Grande do Sul, Brazil

https://orcid.org/0000-0002-5439-2607

Lisiane Manganelli Girardi Paskulin

conception or design of the study/research

analysis and/or interpretation of data

final review with critical and intellectual participation in the manuscript

Hospital de Clínicas de Porto Alegre. Porto Alegre, Rio Grande do Sul, Brazil

https://orcid.org/0000-0003-1444-4086

Corresponding author: Carolina Baltar Day, E-mail: carolina.day@pucrs.br

EDITOR IN CHIEF: Dulce Barbosa

ASSOCIATE EDITOR: Anderson de Sousa

Variables	Time^† † Time 1: one week after SCU-Stroke discharge. Time 2: two months after SCU-Stroke discharge.	Spouse (n=20) n(%)	Non-spouse (n=28) n(%)	p value
Sex
Female	Time 1	17(85)	25(89.3)	0.683
Male	Time 1	3(15)	3(10.7)
Living with the older adult with stroke-induced-dependency
Yes	Time 1	20(100)	23(82.1)	0.066
Experience in caring
Yes	Time 1	19(95)	12(42.9)	0.000^{^* * p<.001;}
Kind of help received
Instrumental	Time 1	15(75)	24(85.7)	0.460
	Time 2	19(95)	22(91.7)	1.000
Emotional	Time 1	13(65)	20(71.4)	0.636
	Time 2	16(80)	13(54.2)	0.072
Financial	Time 1	4(20)	16(57.1)	0.010^{^ p<.01;}
	Time 2	5(25)	15(65.2)	0.013^{^* * p<.05}

Variables	Spouse (n=20) mean (SD)	Non-spouse (n=28) mean (SD)	Mean difference (95% CI)	p value
Caregivers
Age^† † Time 1: one week after SCU discharge;	61.30 (10.08)	47.86 (11.80)	13.44 (6.88 to 20.00)	0.000^{^* * p<.001; ‡ Family monthly income based on the National Brazilian minimum wage in 2018 (R$937.00);}
Family income^‡	2487.30 (1256.28)	1.951 (818.66)	535.87 (-118.80 to 1190.54)	0.105
Education^§ § Education in years;	6.28 (4.08)	10 (3.86)	-3.76 (-6.09 to -1.42)	0.002^{^ p<.01;}
Hours of caring^† † Time 1: one week after SCU discharge;	19.00 (6.50)	19.57 (6.03)	-0.57 (-4.24 to 3.10)	0.756
Older adults with stroke-induced-dependency
Functional Capacity	67.25 (19.98)^† † Time 1: one week after SCU discharge;	52.64 (18.80)^† † Time 1: one week after SCU discharge;	-14.60 (-25.98 to -3.23)	0.013^{^* * p<.05;}
	82.90 (24.10) ^¶	68.82 (25.90)^¶ ¶ Time 2: two months after SCU discharge	-14.07 (-29.92 to -0.76)	0.063

Domain	Spouse (n=20) mean (SD)	Non-spouse (n=28) mean (SD)	Mean differences 95% (CI) ^† † 95% confidence interval. CBS scores were adjusted for functional capacity of older adults with stroke-induced-dependency and caregiver age, education, living arrangements, financial support, and previous experience;	p value^‡ ‡ MANOVA or Multivariate Analyses of Variance;
Isolation	4.61±0.52^§ § Time 1: one week after SCU discharge;	6.27±0.49^§ § Time 1: one week after SCU discharge;	1.65 (-0.02 to 3.28)	0.046^{^* * p<0.05;}
Isolation	4.70±0.52^¶ ¶ Time 2: two months after SCU discharge.	6.69± 0.57^¶ ¶ Time 2: two months after SCU discharge.	1.96 (0.11 to 3.80)	0.038^{^* * p<0.05;}
General Strain	14.20±1.45^§ § Time 1: one week after SCU discharge;	16.81±1.38^§ § Time 1: one week after SCU discharge;	2.62 (-1.90 to 7.13)	0.249
General Strain	13.24±1.53^¶ ¶ Time 2: two months after SCU discharge.	20.47±1.69^¶ ¶ Time 2: two months after SCU discharge.	7.23 (1.82 to 12.64)	0.010^{^* * p<0.05;}
Disappointment	8.52±0.73^§ § Time 1: one week after SCU discharge;	9.36±0.69^§ § Time 1: one week after SCU discharge;	- 0.84 (-1.14 to 3.12)	0.462
Disappointment	8.09±0.86^¶ ¶ Time 2: two months after SCU discharge.	11.09±0.95^¶ ¶ Time 2: two months after SCU discharge.	2.99 (0.71 to 6.06)	0.055
Emotional involvement	3.55±0.30^§ § Time 1: one week after SCU discharge;	3.42±0.288^§ § Time 1: one week after SCU discharge;	0.10 (-0.84 to 1.04)	0.830
Emotional involvement	3.23±0.41^¶ ¶ Time 2: two months after SCU discharge.	3.92±0.45^¶ ¶ Time 2: two months after SCU discharge.	0.68 (0.76 to 2.14)	0.345
Environment	5.02±0.55^§ § Time 1: one week after SCU discharge;	5.90±0.52^§ § Time 1: one week after SCU discharge;	-0.87 (-2.60 to 0.84)	0.310
Environment	4.57±0.42^¶ ¶ Time 2: two months after SCU discharge.	5.53±0.46^¶ ¶ Time 2: two months after SCU discharge.	0.95 (2.46 to 0.59)	0.206

Domain/ Item	Item question			p value^‡ ‡ MANOVA or Multivariate Analyses of Variance;
Domain/ Item	Spouse (n=20) mean (SD)	Non-spouse (n=28) mean (SD)	Mean differences 95% (CI) ^† † 95% confidence interval. CBS scores were adjusted for functional capacity of older adults with stroke-induced-dependency and caregiver age, education, living arrangements, financial support, and previous experience;	p value^‡ ‡ MANOVA or Multivariate Analyses of Variance;
Isolation
Item 1⁰§ Has your social life (with family and friends) been lessened?	1.69±0.28	2.76±0.26	1.07 (0.19 to 1.95)	0.017^{^*}
Item 1¹¶ Has your relative’s problem prevented you from doing what you had planned to do in this phase of your life?	1.78±0.26	2.99±0.29	1.20 (0.27 to 2.13)	0.013^{^*}
General strain
Item 1^¶ ¶ Time 2: two months after SCU discharge; ** p <0.01. Do you find yourself facing purely practical problems in the care of your relative that you think are difficult to solve?	1.40±0.25	2.93±0.28	1.53(0.61 to 2.44)	<0.01^{^**}
Item 5^¶ ¶ Time 2: two months after SCU discharge; ** p <0.01. Do you feel tied down by your relative’s problem?	1.52±0.25	2.60±0.28	1.08 (0.18 to 1.98)	0.020^{^*}
Item 7^¶ ¶ Time 2: two months after SCU discharge; ** p <0.01. Do you think your own health has suffered because you have been taking care of your relative?	1.27±0.21	1.98±0.23	0.76 (0.005 to 1.51)	0.049^{^*}
Item 8^¶ ¶ Time 2: two months after SCU discharge; ** p <0.01. Do you think you spend so much time with your relative that the time for yourself is insufficient?	1.30±0.25	2.44±0.28	1.13 (0.22 to 2.05)	0.016^{^*}

[1] Corresponding author: Carolina Baltar Day, E-mail: carolina.day@pucrs.br

Brasil

Brasil

A longitudinal study of burden among spouse and non-spouse caregivers of older adults with stroke-induced-dependency

Sobrecarga entre cuidadores cônjuges e não cônjuges de idosos dependentes por AVC: estudo longitudinal

La carga entre cuidadores conyugales y no conyugales de ancianos con dependencia inducida por ictus: estudio longitudinal

ABSTRACT

Objective:

Methods:

Results:

Conclusion: