Predictors of Caregiver Burden of Moderate and Severe Stroke Survivors: A Cross-Sectional Study from South India

Abstract

Introduction: Caregivers have an important role in stroke recovery, especially after the acute phase of treatment. Caregiving for stroke survivors is associated with caregiver burden. Knowledge of factors influencing this caregiver burden is important for both the patient and the caregiver. Aim: To study the prevalence and predictors of major caregiver burden in survivors of moderate to severe stroke treated both conservatively and with surgical decompression. Methods: A community-based cross-sectional study where caregivers of stroke survivors with moderate to severe disability at discharge (modified Rankin Scale >3) were assessed between 3 months and 3 years of discharge. Results: Caregivers of 115 stroke survivors (82 conservatively treated and 33 who underwent decompressive hemicraniectomy) were studied. The majority (80%) were females. The mean period of caregiving was 18.8 ± 10.3 months (range 3-44 months). Major caregiver burden was seen in 36% (confidence interval [CI] = 27.3-44.7%). The significant predictors of major caregiver burden were daily caregiving for ≥4 hours (adjusted odds ratio [AOR] 5.3; CI = 1.84-15.3), patient activities of daily living dependency (AOR 3.66; CI = 1.03-13.03), and caregiver being the spouse (AOR 4.52; CI = 1.25-16.3). A total of 17% of the caregivers stopped working. Only (18%) had health insurance and 59% had borrowed money for treatment. A total of 88% of caregivers were happy regarding their decision to opt for surgery despite their current burden. Conclusion: Caregivers had stress in various domains. Shortening the caregiving hours especially in the initial months may help reduce the burden since the caregiver burden is also influenced by the patient’s dependency which improves over time.