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Author List:
Rittman MR (University of Florida)
Qin H
Objectives:
Stroke is the third leading cause of disability in the US and approximately 60-72% of stroke survivors are discharged home to continue recovery placing an enormous responsibility and burden on informal caregivers. Little is known about ethnic variations associated with stroke caregiving. This study investigates ethnic variations in factors associated with the stroke caregiving experience during the first year following discharge home among three ethnic groups.
A conceptual model of risk factors for caregiver burden and coping was adapted from the literature and tested using multiple regression analysis.
Methods:
The sample included 124 caregivers of veterans post stroke. The sample included 45 white, 49 Puerto Rican Hispanic, and 30 African American caregivers.
Data were collected at 1, 6 and 12 months following discharge home. Three sets of independent variables were included in the regression analysis: stroke survivor characteristics (age, ethnicity, functional status, and mental status), caregiver characteristics (age, ethnicity, overall health status, and depression assessed with Geriatric Depression Scale), and the caregiving context (living with veteran/not living with veteran and relation to veteran). Two dependent variables were used in this study: caregiver burden (Sense of Competence Questionnaire) and caregiver coping (Sense of Coherence Questionnaire).
Results:
Patient and caregiver ethnicity and caregiver depression have significant effects on caregiver burden at one and six months. Compared to white caregivers, both Hispanic caregivers (p<.0001) and African-American caregivers (p=0.02) have higher burden scores at one month, and Hispanic caregivers have lower burden scores (p=0.0002) than African American caregivers. At six months, among all groups, Hispanic caregivers have the highest burden scores (p=0.04). At one month and six months caregivers with higher depression scores also have higher burden scores (p<.0001 and p=0.01 respectfully) and have lower coping scores (p<.0001 at both time points). Caregiver health status was associated with caregiver burden at one month (p=0.0539) and was close to significant at six months (p=0.0791), but this effect was not significant at 12 months. At twelve months, caregivers who have higher depression scores have lower coping scores (p=0.0047). Caregivers who are related through kinship have lower coping scores (p=0.01) than caregivers who are not related to veterans. .
Implications:
Ethnic variations in stroke caregiving indicate that Puerto Rican Hispanics and African American caregivers experience signficantly more caregiving burden than white caregivers. Facotrs associated with these variations can be defined.
Impacts:
Variations in stroke caregiving provide information that can help clinicians better understand challenges facing stroke caregivers and may help culturally sensitive target interventions.
