Study On The Burden Of Primary Caregivers Of Stroke Patients Based On Family Resilience Model

Objective1.To investigate the burden status of primary caregivers of stroke patients who could not take care of themselves and analyze its influencing factors.2.To explore the relationship between activities of daily living、family resilience、family support and burden of primary caregivers in stroke patients.MethodsFrom October 2021 to June 2022,convenience sampling was used to select stroke patients who were treated or hospitalized in the Neurology Department of a Class iii Grade A hospital in Yangzhou and could not basically take care of themselves and their main caregivers as the research object.The stroke patients who met the inclusion criteria and their main caregivers were investigated with questionnaires.(1)A self-designed general information questionnaire was used to assess the general demographic data and disease-related data of stroke patients,and the general demographic data of their primary caregivers.(2)The Zarit Caregiver Burden Interview(ZBI)was used to assess the burden level of primary caregivers of stroke patients.(3)The Chinese Version of the Modified Barthel Index(MBI-C)was used to evaluate the activity of daily living of stroke patients.(4)The Shortened Chinese Version of the Family Resilience Assessment Scale(FRAS-C)and Perceived Social Support Scale(PSSS)were used to evaluate the level of family resilience and family support of the main caregivers of stroke patients.Excel 2016 software was used to input data,and SPSS 26.0 software was used for statistical analysis.Count data were described by frequency and constituent ratio;Measurement data with normal distribution were described as mean±standard deviation.To compare the differences in burden scores of primary caregivers with different characteristics and caregivers of stroke patients with different characteristics,two independent sample t-test was used for binary data and one-way analysis of variance was used for multi-categorical data.Pearson correlation analysis was used to explore the correlation between daily living ability of stroke patients,family resilience,family support and burden of main caregivers.Multiple linear regression was used to analyze the influencing factors of burden of primary caregivers of stroke patients.Multiple linear regression analysis was used to analyze the mediating effect.Results1.Current status and influencing factors of burden on primary caregivers of stroke patientsIn this study,the total score of caregiver burden of stroke patients was(40.98±13.68)and the scores of personal burden and responsibility burden were(22.24±6.26)and(12.25±5.15),respectively,which were at a moderate burden level.The proportions of primary caregivers with no burden、mild burden、moderate burden and severe burden were as follows:9.44%(27 cases)、34.62%(99 cases)、45.10%(129 cases)and 10.84%(31 cases),respectively.The results showed that 90.56%of the primary caregivers of stroke patients had different degrees of caregiver burden,and the proportion of moderate to severe burden was 55.94%.The results of single factor analysis showed that there were statistical differences in the score of caregiver burden in the gender、age、education level、perceived health status、relationship with patients、emotional relationship with patients、average daily care time、continuous care time、number of participants in care and family per capita monthly income of the main caregivers(P<0.05);There were statistically significant differences in caregiver burden scores in patients’ age、education level and medical payment method(P<0.05).The results of multiple linear regression analysis showed that female caregivers、education level of main caregivers、children of patients、family monthly income per capita、activities of daily living of patients、family resilience and family support were the influencing factors of the burden of main caregivers of stroke patients,which explained 48.0%of the total variation of the burden of main caregivers.2.Relationship between activity of daily living、family resilience、family support and burden of main caregivers in stroke patientsIn this study,the ADL score of stroke patients who could not take care of themselves was(40.86± 13.14),need help in life;The score of family resilience was(101.85±14.78)and the score of family support was(21.24±3.49),suggesting that the level of family resilience and family support of the main caregivers of stroke patients who could not take care of themselves was relatively high.The results of correlation analysis of the variables showed that:the total score of daily living ability of stroke patients was negatively correlated with the total score of burden of main caregivers(r=-0.359,P<0.01)and positively correlated with the total score of family resilience(r=0.327,P<0.01)and family support(r=0.228,P<0.01).The total score of family resilience was negatively correlated with the total score of burden of main caregivers(r=-0.484,P<0.01)and the total score of family support was negatively correlated with the total score of burden of main caregivers(r=-0.442,P<0.01).Multiple linear regression analysis of relevant variables showed that family resilience was a mediating variable and family resilience could partially mediate the effect of daily living ability of stroke patients on the burden of main caregivers.The mediating effect value was-0.134 and the effect size accounted for 37.44%;Family support was a mediating variable and family support could partially mediate the effect of daily living ability of stroke patients on the burden of main caregivers.The mediating effect value was-0.087 and the effect size accounted for 24.13%.Conclusion1.More than half of the primary caregivers of stroke patients who cannot take care of themselves are in the moderate to severe level of burden and the burden of caregivers is heavier.Female caregivers、education level of main caregivers,children of patients、family monthly income per capita、activities of daily living of patients、family resilience and family support were the influencing factors of the burden of main caregivers of stroke patients.Therefore,medical staff can formulate targeted interventions according to the above influencing factors to reduce the burden of the main caregivers of stroke patients.2.The total score of daily living ability and family resilience of stroke patients were significantly correlated with the total score of primary caregiver burden;The total scores of daily living ability and family support of stroke patients were significantly correlated with the total scores of main caregiver burden.Family resilience and family support can partially mediate the effect of daily living ability of stroke patients on the burden of main caregivers.Therefore,medical staff should actively take effective treatment methods to promote the recovery of daily life ability of stroke patients.At the same time,they should strengthen the health education of patients’ families,encourage family members to strengthen communication and cooperation,actively respond to the challenges brought by the disease,and actively seek the help of social resources and fully tap the overall strength within the family and then reduce the burden of the main caregivers of stroke patients.