Abstract 12562: Uncertainty Can Help Identify Risk for Stress and Burden in Caregivers of Stroke Survivors
Stress in caregivers puts them at high risk for subsequent morbidity and mortality. Immediately following a family member’s stroke, uncertainty about recovery together with the sudden assumption of a new role as caregiver probably accentuates this stress, but little is known about caregiver uncertainty, stress or burden in the very early period of caregiving.
Methods: A prospective, longitudinal observational study was conducted in a convenience sample of 40 caregivers (68% female, mean age 58±14.22 years, 60% children) and stroke-survivors (38% male, mean age 76±7.80 years) recruited from acute-care settings. Uncertainty was measured by the Perception of Uncertainty in Illness Scale for Family Members (range: 31[[Unable to Display Character: –]]155, higher scores: greater uncertainty). Stress was measured with the Perceived Stress Scale (range: 0[[Unable to Display Character: –]]56, higher scores: higher stress) and salivary cortisol. Burden was measured by the Zarit Burden Interview (range: 0[[Unable to Display Character: –]]88, higher scores: greater burden). Multivariate stepwise regression was used to examine the effect of uncertainty on caregiver stress and burden within 2 weeks following stroke (baseline, T1) and again at 6 weeks poststroke (T2).
Results: At T1 both uncertainty (T1: 83.73±23.47, T2: 85.23±23.94) and perceived stress (T1: 24.38±10.15, T2: 24.48±10.74) were higher than reported in other caregiver populations and remained high at T2. Caregivers reported mild to moderate burden (T1: 23.0±17.64, T2: 26.90±17.87) that did not differ significantly across time. Physiological stress (T1: 0.39±0.23 μg/dL waking, 0.12±0.10 μg/dL evening, T2: 0.33±0.21 μg/dL waking, 0.12±0.11 μg/dL evening) also did not differ significantly across time. Greater uncertainty was associated with higher perceived stress at T1 (p ≤ 0.001) and T2 (p ≤ 0.001). Uncertainty did not predict physiological stress at either time point but greater uncertainty was associated with greater burden at both times (T1: p = 0.001, T2: p = 0.031).
Conclusions: Caregivers experience significant stress and burden that declines little over the first six weeks poststroke. Measuring uncertainty may help in early identification of caregivers at risk for stress or burden in need of additional support.
- © 2013 by American Heart Association, Inc.