Page 781

Karger_ESC London_2013

London, United Kingdom 2013 Poster Session Blue Cerebrovasc Dis 2013; 35 (suppl 3)1-854 781 824 Rehabilitation and reorganisation after stroke Carer Strain and Dependence for Activities of Daily Living. A Retrospective Analysis of Clini-cal Trial Data M. Ali1, R. Fulton2, N. Lincoln3, M. Brady On Behalf of the VISTA-Rehab Collaboration4 Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian Uni-versity, Glasgow, UNITED KINGDOM1, Institute of Cardiovascular and Medical Sciences, Uni-versity of Glasgow, Glasgow, UNITED KINGDOM2, Institute of Work, Health & Organisations, University of Nottingham, Nottingham, UNITED KINGDOM3, Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UNITED KINGDOM4 Background: Stroke survivors may depend on carers for assistance with activities of daily living (ADL). Carers may experience health, psychosocial and quality of life related problems; it is unclear to what extent these experiences relate to the physical demands of supporting survivors’ ADL. We examined the relationship between dependence on carers for ADL using the items of the Barthel In-dex (BI), and corresponding scores on the Carer Strain Index (CSI). Methods: We examined data from the rehabilitation section of the Virtual International Stroke Trials Archive (VISTA-Rehab), where item scores for the BI and corresponding assessments of carer strain were available. Using ordinal logistic regression adjusting for patients’ age, sex, history of prior stroke and BI score at initial screening, we examined the relationship between the ADL domains of BI at 3 and 6 months and CSI scores at 6 months. Results: Observations from 88 pairs of patients and carers were available; the median age of stroke survivors was 70, Interquartile Range 62.5, 75 and 74 (84.1%) patients were cared for by a partner/ spouse. By 3 and 6 months respectively, 48 (54.6%) and 30 carers (34.1%) had considerable strain, defined as a score of at least 7 on the CSI. By 6 months, 4/88 (4.5%) carers reported considerable strain in spite of patients’ independence in ADL. Carers with considerable strain typically cared for those with a higher level of dependence. Dependence on carers for bathing, toilet use, transfer from bed to chair and mobility were each significantly associated with increased carer strain at 6 month assessment. Bowel and bladder incontinence were not significantly associated with increased carer strain (Table 1). Conclusion: Confirmation of our findings in a larger study, with adjustment for additional confound-ers will highlight groups of carers who may benefit from additional support, information provision and referral to external services following patient discharge from hospital. Table 1) Relationship between Dependence on Carers for ADL at 3 and 6 Months and Carer Strain at 6 month Follow- Up. Proportion of Patients who were Dependent (n;%) P value Odds Ratio 95% confidence Interval 3 Months Feeding 37; 46.3 0.15 0.5 0.2, 1.3 Bathing 45; 56.3 0.007 0.26 0.1, 0.7 Grooming 22; 27.5 0.29 0.61 0.2, 1.5 Dressing 39; 48.8 0.12 0.45 0.2, 1.2 Bowels 11; 13.8 0.54 0.72 0.2, 2.1 Bladder 19; 23.8 0.46 0.7 0.3, 1.8 Toilet Use 25; 31.3 0.01 0.25 0.1, 0.8 Transfer from Bed to Chair 24; 30 0.05 0.37 0.1, 0.99 Mobility on Level Surfaces 25; 31.3 0.006 0.26 0.1, 0.7 Stairs 43; 53.8 0.1 0.45 0.2, 1.1 6 Months Feeding 39; 44.3 0.004 0.24 0.1, 0.6 Bathing 55; 62.5 0.0001 0.12 0.04, 0.4 Grooming 23; 26.1 0.0001 0.11 0.04, 0.3 Dressing 38; 43.2 0.001 0.18 0.1, 0.5 Bowels 14; 15.9 0.82 0.87 0.3, 2.8 Bladder 20; 22.7 0.27 0.57 0.2, 1.5 Toilet Use 25; 28.4 0.003 0.18 0.1, 0.6 Transfer from Bed to 29; 33 0.006 0.24 0.1, 0.7 Chair Mobility on Level Surfaces 28; 31.8 0.009 0.27 0.1, 0.7 Stairs 46; 52.3 0.0006 0.17 0.1, 0.5


Karger_ESC London_2013
To see the actual publication please follow the link above