Caregiver burden among informal caregivers of stroke survivors in Harare, Zimbabwe.
Farayi Kaseke, Lovemore Gwanzura, Timothy Kaseke and 4 others
PMID 39649525WHAT IT FOUND
Caregivers of stroke survivors reported higher strain when they were anxious, depressed, overwhelmed, or had adjusted work, and when survivors had poor physical, motor, or social outcomes.
This reports associations, not proof that treatment reduces burden.
Key findings
01Caregivers of stroke survivors with poor physical outcomes reported median strain scores of 9 versus 5 at 3 months, and 10 versus 4 at 12 months.
02Caregivers who reported anxiety or depression had significantly higher strain at both 3 and 12 months, while work adjustments and feeling completely overwhelmed were significantly higher at 3 months.
03At 12 months, caregivers of married stroke survivors had significantly lower strain, while caregivers of survivors with poor social outcomes had significantly higher strain.
STILL TO COME
How it was doneWhat they foundWhat it means for PTsWhat it means for OTs
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What it does not show
Only 87 caregivers were analysed at 3 months and 65 at 12 months, although 188 dyads were recruited at baseline. The authors excluded 101 caregiver and survivor dyads at 3 months because of missing strain information, and 84 stroke survivors died during the year. Caregivers were followed only if the stroke survivor was alive and could be found, so burden after death or after moving away was not captured. Loss to follow-up was 20%. Strain was self-reported, and the authors note possible response bias. Attrition may have introduced selection bias, and the authors say the study might have been underpowered, with wide confidence intervals. The study was done in three public hospitals in Harare, Zimbabwe, so it may not apply to other settings. The study measured associations, not the effect of any treatment.
Declared interests
The corresponding author received financial support for her PhD research from the NIH Fogarty International Center, grant 5D43TW009539-05, and the funding lapsed in 2018.
The easy way to misread this
Do not conclude that improving stroke survivors’ motor or social outcomes will reduce caregiver burden. This study measured associations over time, did not test a treatment, and had substantial attrition.