PREVALENCE AND DETERMINANTS OF STRAIN AMONG CAREGIVERS OF STROKE SURVIVORS IN OYO STATE, NIGERIA

Abstract

Stroke, a cerebrovascular accident, is one of the leading causes of death and disability in the world. It exerts a significant effect not only on patients but also on family caregivers. Caregivers play a vital role in the functional recovery of stroke survivors, their role however, puts them in an extremely stressful and dauntingly overwhelming position which leaves them feeling quite strained, hence the concept of caregiver strain. Hence, this study aims to find the prevalence of caregiver strain, to determine the factors associated with caregiver strain and to assess the quality of life of Caregivers of Stroke survivors in Oyo State, Nigeria. This was a multicenter study conducted in the following clinics; University College Hospital, Ibadan (UCH), Ring-Road State Hospital Adeoyo, Ibadan, Adeoyo Maternity Hospital, Yemetu, Jericho Nursing Home, Ibadan, Family Medicine Clinic, Ibadan and General Hospital, Oyo town. This study focused on caregivers of stroke patients who accompany the patients to clinic visits. It employed a cross-sectional study design. Two hundred and forty-one caregivers of stroke patients were selected using systematic sampling were studied. A four-part questionnaire was used to collect data on socio-demographic characteristics of caregivers, caregiver strain index (CSI), disability status (Barthel Index) of stroke survivors and quality of life (using WHO-BREF 26) short form tool. Data was summarized using percentages, frequencies for categorical data and mean ± SD for continuous variables. Chi-square tests was used to check for association between categorical variables, correlation was used to check for association between continuous variables, and logistic regressions were employed to measure extent of association between variables. All test for associations were conducted at 95% Confidence Level. Data analysis was done with Statistical Package for Social Sciences (SPSS) version 20. AFRICAN DIGITAL HEALTH REPOSITORY PROJECT UNIVERSITY OF IBADAN LIBRARYvi The mean age of respondents was 39.5 ± 15.6 years. Females numbered 134 (55.6%) and 108 (44%) had secondary education. Respondents were caregivers to their parents (42.7%), spouses (21.6%) and siblings (6%). The prevalence of caregiver strain was 71.8%. Factors associated with caregiver strain include; availability of support and finances (χ2 = 22.561, p < 0.05), length of caregiving time (r = 0.143, p = 0.02), disability status (r = -0.326, p = 0.04), physical health of caregiver (r = -0.129, p = 0.00). Mean Quality of life scores by their domains include; Physical (72.44 ± 11.321), Emotional / Psychological (62.19 ± 9.04), Social relationships (72.44 ± 16.20) and Environmental (62.77 ± 10.49). Findings of this study shows high prevalence of strain among caregivers of stroke survivors. Caregivers should be well integrated into the program for rehabilitating stroke survivors so as to lessen their strain. Strain or burden interviews should be performed on each clinic visit. Caregivers should be assessed when they present at the Clinic each time they visit with patients as a beneficial intervention.