Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India

Background: Post-stroke depression (PSD) is seen in up to 35% of stroke survivors, contributing to morbidity and caregiver burden, that could deter the acute and rehabilitation treatment. Depression in stroke contributes to more disability and caregiver burden. Understanding coping methods of caregi...

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Main Authors: Saraswathi Nagaraju, Aralikatte Onkarappa Saroja, Karkal Ravishankar Naik, Vijaykumar Harbishettar
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2022-01-01
Series:Journal of Geriatric Mental Health
Subjects:
Online Access:http://www.jgmh.org/article.asp?issn=2348-9995;year=2022;volume=9;issue=2;spage=93;epage=99;aulast=Nagaraju
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author Saraswathi Nagaraju
Aralikatte Onkarappa Saroja
Karkal Ravishankar Naik
Vijaykumar Harbishettar
author_facet Saraswathi Nagaraju
Aralikatte Onkarappa Saroja
Karkal Ravishankar Naik
Vijaykumar Harbishettar
author_sort Saraswathi Nagaraju
collection DOAJ
description Background: Post-stroke depression (PSD) is seen in up to 35% of stroke survivors, contributing to morbidity and caregiver burden, that could deter the acute and rehabilitation treatment. Depression in stroke contributes to more disability and caregiver burden. Understanding coping methods of caregivers in PSD results in better caregiving, reduces stress and improves family relationships. There is paucity of studies examining PSD and its determinants in Indian context. Objectives: The objective is to study the association of PSD with disability, with caregiver burden, and coping methods adopted by the caregivers. Methods: Consenting participants (and their caregivers) attending Neurology outpatients with the first episode of Stroke (N=226) in a tertiary care center in a tier 2 city in South India, with 56% participants from rural background, were evaluated between three and six months of stroke. Two groups namely PSD (n = 67) and post-stroke without depression (PSwD, n = 159) based on cutoff score of 9/10 on a valid Hamilton Depression Rating Scale were compared for their demographics, social, physical, and functional factors. Barthel Disability Index (BDI) for disability, Zarit Burden Interview (ZBI) for caregiver burden and coping checklist (CCL) by Rao et al. on caregivers particularly prepared for studying in the Indian context were also administered. Results: The rate of PSD was found to be 29.6%. PSD group were older and had relatively more common in females (p < 0.001). The type of stroke and site of vascular lesion were not associated with PSD (p = 0.68 and p = 0.24). Stroke severity scores were higher in PSD group (p < 0.001). Disability as per BDI scores was greater in PSD group against PSwD group (p < 0.001). ZBI scores show greater caregiver burden in PSD group than PSwD (p < 0.001). Measures were significantly higher in all CCL sub-categories in caregivers of PSD group compared with PSwD. Conclusion: PSD prevalence of close to one third in stroke survivors, with female gender, older age, stroke severity, and functional disability as its key determinants. Furthermore, the PSD was significantly associated with caregiver burden and study also found preferred coping methods were adopted by caregivers of PSD group. Early identification and treatment of PSD is of utmost important to minimize disability, reduce caregiver burden and improvise coping methods.
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spelling doaj.art-1ea111edd4944374a46ea3d0872748732023-10-30T09:48:50ZengWolters Kluwer Medknow PublicationsJournal of Geriatric Mental Health2348-99952395-33222022-01-0192939910.4103/jgmh.jgmh_47_22Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South IndiaSaraswathi NagarajuAralikatte Onkarappa SarojaKarkal Ravishankar NaikVijaykumar HarbishettarBackground: Post-stroke depression (PSD) is seen in up to 35% of stroke survivors, contributing to morbidity and caregiver burden, that could deter the acute and rehabilitation treatment. Depression in stroke contributes to more disability and caregiver burden. Understanding coping methods of caregivers in PSD results in better caregiving, reduces stress and improves family relationships. There is paucity of studies examining PSD and its determinants in Indian context. Objectives: The objective is to study the association of PSD with disability, with caregiver burden, and coping methods adopted by the caregivers. Methods: Consenting participants (and their caregivers) attending Neurology outpatients with the first episode of Stroke (N=226) in a tertiary care center in a tier 2 city in South India, with 56% participants from rural background, were evaluated between three and six months of stroke. Two groups namely PSD (n = 67) and post-stroke without depression (PSwD, n = 159) based on cutoff score of 9/10 on a valid Hamilton Depression Rating Scale were compared for their demographics, social, physical, and functional factors. Barthel Disability Index (BDI) for disability, Zarit Burden Interview (ZBI) for caregiver burden and coping checklist (CCL) by Rao et al. on caregivers particularly prepared for studying in the Indian context were also administered. Results: The rate of PSD was found to be 29.6%. PSD group were older and had relatively more common in females (p < 0.001). The type of stroke and site of vascular lesion were not associated with PSD (p = 0.68 and p = 0.24). Stroke severity scores were higher in PSD group (p < 0.001). Disability as per BDI scores was greater in PSD group against PSwD group (p < 0.001). ZBI scores show greater caregiver burden in PSD group than PSwD (p < 0.001). Measures were significantly higher in all CCL sub-categories in caregivers of PSD group compared with PSwD. Conclusion: PSD prevalence of close to one third in stroke survivors, with female gender, older age, stroke severity, and functional disability as its key determinants. Furthermore, the PSD was significantly associated with caregiver burden and study also found preferred coping methods were adopted by caregivers of PSD group. Early identification and treatment of PSD is of utmost important to minimize disability, reduce caregiver burden and improvise coping methods.http://www.jgmh.org/article.asp?issn=2348-9995;year=2022;volume=9;issue=2;spage=93;epage=99;aulast=Nagarajucaregiver burdencoping strategiesdisabilitypost-stroke depressionstroke severity
spellingShingle Saraswathi Nagaraju
Aralikatte Onkarappa Saroja
Karkal Ravishankar Naik
Vijaykumar Harbishettar
Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India
Journal of Geriatric Mental Health
caregiver burden
coping strategies
disability
post-stroke depression
stroke severity
title Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India
title_full Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India
title_fullStr Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India
title_full_unstemmed Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India
title_short Relationship between disability, caregiver burden and coping with depression in stroke survivors: A cross-sectional study in South India
title_sort relationship between disability caregiver burden and coping with depression in stroke survivors a cross sectional study in south india
topic caregiver burden
coping strategies
disability
post-stroke depression
stroke severity
url http://www.jgmh.org/article.asp?issn=2348-9995;year=2022;volume=9;issue=2;spage=93;epage=99;aulast=Nagaraju
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