Anxiety, Depression And Its Related Factors In The Spouses Of Stroke Patients

Stroke not only gives a huge hit the patients on psychologic and physical health, but also to his family.Especially give psychologic,physical and economic stress to his or her spouse.The patients need support from their family,psychologic and physical support.As mostly social workers and director caregivers of stroke patients, the spouses should take care of patients' life,give affectional aegis and economy support,urge and assist them to do rehabilitation training.All of these-making them feel family's warmth and attention.On the other hand,society also offer powerful aegis,especially the aegis of affection.All of these are very important and have no susbstitution in the process of sufferer' recovery.Caregivers are very important for stroke patients.But in the process of taking care of stroke patients spouses not only turn their hand on the heavy everyday.attend and tend heavy econmy,but also take control their feeling and offer active affectional aegis for stroke patients,Those bring disadvantage influence to spouse's psychology and physical health.60%informally favourer are spouse in china,spouse's feelings are very easy to be infecter to the patients;On the other hand,spouse's psychology and physical health areprecondition.when curing and take care of patients.we should be positive to attend spouse's psychology condition. Give our attention to their positivity,offer favourable family aegis,to promote patient recovery.It is very important to discuss the factor of influence the spouse's psychology health level and put the psychology health into interference.it have been reported by literature.The rate of family favourer'ssocial psychology disease is far higher than social public.As favourers are in anxiety and depression condition.It will influence the care's quality directly for the patients.Also bring the patient's different degree of anxiety and depression.And it's disadvantage to body and mind health when the favourous are chronically in bad mood.it is critical effect in focusing on the stroke survival's spouse's psychology health of the spouse by providing gist For the pertinrnce interference measure of instituting to enhance the support level to the survival.Objective:We investigate anxiety,depression,social support and its related factors of 140 stroke patients' spouses,The purpose is to find out anxiety,depression,social support and its related factors of stroke patients' spouses in the background of our country culture.and provide evidence for constitute pertinence intervene measure.identificate determinants of the spouse's anxiety and depression will help to target caregiver interventions,Improving the spouse's mental health level,then improving the support level for stroke survival.accelerate recover of stroke survival's mental and physiology function.Methods:Patients and their spouses were collected prospectively in 140 stroke survivors via the information provided by the trained medical personal in stroke registering database from October 2007 to December 2008.Assessing the degree of physical disorder for stroke survivor's.using the modified Rankin Scale(mRS). Assessing the spouse's anxiety.depression and social support using self-rating anxiety scale(SAS),self-rating depression scale(SDS),and social support rating scale (SSRS),Using self-edited questionnaire for Investigating stroke survivors and their spouses' general information and information of the patient's disease. Results:1) The mean score in SDS of the spouses higher than domestic norm (51.42±13.63 vs 33.46±8.55,t=15.594,P＜0.001);The mean score in SAS of the spouses higher than domestic norm(48.00±13.65 vs 29.78±0.46,t = 15.799, P＜0.001).2) Subjective support and external support and availability of social suppor of depression team were lower non-depression team's and the difference has statistics signification.3) The result of analysis for related factor of spous's anxiety and depression symptom show the higher score of modified Rankin Scale(mRS),lower family income,the elder aged spouus,poor eduction,unemployment,the higher score of Emotional Self-Awareness will lead the higher mean score in SAS and SDS of the spouses.But the difference of anxiety and depression symptom has no statistics signification between every team based on patients's course of diseases,the way of pay for cure diease,the number of children gestated,the spouse's sex,everyday average time for take care patient.and weather another person take care patient.4) Dependent variable is the spouse's score in SAS and SDS.Independent variable is significative variable in factor analyse between teams(P＜0.1).We do multiple regression analysis.The multiple regression analysis showed that SDS in the spouses were related with the modified Rankin Scale(mRS),the spouse's age,score of self-sensation pressure of the spouse;SAS in the spouses were related with the modified Rankin Scale(mRS),employment,external support and score of self-sensation pressure of the spouse.The exteral support and employment were negatively correlated to the level of anxiety.Conclusion:Stroke survivor's state of an illness is dangerous and their course of diseases is very long.It not only bring huge painful for suvival but also is serious negative living event for survivor's spouse.This conclusion of the questionnaier show: the status in que of spouse' mental health is poor.The patients' score of the modified Rankin Scale(mRS) deeply infuence the spous' anxiety and depreesion symptoms. There have strong related between them along with improving of the level of medical treatment.The death rate of stroke patient is debasing obviously.But there still remain disorder of the survivor's physical function.Lots of investigation conclusion show:The defoormity rate of stroke survival is 70%～80%.The conclusion of this study and many literatures is:the serious disorder of the patient's physical function,the higher rate of the spouse's depression and anxiety symptoms perhaps the patients athletics and cognize function were in disorder or forfeiture.For example,paralysis,emiction irretention and behavior disorder.So the degree of the patients depend on their spouse is increasing.Then time for take care patients be prolonged in addition to the patients perhaps were in depression symptom of varying degrees.all above aggravate the spouse's burden of take care patients and psychology burden.The conclusion of this questionnaire show:the mean score of SDS and SAS in the spouse's who feels their self-sensation pressure higher than 50 higher than who feels their self-sensation pressure less than 50.This conclusion is the same with the former,we discovered:the spouse'score of SDS and SAS who are in low income, aged,low educationed,unemployed higher than the score of Domestic noma.There are lots of domestic and oversras literature indicated:social support can reduce serious degree of reaction effectively.then improve the spouse's psychology health. The main carer's stress can lead depression symptom.This investigation also conclude the similar result.In this investigation,the author analyse the number of children who were born by the stroke and their spouse as independent factor.The resultis that the spouse who have lesser children get high score of SDS and SAS.It may be associated with the fewer family and social support which this particular crowd get.China's current one-child and home Dinke increasing.This should be given more attention to this special populations.Recently year scholars at home and abroad to strengthen the mental health status of the spouse's concern and the adverse psychological status of intervention is to do an exploratory survey study.Most scholars believe thai this special group should be given to support from the physical to the psychological.Early identification of stroke patients should take care of the burden and impact of factors,this special group should be given psychological intervention early.If necessary,the family members of this special groups should be cure through collective psychological intervention.So that the spouse can manage better their own lives and the prevention of anxiety,depression,or irritable mood happened.Abroad literature has reported that effective behavioral interventions is beneficial for promote the recovery of stroke patients with disabilities.And it can enhance the rehabilitation confidence of patients and their families.Wilz G and Barskova T have done a compare test.The result of the compare test of interventions and non-interventions on stroke patient and his spouse's cognitive behavioral shows that interventions for improving the main favorers' short-term and long-term quality of life and depressive symptoms are effective.Research shows:interventions and discussions for stroke patients' close relatives significantly reduce their psychological burdens.There are studies suggesting that short-term support education and professional guidance can alleviate their burdens and stress for favorers.However, once these support stops,the stress and burden will return to the original level,so these special groups should be given to long-term support,psychological interventions and specialized guidance.Spouse of stroke not only needs psychological care and help,but also need basic knowledge of rehabilitation nursing and basic skills of rehabilitation training.Health care works should be fully aware of the physical and psychological needs of the spouse,in accordance with its need to strengthen knowledge and skills.There are very favorable in reducing their stress, improving the level of care.Knowledge of related literatures proposed contributes to change its feelings of pressure.The support training of psychology,knowledge,skills, for patients and their family main favorers can enhance their psychological adaptation in the long process of rehabilitation as soon as possible.Appropriate rehabilitation care for patients is also an important factor that patients return to society at an early date.Some literatures shows:spouse of social intercourse at the largest load area, followed by the psychological load,and finally the physical load.After spouse assumes the burden of taking care of the sick,they would be isolated in society, having a serious impact on social anxiety load is the real reason of spouse.Health care workers should pay attention to favorers' needs in this regard in the process of diagnosis and treatment,fully understanding the social load spouses feel.Especially for the spouses of high-risk targets,such as middle-aged and old women,older,bad economic condition,low education level,personality and so on.Effective communication and consultation can reduce a sense of community separation of spouse to help them rebuild their interpersonal environment.If possible,the medical staff can assist spouse of patient setting up self-support groups,through psychological counseling,as well as among members of the support,encouragement,emotional expression and experience sharing to reduce their feelings of stress,taking better care of patients.Some scholars believe that the fundamental solution to solve this problem is to reduce the time of care.If the economic circumstances permit,they can employ professionals and ask other members of the family to take care of patients in order to reduce spouse's time of care.The communities where patients live can help to provide some relevant.In a word,being concern about psychological condition of spouse of patients and their main family favorers and analyzing its impact factors have become of great importance to scholars both at home and abroad.In the diagnosis and treatment of stroke patients,at the same time,health care workers should pay close attention to the spouse of high-risk groups,psychological counseling for them to relieve their stress,providing them with teclmical training and education. At the same time,the condition in which favorers alternate a short period of time and communities support can reduce spouse's time of care.But what about the impact of factors and the psychological status of patients with a spouse whether the effect of a series of measures provided to spouse is indeed effective need further investigation and study.