| Objective:To investigate the level and change trend of care burden of family caregivers in patients with first-episode ischemic stroke during acute hospitalization,1 month after discharge and 3 months after discharge,and to further analyze the correlation between self-efficacy,social support,coping style and care burden.To explore the main factors affecting the care burden at each time point,so as to facilitate medical staff to formulate targeted and feasible intervention measures to reduce the care burden of family caregivers of patients with firstepisode ischemic stroke in the future.Methods:This study adopted a prospective longitudinal study design.From November 2021 to November 2022,254 patients with first-episode ischemic stroke and family caregivers in the departments of Neurology and Encephalopathy of three Grade 3A Hospitals in Shandong Province were selected by convenient sampling method.A questionnaire survey was conducted during acute hospitalization,1 month after discharge and 3 months after discharge.Including patient general condition questionnaire,disease related information questionnaire and family caregiver general condition questionnaire,General Self-Efficacy Scale(GSES),Social Support Rating Scale(SSRS),Simplified Coping Style Questionnaire(SCSQ),Zarit Caregiver Burden Interview(ZBI).The data were analyzed by SPSS21.0 statistical software,including descriptive analysis,Mann-Whitney U or Kruskal-Wallis H nonparametric rank sum test,Spearman rank correlation analysis,multiple stepwise regression analysis and repeated measurement variance.Results:1.The level of caregiver burden at different time points(1)The average score of caregiver burden during acute hospitalization was(30.04±12.22),which was at a mild level.The scores of individual burden dimension and responsibility burden dimension were 16.82 ±6.74 and 7.94 ±4.14 respectively.(2)One month after discharge,the average score of caregiver burden was(38.86±13.20),which was slightly above the level.The scores of individual burden dimension and responsibility burden dimension were 21.60 ±7.65 and 10.43 ±3.61 respectively.(3)Three months after discharge,the average score of caregiver burden was(41.74±12.53),which was at a moderate level.The scores of individual burden dimension and responsibility burden dimension were 21.73 ±7.49 and 13.00 ±2.98 respectively.2.The changing trend of caregiver burdenThe score of caregiver burden of the subjects showed an upward trend at three time points as a whole,especially from acute hospitalization to 1 month after discharge,the rising trend was the most obvious,and the difference was statistically significant(P < 0.001).The dimension of individual burden and the dimension of responsibility are also on the rise.3.Influencing factors of caregiving burden at different time points(1)The main factors influencing caregiving burden during acute hospitalization were the patients’ ability of daily living activities,self-care level,payment method of medical expenses and the age of caregivers.(2)The main factors affecting care burden one month after discharge were hemiplegia,aphasia,activities of daily living,caregiver’s place of residence,self-efficacy,social support,coping style and average daily care time.(3)The main factors affecting the burden of care 3 months after discharge were hemiplegia,activities of daily living,level of self-care,place of residence of caregivers,social support and average daily care time.Conclusion:1.The overall level of caregiver burden of family caregivers in patients with firstepisode ischemic stroke was mild to moderate from acute hospitalization to 3 months after discharge.2.The caregiver burden of family caregivers in patients with first-episode ischemic stroke changed with time.The care burden of family caregivers increased gradually from acute hospitalization to 3 months after discharge,and the degree of care burden was different at different time points.The burden of all dimensions of taking care of the burden is also on the rise.3.The care burden of family caregivers in patients with first-episode ischemic stroke is affected by many factors,including the ability of daily living activities,self-care level,hemiplegia,social support,daily care time and other factors.Attention should be paid to strengthen the intervention of stroke patients with low activities of daily living,low level of self-care,hemiplegic stroke patients and family caregivers with low level of social support and long daily care time,so as to reduce the caregiver burden.4.The main influencing factors of care burden of family caregivers of patients with firstepisode ischemic stroke are different in different periods,which suggests that medical staff should pay attention to identify the factors that affect care burden in different periods,and then take targeted intervention measures. |
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