Conflict of interest: None declared.
Letter to the Editor
Psychosocial problems, quality of life, and caregiver burden among stroke caregivers in India
Article first published online: 20 DEC 2011
© 2011 The Authors. International Journal of Stroke © 2011 World Stroke Organization
International Journal of Stroke
Volume 7, Issue 1, pages 100–101, January 2012
How to Cite
Raju, R. S., Kaur, P. and Pandian, J. D. (2012), Psychosocial problems, quality of life, and caregiver burden among stroke caregivers in India. International Journal of Stroke, 7: 100–101. doi: 10.1111/j.1747-4949.2011.00721.x
- Issue published online: 20 DEC 2011
- Article first published online: 20 DEC 2011
From November 1, 2008 to February 1, 2010, patients were interviewed after more than one-month poststroke. Anxiety and depression were recorded using the Hospital Anxiety and Depression Scale. The World Health Organization (WHO) Quality of Life Instrument (WHOQOL-Bref) was used, and caregiver burden was evaluated using modified caregiver strain index (modified CSI).
One-hundred fifty-two caregivers participated (mean age 40·5 ± 13·8 years (range 17 to 78); women 104 (68·4%)). Majority of the caregivers (100 (65·8%)) belonged to joint families. Mean duration of follow-up was 18·9 ± 26·7 months (range 1 to 147), and 113 (74·3%) patients had an ischemic stroke. Anxiety was seen in 72 (47%) caregivers and 66 (43%) had depression. The mean transformed scores for the domains of WHOQOL were as follows: physical 57·6 ± 13·5; psychological 62·9 ± 14·7; social 72·6 ± 19·4; and environmental 62·8 ± 17·9.
The mean score for modified CSI was 12·6 ± 6·8 and caregiver strain was seen in 129 (85%) subjects. In the multivariate logistic regression analysis, anxiety was the predictor of caregiver strain (Table 1). Ischemic stroke and WHOQOL psychological domain were the predictors of depression (Table 1).
|Variables||Adjusted odds ratiob||95% CI||P-valuec|
|Psychological domaina||Modified CSI||2·22||1·08–4·54||0·03|
|Type of stroke||0·21||0·08–0·57||0·002|
|Modified CSI||Social domain||0·29||0·11–0·81||0·02|
Anxiety (47%) and depression (43%) frequency was lower in our cohort compared with the Kolkata study from India (anxiety and depression 76%) . The caregivers in our study were found to have high scores on all four domains of WHOQOL in contrast with studies from Nigeria  and the Netherlands , where low scores were observed in caregivers for all the domains of QOL. Despite high scores in QOL, our cohort experienced a high caregiver strain.
The better QOL and low frequency of anxiety and depression could be related to the good social support that caregivers and patients receive in a joint family. This also enables them to cope with a high caregiver strain.
Rinu Susan Raju, Parmdeep Kaur, and Jeyaraj D. Pandian*
Stroke Unit, Department of Neurology, Christian Medical College, Ludhiana, Punjab, India