FAMILY FUNCTION, STROKE RECOVRY, AND CAREGIVER OUTCOMES

在美国估计的四百万中风幸存者中， 在美国，大约66%的人患有中度至重度损伤。家庭 照顾者在中风幸存者的康复中起着重要作用， 康复方面;然而，照顾者可能会遇到负面影响， 心理和身体后果，包括死亡风险增加。的 家庭功能和卒中特征等因素的影响 幸存者（例如记忆和行为问题）对护理者结局和卒中的影响 幸存者的身体康复情况尚不清楚。由于变量 中风恢复过程的轨迹，前瞻性的纵向设计 基于实力-脆弱性模型，将用于研究 170例脑卒中后第一年存活者的样本 中风这一创新性建议是对一项国家方案的补充性次级研究。 临床试验，“生殖力限制诱导治疗评价（EXCITE）” 根据RFA NR-4-00-003开发。子研究的目的是： (1)确定家庭照顾者结果之间的关系（抑郁， 疲劳和整体健康）、家庭功能和中风幸存者的身体状况 随着时间的推移，功能和记忆/行为问题，（2）确定 中风后大约一年的护理结果，以及（3）检查 家庭功能和EXCITE治疗组对卒中的相互作用 幸存者功能恢复将在基线（3-6个月）时收集数据 中风后），以及四个月和八个月后，通过亲自施用 问卷调查和半结构化访谈。成本效益战略将 将联合收割机前瞻性收集的护理人员数据与卒中幸存者数据相结合 用于EXCITE临床试验。确定最突出的 与照顾者抑郁、疲劳和健康状况相关的因素 不同的恢复点对于未来的开发和测试至关重要， 干预措施，以改善照顾者和中风幸存者的结果。

Of the estimated four million stroke survivors in the United States, approximately 66% live with moderate to severe impairment. Family caregivers have a major role in stroke survivors' recovery including all aspects of rehabilitation; however, caregivers may experience negative psychological and physical outcomes including increased risk of mortality. The effects of factors such as family functioning and characteristics of the stroke survivor (e.g. memory and behavior problems) on caregiver outcomes and stroke survivors' physical recovery are not well understood. Because of the variable trajectory of the stroke recovery process, a prospective longitudinal design based on the strength-vulnerability model will be used to study outcomes in a sample of 170 caregiver-stroke survivor dyads during the first year post stroke. This innovative proposal is a complementary sub-study to a national clinical trial, "Extremity Constraint Induced Therapy Evaluation (EXCITE)" developed in response to RFA NR-4-00-003. The purposes of the sub-study are to: (1) determine relationships among family caregiver outcomes (depression, fatigue and overall health), family functioning, and stroke survivor physical function and memory/behavior problems over time, (2) determine predictors of caregiver outcomes approximately one year post-stroke, and (3) examine the interaction of family function and the EXCITE treatment group on stroke survivor functional recovery. Data will be collected at baseline (3-6 months post-stroke), and four and eight months later via in-person administration of questionnaires and a semi-structured interview. A cost-effective strategy will combine prospectively collected caregiver data with stroke survivor data collected for the EXCITE clinical trial. Identification of the most salient factors associated with caregiver depression, fatigue, and health status at different points in recovery is essential for future development and testing of interventions to improve outcomes of caregivers and stroke survivors.