FAMILY FUNCTION, STROKE RECOVRY, AND CAREGIVER OUTCOMES

在美国估计有400万中风幸存者中 在美国，大约66%的人生活在中度到严重的损害中。家庭 护理者在中风幸存者的康复中发挥着重要作用，包括所有 康复的方方面面；然而，照顾者可能会经历负面 心理和身体后果，包括死亡风险增加。这个 家庭功能和卒中特征等因素的影响 幸存者(如记忆和行为问题)对照顾者结局和中风的影响 幸存者的身体恢复情况还没有得到很好的理解。因为变量 中风恢复过程的轨迹，前瞻性的纵向设计 基于强度-脆弱性模型将被用于研究 第一年期间170名照顾者中风幸存者夫妇的样本 卒中。这项创新的建议是对一个全国性研究的补充 临床试验，《肢体束缚诱导治疗评估(EXCEITE)》 为响应RFA NR-4-00-003而开发。分组研究的目的是： (1)确定家庭照顾者结果之间的关系(抑郁症、 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 卒中后大约一年的照顾者结局，以及(3)检查 卒中患者家庭功能与激动组的交互作用 幸存者功能恢复。将在基线(3-6个月)收集数据 中风后)，并在四个月和八个月后通过亲自给药 问卷调查和半结构化访谈。具有成本效益的战略将 将前瞻性收集的护理者数据与中风幸存者数据相结合 为Excite临床试验收集的。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是至关重要的 改善照顾者和中风幸存者预后的干预措施。

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.