Psychosocial Impact of Stroke on Family Caregivers

中风是美国成年人残疾的主要原因，大约有4，000，000美国人 是中风幸存者，他们生活在中风后的损伤中。绝大多数中风幸存者生活在 家庭，在那里他们通常得到家庭成员的大量照顾和帮助。前几 对中风幸存者的家庭照顾者的研究表明，照顾者往往有较高的水平， 中风后急性期和慢性期的抑郁症。然而，这些研究 通常是基于小方便的样本，往往缺乏足够的比较， 组实际上没有关于家庭照顾者之间潜在的民族或种族差异的资料 中风幸存者这项拟议中的调查将比较300名中风幸存者的家庭照顾者和一名 配对样本300名非照顾者的抑郁，生活满意度，身体健康，健康 护理利用、生活质量和生活压力。两组中至少有一半的参与者将 非裔美国人照顾者和非照顾者都将从同一个国家招募， 脑卒中发病率的流行病学研究（N = 30，000）。计算机辅助电话面试将 用于跟踪照顾者和非照顾者随时间的心理社会适应，以及家庭评估 将用于评估卒中幸存者损伤和卒中特异性生活质量。 该项目的具体目标是（1）确定中风对抑郁，生活满意度， 主要家庭照顾者的身体健康、卫生保健利用和生活质量;（2）比较 非裔美国人和白色家庭照顾者之间的相互影响;（3）跟踪中风的影响 （4）检验社会支持、压力评定和家庭照料者的影响。 获得护理的中介照顾者抑郁，身体健康和生活满意度的种族差异; (5)评估照顾者抑郁、生活质量和压力评估对身体的影响， 和情绪恢复的中风幸存者，（6）建立一个多变量预测模型， 家庭照顾者的结果，用于规划未来的干预工作。以前的研究表明 照顾者的抑郁和适应不良不仅影响照顾者本身， 会导致中风幸存者的预后不良。拟议项目将推动 了解这些机制，并为未来的干预工作提供有益的启示。

Stroke is the leading cause of adult disability in the United States, Approximately 4,000,000 Americans are stroke survivors who are living with post-stroke impairments. A large majority of stroke survivors live at home, where they typically receive substantial care and assistance from family members. Several previous studies of the family caregivers of stroke survivors have shown that caregivers tend to have elevated levels of depression during both the acute and chronic phases after the stroke. However, these studies have usually been based on small convenience samples and often lack adequate comparisons to noncaregiving groups. Virtually no information is available on potential ethnic or racial differences among family caregivers of stroke survivors. The proposed investigation will compare 300 family caregivers of stroke survivors to a matched sample of 300 noncaregivers on measures of depression, life satisfaction, physical health, health care utilization, quality of life, and caregiving stress. At least half of the participants in both groups will be African Americans. Both caregivers and noncaregivers will be recruited from the same national, epidemiological study of stroke incidence (N = 30,000). Computer-assisted telephone interviewing will be used to track psychosocial adjustment over time in caregivers and noncaregivers, and in-home evaluations will be used to obtain assessments of stroke survivor impairments and stroke-specific quality of life. The specific aims of the project are (1) to identify the effects of stroke on the depression, lifesatisfaction, physical health, health care utilization, and quality of life of primary family caregivers; (2) to compare the effects of caregiving between African American and White family caregivers; (3) to track the effects of stroke on family caregivers longitudinally; (4) to test the effects of social support, stressfulness appraisals, and access to care for mediating racial differences in caregiver depression, physical health, and life satisfaction; (5) to assess the impact of caregiver depression, quality of life, and stressfulness appraisals on the physical and emotional recovery of the stroke survivor, and (6) to develop a multivariate predictive model of poor outcome in family caregivers for use in planning future intervention efforts. Previous studies have suggested that depression and poor adjustment among caregivers not only affect the caregivers themselves, but also contribute to poor outcomes among the stroke survivors. The proposed project will advance the understanding of these mechanisms, and provide useful implications for future intervention efforts.