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400万美国人 是中风幸存者，他们生活在中风后的障碍中。绝大多数中风幸存者生活在 在那里，他们通常从家庭成员那里得到实质性的照顾和帮助。之前的几个 对中风幸存者的家庭照顾者的研究表明，照顾者的水平往往较高 在中风后的急性期和慢性期，抑郁症的发生率都很高。然而，这些研究已经 通常是基于小的便利样本，通常缺乏与非照顾的充分比较 组。几乎没有关于家庭照顾者之间潜在的民族或种族差异的信息。 中风幸存者。这项拟议的调查将对300名中风幸存者的家庭照顾者与 300名非照顾者的匹配样本，测量抑郁、生活满意度、身体健康、健康 护理利用、生活质量和护理压力。两组中至少有一半的参与者将是 非裔美国人。照顾者和非照顾者都将从同一个国家招募， 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是 用于跟踪照顾者和非照顾者随时间的心理社会适应情况，以及家庭评估 将用于获得中风幸存者损伤和中风特定生活质量的评估。 该项目的具体目标是(1)确定中风对抑郁、生活满意度、 主要家庭照料者的身体健康、卫生保健利用和生活质量；(2)比较 非裔美国人和白人家庭照顾者之间的照顾效果；(3)追踪中风的影响 (4)测试社会支持、压力评估和 在照顾者抑郁、身体健康和生活满意度方面调解种族差异的获得护理的机会； (5)评估照顾者抑郁、生活质量和压力评估对身体的影响 和卒中幸存者的情绪恢复，以及(6)建立不良的多变量预测模型 对家庭照顾者的结果，用于规划未来的干预工作。此前的研究表明， 照顾者中的抑郁和不良适应不仅影响照顾者本身，而且还 导致中风幸存者预后不良的原因之一。拟议的项目将推进 了解这些机制，并为今后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.