Abstract
Introduction: Cerebrovascular accident (CVA), is the first cause of long term disability for adults, with high levels of burden to the patient itself, the family and the National Health System, worldwide The disability to perform daily activities affects the quality of life of stroke survivor and the family’s life. The responsibility of the role, the uncertainty and the lack of control, results in additional burden for the caregivers and affects their health promotion behavior, as well as their physical, mental and social health. The degree of functional disability of the patients to perform everyday activities, affects the caregivers’ health promotion behavior. This condition has a negative effect on caregiver’s health and the whole family.Purpose: The purpose of this study was to assess the burden the depression and the social support of the primary caregivers, as well as the functional ability of the stroke patient at the degree that the specific variables affect the caregivers’ hea ...
Introduction: Cerebrovascular accident (CVA), is the first cause of long term disability for adults, with high levels of burden to the patient itself, the family and the National Health System, worldwide The disability to perform daily activities affects the quality of life of stroke survivor and the family’s life. The responsibility of the role, the uncertainty and the lack of control, results in additional burden for the caregivers and affects their health promotion behavior, as well as their physical, mental and social health. The degree of functional disability of the patients to perform everyday activities, affects the caregivers’ health promotion behavior. This condition has a negative effect on caregiver’s health and the whole family.Purpose: The purpose of this study was to assess the burden the depression and the social support of the primary caregivers, as well as the functional ability of the stroke patient at the degree that the specific variables affect the caregivers’ health promotion behavior.Method: Using purposive sampling, 109 couples of patients and their respective caregivers were recruited from Attica. One of the basic selection criteria was that the patient was facing functional disabilities and the caregivers were members of the family, and also the primary caregivers. The collection of the data was performed by the researcher with home visits. The functional ability of the patients was assessed using the Barthel's scale, the health promotion behaviors and the life style profile ofthe caregivers was assessed using the HPLP II scale and the changes in caregivers’ life, the depression and the social support received were assessed using the following scales, Bakas Caregiving Outcomes Scale (BCOS), CES-D and Personal Resourse Questionnaire (PRQ 2000). For the description of the quantitative variables, the absolute and relative frequencies were used, whereas for the description of the qualitative variables, the average values, the standard deviation, the medians and interquartile ranges were used. For the comparisons, the Student’s t-test and the parametric analysis of variance control (ANOVA) were used. For the test of the correlation of the quantitative variables the Pearson or Spearman(r) factor was used. For the check of type I errors, due to the multiple comparisons, the Bonferroni correction was used, in which the level of importance is 0,05/k (in which k is the number of comparisons). The linear regression analysis was used in order to find independent factors that are related to the scales from which the dependency rates and their standard errors results. The intraclass correlation coeffcients (ICCs) were used in order to study the agreement of the answers given to the questionnaires HPLPII and PRQ 2000. The internal reliability was checked with the coefficient Cronbach’s-alpha. The statistical importance was set as 0,05. For the analysis, the statistical software SPSS V.19.0. was used.Results: The largest percentage of caregivers (67,95%) were women and 50,5%were spouses of the patients, with an average of 58 years of age. A significant percentage (39,4%) were high school or senior high school graduates, 90,6% hadadult children and 53,2% were pensioners. The annual family income was more than 5.000 € for 39,4% of the caregivers and less than 5.000 € for 14,7%. Half of them were taking care of the patient for at least 8 months with a daily average of 13,2 hours. The average age of the patients was 69,3 and most of them were men (51,4%). According to the self-perception of the caregivers, 49,5% of them characterize their health as moderate. The average value on the scale of burden was found to be 48,3, on the scale of depression 21,7, on the scale of social support 77,7 and on the scale of functionality of the patients 44,0. The functionality of the patients was significantly higher when the patients were men. The correlation was negative in relation to the age of the patients (p=<0,001), the number of children (p=0,014) and the total time of caregiving (p=0,009), as well as in relation to the daily hours of caregiving (p=<0,001). There was also, a significant negative correlation of the scale of burden with the scale of depression (r=-0,36,p=<0,001) and a positive correlation of the scale of burden with the scale of social support (r=0,29,p=0,002). The total ranking of the scale HPLP II ranges from 1,69 to 3,17 (Interpersonal relationships 2,66, spiritual growth 2,61, dietary habits 2,25, responsibility for the health 2,25, management of stress 2,04, physical exercise 1,60). Furthermore, there was a significant positive correlation between all the dimensions of the scale. Positive was the correlation of the scale with the level of education of the caregivers (p=0,026) as was the case also with the income (p=0,17). Negative was the correlation of the scale with the time length of the daily caregiving (r=-0,29). Significantly positive correlation was found between the scale HPLP II and the scales: burden (r=0,25, p=0,008), assessment of the functionality (r=0,24,p=0,011) and social support (r=0,49,p=<0,001). The scale of social support had a significantly positive correlation with all the dimensions of the promotion of health. In the contrary, the correlation of the scale HPLP II with the scale of depression was not significantConclusions: The health promotion behavior of the caregiver is mainly affected by the functional ability of the patient, the burden and the social support, and less affected by the depression symptoms. The many hours of caregiving as well as the low educational level and the low income, negatively affect the way of life and the caregivers’ health behavior of the patients having suffered a stroke. The caregivers do not take part in activities that are related to physical exercise. The present study was a first approach to the subject of the health promotion behavior of the Greek family of patients that have survived a stroke and live in the community. The results of the study can be used by nurses in the community in order to support family caregivers, by implementing personal and group health educational programs, counseling and social support actions at the level of primary health care.
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