Effect of main family caregiver\u2019s anxiety and depression on mortality of patients with moderate-severe stroke

Jianting Zhao,Jianhua Xu,Ping Chen,Yujun Chen,Jianping Yu,Yulong Ma,Jing Li,Zhilei Zeng

doi:10.1038/s41598-021-81596-8

Abstract

Anxiety and depression are common mental illness in stroke caregivers, resulting in significant stress to the emotion health of caregivers. Caregivers’ emotion can seriously affect the recovery rate of stroke patient, therefore, how to control and affect the caregivers’ anxiety and depression is of great importance. Here three multiple centers observation and validation study were performed to screen out the risk factors for development of anxiety and depression in main family caregiver, and the effect of anxiety and depression of family caregivers on 6-month mortality of patients with moderate-severe stroke. The severity of the stroke, the duration of care time and the medical payment associated with increased risk of anxiety and depression. Anxiety and depression of main family caregivers are associated with increased risk 6-month mortality of patients with moderate-severe stroke. Therefore, the support provided to the family caregivers might have positive effect on prognosis of the patients with stroke.

Highlights

Stroke is the dominant leading cause of death and disability among Chinese adults for recent 3 d ecades[1]
A total of 1018 patients with first-ever stroke lived at home after discharge (NIHS ≥ 6) were included from four multicenter, 42 patients refused to participate in the study, 46 patients met exclusion criteria, 111 paired caregivers were excluded because they met 1 or more of the other exclusion criteria (Fig. 1), the remaining 819 caregivers (249 male; 570 female) were recruited in this study, and the mean age was 55.64 ± 10.09 years (18–88 years)
To further analyze the risk factors for the anxiety of main family caregivers, multivariable logistic regression was performed, after adjusting for caregivers’ age, National Institutes of Health Stroke Scale (NIHSS), duration of care time, sex, education, care time per day > 8 h, self-finance, relationship to the patients, household income, the results showed that NIHSS, duration of care time(aOR, 1.03; 95% confidence intervals (CI), 1.02–1.04; < 0.001),care time per day > 8 h, self-finance were associated with increased risk of anxiety

Summary

Introduction

Stroke is the dominant leading cause of death and disability among Chinese adults for recent 3 d ecades[1]. The main caregivers must have to take care of the patients’ physical and daily activities, including communication and emotional support. The long-time care process may cause great psychological pressure on the family caregivers, while it brings a heavy burden, the anxiety and depression introduced silently[5,6]. The prevalence of anxiety and depressive symptoms for main caregivers of patients with stroke have been reported to 30%-45% and 20–50%, r espectively[5,11,12]. Many studies suggested that the anxiety or depressive symptoms of caregivers have a negative impact on caregivers’ socioeconomic status, physical health and quality of life[13,14,15]. When main caregivers are in a state of anxiety or depression, they may not provide valuable support

Methods

Results

Discussion

Conclusion