THE EFFECT OF CAREGIVER EDUCATION PROGRAM ON FUNCTIONAL INDEPENDENCE AND MORTALITY IN FIRST-EVER STROKE

Abstract

Background: At present, the management of stroke focuses not only on the acute stage of saving the penumbra but also on the secondary prevention of managing the potential sequel following stroke, preventing the occurrence of another attack, and improving the quality of life. Continuous role of caregivers in supporting stroke survivor after passing the acute phase is therefore invaluable. Caregiver education program (CEP) was routinely used as a part of discharge plan on acute stroke patients in stroke unit in Indonesia. This study aims to evaluate the effect of CEP as one of stroke rehabilitation modalities using a historical data that still correlated to the practice in stroke unit nowadays. Methods: A single-blinded randomized controlled trial was performed on 172 subjects of first-ever stroke with no other comorbidities and not having invasive treatment on the recruitment time. The subjects were randomly allocated into two groups: a group receiving CEP (n=88) as the experiment group and a control group (n=84). A four-session CEP, held since the second week of admission by interactive discussion using overhead projector and poster, was performed by a neurologist to the caregiver member of experiment group stroke survivor. The outcome of functional independence and mortality on the third month post-onset was assessed using Barthel activity daily living (ADL) index and the mortality report, respectively. Results: No statistical difference was found on the baseline of the two groups. CEP significantly increased the functional independence (RR=1.30, 95% CI 1.03-1.63) of stroke survivor. Despite the insignificant effect on three-month survival, the group receiving CEP had less mortality rate over time. Conclusion: Caregiver education program had a positive outcome on the patient’s functional independence. Thus, it improves the quality of life.