Burden, anxiety and depressive symptoms in partners – course and predictors during the first two years after stroke

Figures & data

Table 1. Partners’ and patients’ baseline characteristics (N = 215 dyads).

Partner characteristics		Mean (SD)	n (%)
Age in years, mean (SD)		62.6 (10.8)
Male sex			47 (21.9)
Higher education^a (n = 198)			56 (28.3)
Patient characteristics		Mean (SD) Median (IQR)	n (%)
Age in years, mean (SD)		64.3 (11.0)
Male sex			169 (78.6)
Higher education^a (n = 210)			65 (31.0)
Ischemic stroke			204 (94.9)
Recurrent stroke			26 (12.1)
Stroke severity (NIHSS), median (IQR)		2.0 (3.0)
No stroke symptoms (NIHSS 0)			51 (23.7)
Minor stroke symptoms (NIHSS 1–4)			120 (55.8)
Moderate stroke symptoms (NIHSS 5–12)			37 (17.2)
Moderate to severe symptoms (NIHSS > 12)			7 (3.3)
ADL independence (Barthel Index), median (IQR)		20.0 (4.0)
ADL-dependent (Barthel Index < 19)			78 (36.3)
Cognitive functioning (MoCA) (n = 192), median (IQR)		24.0 (5.8)
Cognitively impaired (MoCA < 26) (n = 192)			122 (63.5)
Destination after discharge from hospital
Home			163 (75.8)
Rehabilitation center			34 (15.8)
Nursing home			18 (8.4)

a Completed upper level secondary school and/or university degree.

NIHSS: National Institutes of Health Stroke Scale; ADL: activities of daily living; MoCA: Montreal Cognitive Assessment.

Table 2. Partners’ burden, anxiety and depressive symptoms.

	n	Mean	Standard deviation	Above cutoff*n (%)
Burden (CSI) [Possible range: 0–13]
2 months	192	4.0	3.3	46 (24.0)
6 months	193	4.1	3.3	47 (24.4)
1 year	181	4.0	3.3	41 (22.7)
2 year	176	4.2	3.4	44 (25.0)
Anxiety (HADS-A) [Possible range: 0–21]
2 months	193	5.5	4.0	58 (30.1)
6 months	193	4.7	3.6	40 (20.7)
1 year	182	4.8	3.6	35 (19.2)
2 year	176	5.6	4.0	51 (29.0)
Depressive symptoms (HADS-D) [Possible range: 0–21]
2 months	193	3.1	3.1	22 (11.9)
6 months	193	3.3	3.4	25 (13.0)
1 year	182	3.3	3.2	23 (12.6)
2 year	176	3.6	3.4	27 (15.3)

CSI: Caregiver Strain Index; HADS-A: Hospital Anxiety and Depression Scale-Anxiety subscale; HADS-D: Hospital Anxiety and Depression Scale-Depression subscale.* cutoff points CSI ≥ 7, HADS-A > 7, HADS-D > 7.

Table 3. Predictors of partner’s burden, anxiety and depressive symptoms.

	Burden		Anxiety		Depressive symptoms
Predictors	Estimate (95% CI)	p-value	Estimate (95% CI)	p-value	Estimate (95% CI)	p-value
Intercept	4.35 (−0.39; 9.10)	0.072	5.74 (0.61; 10.87)	0.028	2.83 (−1.08; 6.74)	0.156
Time (months)	0.01 (−0.01; 0.04)	0.246	−0.23 (−0.43; −0.03)	0.023	0.01 (−0.01; 0.02)	0.341
Quadratic effect of time	-		0.01 (0.00; 0.01)	< 0.001	-
Cubic effect of time	-		-		-
Partner characteristics
Age in years	−0.03 (−0.06; 0.00)	0.049	−0.03 (−0.06; 0.01)	0.155	0.04 (0.01; 0.06)	0.006
Age in years*time	-		0.00 (0.00; 0.00)	0.308	-
Male sex	−0.39 (−1.12; 0.35)	0.303	−0.25 (−0.99; 0.50)	0.512	0.21 (−0.41; 0.84)	0.505
Male sex*time	-		-		-
Higher education	0.86 (0.17; 1.55)	0.014	0.08 (−0.62; 0.78)	0.819	−0.10 (−0.68; 0.49)	0.745
Higher education*time	-		-		-
Burden (CSI)			0.28 (0.19; 0.36)	< 0.001	0.16 (0.09; 0.24)	< 0.001
Burden (CSI)*time			-		-
Anxiety (HADS-A)	0.22 (0.15; 0.29)	< 0.001			0.42 (0.36; 0.48)	< 0.001
Anxiety (HADS-A)*time	-				-
Depressive symptoms (HADS-D)	0.18 (0.10; 0.27)	< 0.001	0.56 (0.48; 0.64)	< 0.001
Depressive symptoms (HADS-D)*time	-		-
Proactive coping (UPCC)	0.01 (−0.69; 0.72)	0.967	−0.04 (−0.86; 0.79)	0.930	−1.27 (−1.86; −0.68)	< 0.001
Proactive coping (UPCC)*time	-		0.01 (−0.02; 0.05)	0.488	-
Self-efficacy (GSES)	0.07 (−0.01; 0.16)	0.096	−0.12 (−0.20; −0.03)	0.006	0.00 (−0.07; 0.07)	0.967
Self-efficacy (GSES)*time	-		-		-
Patient characteristics
Stroke severity (NIHSS)	0.15 (0.02; 0.29)	0.026	-		-
Stroke severity (NIHSS)*time	−0.01 (−0.01; 0.00)	0.108	-		-
ADL independence (BI)	−0.07 (−0.15; 0.02)	0.127	0.02 (−0.06; 0.10)	0.557	0.02 (−0.05; 0.08)	0.642
ADL independence (BI)*time	-		-		-
Cognitive functioning (MoCA)	−0.10 (−0.19; −0.01)	0.027	0.08 (−0.01; 0.17)	0.067	−0.05 (−0.13; 0.02)	0.154
Cognitive functioning (MoCA)*time	-		-		-
Anxiety (HADS-A)	0.09 (0.02; 0.16)	0.013	0.06 (−0.02; 0.13)	0.148	−0.03 (−0.09; 0.04)	0.446
Anxiety (HADS-A)*time	-		-		-
Depressive symptoms (HADS-D)	0.16 (0.10; 0.23)	< 0.001	0.05 (−0.05; 0.15)	0.346	0.08 (0.01; 0.15)	0.019
Depressive symptoms (HADS-D)*time	-		−0.01 (−0.01; 0.00)	0.064	-

CSI: Caregiver Strain Index; HADS-A: Hospital Anxiety and Depression Scale-Anxiety subscale; HADS-D: Hospital Anxiety and Depression Scale-Depression subscale; UPCC: Utrecht Proactive Coping Competence Scale; GSES: General Self-Efficacy Scale; NIHSS: National Institutes of Health Stroke Scale; ADL: activities of daily living; BI: Barthel Index; MoCA: Montreal Cognitive Assessment.