Depressive symptoms in caregivers immediately after stroke

ABSTRACT

Background: Caregivers of stroke survivors often suffer depressive symptoms that interfere with their own health. Early recognition may lead to attenuation of symptoms and better health and well-being for caregivers.

Objective: We examined characteristics of caregivers and stroke survivors associated with caregivers’ depressive symptoms in the early poststroke period.

Methods: We conducted a prospective, longitudinal exploratory observational study with a convenience sample of 63 caregivers of older adult (≥ 65 years) stroke survivors recruited from urban acute-care settings. We enrolled caregivers by 2 weeks poststroke (T1) and revisited them 4 weeks later (T2). Depressive symptoms were measured using the Patient Health Questionnaire-9. A separate unadjusted linear mixed model was computed to explore significant associations between each caregiver or stroke-survivor characteristic and depressive symptoms.

Results: Caregivers, on average, reported mild depressive symptoms at T1 and T2. Each of the following characteristics was independently associated with caregiver depressive symptoms over the first 6 weeks poststroke: caregiver uncertainty (p < 0.001), perceived stress (p < 0.001) but not cortisol levels (p = 0.858 on waking, p = 0.231 evening), coping (p < 0.001), social support (p = 0.006), race (p = 0.022), income (p = 0.001), time spent on care (p = 0.039), and stroke-survivor race (p = 0.033) and functional status (p = 0.003). At T2, caregiver depressive symptoms were correlated with evening cortisol level (p = 0.001).

Conclusions: Caregiver and stroke-survivor characteristics may help identify caregivers at highest risk for early depressive symptoms and guide interventions aimed at their resolution.

KEYWORDS:

• Caregivers
• coping
• cortisol
• depression
• depressive symptoms
• stroke
• stress
• uncertainty

Acknowledgments

This study was supported by grants from the John A. Hartford Foundation’s Patricia G. Archbold Scholars Award Program; National Institutes of Health/National Institute of Nursing Research (T32NR009356); Neuroscience Nursing Foundation; Sigma Theta Tau International Xi Chapter; and the Frank Morgan Jones Fund. We acknowledge the current funding for Eeeseung Byun by the National Institutes of Health/National Institute of Nursing Research (K23NR017404).

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Funding

This work was supported by the John A. Hartford Foundation;National Institute of Nursing Research [K23NR017404]; National Institute of Nursing Research [T32NR009356]; Neuroscience Nursing Foundation; Frank Morgan Jones Fund; Sigma Theta Tau International Xi Chapter.