Strain and Burden among Caregivers of Stroke Survivors in Punjab: A Cross-Sectional Study

Abstract

Introduction: Caregivers may feel stressed and burdened while caring for a stroke survivor. However, very few studies have assessed the burden among caregivers of Indian stroke patients. Objectives: The present study was done to assess the magnitude and predictors of strain and burden among caregivers of stroke survivors discharged from a tertiary care hospital in Punjab, India. Method: This cross-sectional study included consecutive newly diagnosed stroke patients from January 2021 till April 2022 at a tertiary care teaching hospital in Amritsar, India. The level of strain and burden among the caregivers was assessed using the Caregiver’s strain index (CSI) and Zarit Caregiver Burden Scale (ZCBS) respectively. A minimum sample size of 110 stroke patients was calculated. Odds ratios were calculated for identifying predictors of strain and burden among caregivers using multivariate regression analysis. Results: Mean CSI for all caregivers was 6.67 ± 1.81. Using a cut-off of ≥ 7, authors found 40.2% of the caregivers to have great strain. Modified rankin scale (mRS) at the time of interview (AOR = 2.77, p value = 0.0063), presence of comorbidities in the patient (AOR = 3.07, p value = 0.023 and caregiver being female (AOR = 2.96, p value = 0.036) to be significantly associated with higher odds of having great strain. Using ZCBS, 18.1% had minimal burden, 53.5% had mild to moderate burden, 24.4% had moderate to severe burden and 3.9% had severe burden. mRS at the time of interview (AOR = 5.38, p value = 0.0048), presence of comorbidities in the patient (AOR = 7.63, p value = 0.0031), caregiver being female (AOR = 9.67, p value = 0.0072) and not being at all confident to care (AOR = 4.94, p value = 0.013) to be significantly associated with higher odds of having great burden, while rural residence (AOR = 0.55, p value = 0.0011) was associated with lower odds of high burden. Conclusion: High strain was observed among 40.1% of the care givers of Indian stroke survivors and 24.4% had moderate to severe burden. Thus, the strain and burden among caregivers of Indian stroke patients is very high.