Exploring Caregiving Burden and Family Resilience Among Caregivers of Young and Middle-Aged Stroke Survivors in China

Bei Zhu; Mohamed Saifulaman Mohamed Said; Beng Geok Tan

doi:10.25163/angiotherapy.889967

Angiogenesis, Inflammation & Therapeutics | Online ISSN 2207-872X

RESEARCH ARTICLE (Open Access)

Previous Next Contents Vol 8 (8)

Exploring Caregiving Burden and Family Resilience Among Caregivers of Young and Middle-Aged Stroke Survivors in China

Bei Zhu ¹, Mohamed Saifulaman Mohamed Said ¹*, Beng Geok Tan ²

+ Author Affiliations

Journal of Angiotherapy 8 (8) 1-9 https://doi.org/10.25163/angiotherapy.889967

Submitted: 01 July 2024 Revised: 11 August 2024 Published: 13 August 2024

Abstract

Background: Stroke, characterized by high morbidity, disability, and mortality, has increasingly affected younger populations. In China, the proportion of strokes among individuals aged 40-64 has risen significantly. This study explored the caregiving burden and family resilience among caregivers of young and middle-aged first-stroke survivors, comparing caregivers of those with good versus poor functional outcomes. Methods: A cross-sectional survey was conducted from January to June 2024, involving 119 family caregivers of stroke survivors from two tertiary hospitals in Yancheng City, Jiangsu Province, China. Data were collected using the Modified Rankin Scale (mRS), Zarit Burden Interview (ZBI), and the Family Resilience Assessment Scale (FRAS-C). Independent t-tests and Pearson's correlation analysis were performed to examine differences in care burden and family resilience between caregiver groups. Results: Caregivers had an average ZBI score of 28.32±20.66, with 39.5% reporting no or minimal burden, 29.4% light burden, and 25.2% moderate burden. Caregivers of patients with mRS 0-2 had significantly lower care burdens (23.84 vs. 37.17, p<0.01) and higher family resilience (98.22 vs. 93.00, p<0.05) compared to those with mRS 3-5. Care burden was negatively correlated with family resilience (r=-0.243, p=0.008). Conclusion: Caregivers of young and middle-aged stroke survivors generally experienced mild to moderate care burden, while family resilience was moderate. Caregivers of survivors with better functional outcomes had lower care burdens and higher family resilience. These findings highlight the need for targeted interventions to support caregivers of survivors with poorer functional outcomes to enhance family resilience and reduce care burden.

Keywords: Caregiving burden, Family resilience, Stroke survivors, Young adults, China

References

Achilike, S., Beauchamp, J. E. S., Cron, S. G., Okpala, M., Payen, S. S., Baldridge, L., Okpala, N., Montiel, T. C., Varughese, T., Love, M., Fagundes, C., Savitz, S., & Sharrief, A. (2020). Caregiver Burden and Associated Factors Among Informal Caregivers of Stroke Survivors. The Journal of neuroscience nursing : journal of the American Associat ion of Neuroscience Nurses, 52(6), 277-283. doi:10.1097/jnn.0000000000000552

Chen, C. M., Du, B. F., Ho, C. L., Ou, W. J., Chang, Y. C., & Chen, W. C. (2018). Perceived Stress, Parent-Adolescent/Young Adult Communication, and Family Resilience Among Adolescents/Young Adults Who Have a Parent With Cancer in Taiwan: A Longitudinal Study. Cancer Nurs, 41(2), 100-108. doi:10.1097/ncc.0000000000000488

Collaborators, G. S. (2021). Global, regional, and national burden of stroke and its risk factors, 1990-2019: a systematic analysis for the Global Burden of Disease Study 2019. Lancet Neurol, 20(10), 795-820. doi:10.1016/s1474-4422(21)00252-0

Cui, P., Shi, J., Li, S., Getu, M. A., Wang, R., & Chen, C. (2023). Family resilience and its influencing factors among advanced cancer patients and their family caregivers: a multilevel modeling analysis. BMC Cancer, 23(1), 623. doi:10.1186/s12885-023-11101-z

Fang, L., Dong, M., Fang, W., & Zheng, J. (2022). Relationships between care burden, resilience, and depressive symptoms among the main family caregivers of stroke patients: A cross-sectional study. Front Psychiatry, 13, 960830. doi:10.3389/fpsyt.2022.960830

Go, A. S., Mozaffarian, D., Roger, V. L., Benjamin, E. J., Berry, J. D., Blaha, M. J., Dai, S., Ford, E. S., Fox, C. S., Franco, S., Fullerton, H. J., Gillespie, C., Hailpern, S. M., Heit, J. A., Howard, V. J., Huffman, M. D., Judd, S. E., Kissela, B. M., Kittner, S. J., Lackland, D. T., Lichtman, J. H., Lisabeth, L. D., Mackey, R. H., Magid, D. J., Marcus, G. M., Marelli, A., Matchar, D. B., McGuire, D. K., Mohler, E. R., 3rd, Moy, C. S., Mussolino, M. E., Neumar, R. W., Nichol, G., Pandey, D. K., Paynter, N. P., Reeves, M. J., Sorlie, P. D., Stein, J., Towfighi, A., Turan, T. N., Virani, S. S., Wong, N. D., Woo, D., & Turner, M. B. (2014). Heart disease and stroke statistics--2014 update: a report from the American Heart Association. Circulation, 129(3), e28-e292. doi:10.1161/01.cir.0000441139.02102.80

Group., R. o. s. p. a. t. i. C. W., & Wang, L. D. (2020). Brief report on stroke prevention and treatment in China, 2019. Chinese Journal of cerebrovascular disases, 17, 272-281. doi:10.3969/i.issn.1672-5921.2020.05.008 in chinese]

Hodson, T., Gustafsson, L., & Cornwell, P. (2019). Unveiling the complexities of mild stroke: An interpretative phenomenological analysis of the mild stroke experience. Aust Occup Ther J, 66(5), 656-664. doi:10.1111/1440-1630.12607

Hu, P., Yang, Q., Kong, L., Hu, L., & Zeng, L. (2018). Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients. Medicine (Baltimore), 97(40), e12638. doi:10.1097/md.0000000000012638

Kumar, R., Kaur, S., & Reddemma, K. (2015). Burden and coping strategies in caregivers of stroke survivors. J Neurol Neurosci, 6(5), 1-5. doi:10.21767/2171-6625.S10005

L, W., XS, Y., Z, H., & QL, F. (2006). Application and evaluation of the Chinese version of the caregiver burden scale. Chinese Journal of Public Health, 22(8), 970-972. doi:1001-0580( 2006) 08-0970-03 in chinese]

Li, Q., Luo, C., Ye, J., Bian, Z., Sun, W., Zhou, M., & Rong, M. (2024). Relationship Between Illness Uncertainty and Family Resilience Among Caregivers of Stroke Patients in Chinese Nuclear Families: The Mediating Role of Perceived Stress. Patient Prefer Adherence, 18, 1095-1105. doi:10.2147/ppa.S463562

Li, X., & Li, H. (2021). Reliability and validity of the Chinese version of the Revised Walsh family resilience questionnaire. Ann Palliat Med, 10(8), 8709-8717. doi:10.21037/apm-21-1152

Li, Y., Wang, K., Yin, Y., Li, Y., & Li, S. (2018). Relationships between family resilience, breast cancer survivors' individual resilience, and caregiver burden: A cross-sectional study. International journal of nursing studies, 88, 79-84. doi:10.1016/j.ijnurstu.2018.08.011

Lu, Y. (2024). Independent predictors of family resilience in patients with ischemic stroke: A cross-sectional survey. Heliyon, 10(3), e25062. doi:10.1016/j.heliyon.2024.e25062

Ma, Q., Li, R., Wang, L., Yin, P., Wang, Y., Yan, C., Ren, Y., Qian, Z., Vaughn, M. G., McMillin, S. E., Hay, S. I., Naghavi, M., Cai, M., Wang, C., Zhang, Z., Zhou, M., Lin, H., & Yang, Y. (2021). Temporal trend and attributable risk factors of stroke burden in China, 1990-2019: an analysis for the Global Burden of Disease Study 2019. Lancet Public Health, 6(12), e897-e906. doi:10.1016/s2468-2667(21)00228-0

Maurovic, I., Liebenberg, L., & Feric, M. (2020). A review of family resilience: Understanding the concept and operationalization challenges to inform research and practice. Child Care in Practice, 26(4), 337-357. doi:10.1080/13575279.2020.1792838

Ning, X., Sun, J., Jiang, R., Lu, H., Bai, L., Shi, M., Tu, J., Wu, Y., Wang, J., & Zhang, J. (2017). Increased Stroke Burdens Among the Low-Income Young and Middle Aged in Rural China. Stroke, 48(1), 77-83. doi:10.1161/strokeaha.116.014897

Park, M., Choi, E. K., Lyu, C. J., Han, J. W., & Hahn, S. M. (2022). Family resilience factors affecting family adaptation of children with cancer: A cross-sectional study. Eur J Oncol Nurs, 56, 102078. doi:10.1016/j.ejon.2021.102078

Sardar, A., Shahzad, K., Arshad, A. R., Shabbir, K., & Raza, S. H. (2022). Correlation Of Caregivers' Strain With Patients' Disability In Stroke. J Ayub Med Coll Abbottabad, 34(2), 326-330. doi:10.55519/jamc-02-9488

Shamoun, C., & Harris, M. A. (2022). Impact of Stroke Survivors' Physical Disability on the Presence of Caregiver Burden: A Systematic Review. The Journal of neuroscience nursing : journal of the American Associat ion of Neuroscience Nurses, 54(4), 146-150. doi:10.1097/jnn.0000000000000651

Sixbey, M. T. (2005). Development of the family resilience assessment scale to identify family resilience constructs: University of Florida.

Tu, W. J., & Wang, L. D. (2023). China stroke surveillance report 2021. Mil Med Res, 10(1), 33. doi:10.1186/s40779-023-00463-x

Ugur, H. G., & Erci, B. (2019). The Effect of Home Care for Stroke Patients and Education of Caregivers on the Caregiver Burden and Quality of Life. Acta Clin Croat, 58(2), 321-332. doi:10.20471/acc.2019.58.02.16

Walsh, F. (1996). The concept of family resilience: crisis and challenge. Fam Process, 35(3), 261-281. doi:10.1111/j.1545-5300.1996.00261.x

Yuda, T. K., & Munir, M. (2023). Social insecurity and varieties of family resilience strategies during the COVID-19 pandemic. International Journal of Sociology Social Policy, 43(7/8), 756-776. doi:10.1108/IJSSP-08-2022-0201

Yuliana, S., Yu, E., Rias, Y. A., Atikah, N., Chang, H. J., & Tsai, H. T. (2023). Associations among disability, depression, anxiety, stress, and quality of life between stroke survivors and their family caregivers: An Actor-Partner Interdependence Model. J Adv Nurs, 79(1), 135-148. doi:10.1111/jan.15465

Zarit, S. H., Todd, P. A., & Zarit, J. M. J. T. G. (1986). Subjective burden of husbands and wives as caregivers: a longitudinal study. 26(3), 260-266.

Zhang, W., Feng, X., Zhang, H., & Sun, J. (2023). Family resilience experience of young and middle?aged stroke patients: a qualitative study. Chinese nursing research, 37(4), 717-721. doi:10.12102/i.issn.1009-6493.2023.04.029 [in chinese]

Zhang, W., Zhou, W., Ye, M., Gao, Y., & Zhou, L. (2022). Family resilience of stroke survivors within 6 months after a first-episode stroke: A longitudinal study. Front Psychiatry, 13, 968933. doi:10.3389/fpsyt.2022.968933

Zhou, J., He, B., He, Y., Huang, W., Zhu, H., Zhang, M., & Wang, Y. (2020). Measurement properties of family resilience assessment questionnaires: a systematic review. Family Practice, 37(5), 581-591.

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