Abstract
Objectives
To identify and describe caregiver profiles based on their psychosocial health characteristics
over a 12-month period and transitions among these profiles, to determine if stroke
rehabilitation use at 12 months post-stroke differed by caregiver profile transition
patterns, and to investigate if caregiver profiles at 3 months post-stroke moderate
the association of stroke rehabilitation use at 3 months and 12 months post-stroke
after accounting for covariates.
Design
Latent profile transition analysis of caregiver psychosocial health with stroke rehabilitation
use at 12 month post-stroke as outcome.
Setting and Participants
A total of 149 stroke patient-caregiver dyads from the Singapore Stroke Study.
Methods
Cross-sectional latent profile analyses were conducted on caregiver psychosocial health
indicators of burden, depression, health status, quality of relationship with patient,
and social support. Changes in latent profile classification over 3 time points (baseline,
3 months, and 12 months post-stroke) were analyzed using latent transition analysis.
A transition model with stroke rehabilitation use at 12 months post-stroke as the
outcome was tested after accounting for covariates.
Results
Two distinct caregiver psychosocial health latent profiles were found across time:
nondistressed and distressed. Most caregivers were classified as nondistressed and
remained nondistressed over time. Distressed caregivers at baseline were 76% likely
to become nondistressed at 12 month post-stroke. Regardless of profile transition
patterns, nondistressed caregivers at 12 months post-stroke tended to have cared for
stroke rehabilitation nonusers at 12 months post-stroke. Patient depression explained
profile classification at 3 months and 12 months post-stroke. After accounting for
covariates, rehabilitation users at 3 months post-stroke tended to continue using
rehabilitation at 12 months post-stroke only when they had nondistressed caregivers
at 3 months post-stroke.
Conclusions and Implications
Whether caregiver adaptation explains the associations between the latent profile
transition patterns and rehabilitation use at 12 months post-stroke should be examined.
Early psychosocial health assessment and sustained support should be made available
to stroke caregivers to enhance their well-being and subsequent patient rehabilitation
participation.
Keywords
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Article info
Publication history
Published online: April 01, 2021
Footnotes
The authors declare no conflicts of interest.
This work was supported by a Health Services Research Competitive Research Grant (Project Number: HSRG/0006/2010) from the National Medical Research Council, Singapore.
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© 2021 AMDA - The Society for Post-Acute and Long-Term Care Medicine.
