Health-related quality of life predictors for patients with stroke: A prospective longitudinal study of matched pairs of patients with stroke and family caregivers

J Clin Nurs. 2024 May 8. doi: 10.1111/jocn.17173. Online ahead of print.

Abstract

Background: Patients with stroke require long-term rehabilitation for functional recovery and daily activities. The health-related quality of life (HRQOL) of patients with stroke may deteriorate because of family caregivers' nonpreparedness and increased role burden.

Aim(s): To investigate how caregivers' preparedness and sense of competence predict the HRQOL of patients with stroke.

Design: A prospective longitudinal study.

Methods: The study population comprised patients with stroke who were hospitalized for rehabilitation and their family caregivers. A total of 158 patient-family caregiver dyads were recruited from June to September 2021. Data were collected at the initiation of rehabilitation therapy and upon discharge. Information about the characteristics of the family caregivers and patients with stroke and about the former's preparedness and sense of competence were collected at baseline. Furthermore, the HRQOL of patients with stroke was measured at baseline and upon discharge to evaluate the change.

Results: This study of matched pairs of patients and family caregivers demonstrated that the latter's caregiving preparedness and sense of competence predicted positive changes in patients' HRQOL. Family caregivers who were satisfied with their care recipients (patients) and had better recognition of the consequences of care involvement better predicted changes in patients' HRQOL.

Conclusion: The findings of this study indicate the importance of family caregivers' caregiving preparedness and sense of competence in predicting changes in patients' HRQOL.

Implications for patient care: Clinically, the findings of this study highlight the importance of assessing and supporting family caregivers in developing a strong caregiving preparedness and sense of competence and in understanding the implications of their role as caregivers as it may help improve patients' HRQOL. The integration of interventions that enhance caregiver satisfaction and awareness into clinical practice may result in a more comprehensive and effective patient care. WHAT IS ALREADY KNOWN ABOUT THIS TOPIC?: Previous studies have demonstrated that the health-related quality of life (HRQOL) of patients with stroke is influenced by sociodemographic factors, such as sex, age, marital status, pain, cognitive ability and activities of daily living. A substantial association was observed between caregivers' preparedness and the HRQOL of patients with stroke. However, few studies have examined the association between caregivers' sense of competence and the HRQOL of patients with stroke.

Implications for practice: The present study indicated that clinical nursing activity must include assessment and intervention of family caregivers to improve the HRQOL of patients with stroke. The family caregivers of patients with stroke hospitalized in the post-stroke period may experience a sense of sacrifice and limitation in their personal lives. Clinical nursing practice should assess family caregivers' caregiving preparedness and sense of competence to improve the HRQOL of patients with stroke.

Reporting method: This study adhered to the relevant EQUATOR guidelines and named the reporting method.

Keywords: caregivers; preparedness; quality of life; role burden; stroke.