Emotional well-being of close relatives to stroke survivors

Objective: To compare the well-being of stroke patients' relatives with that of a reference group, and to identify variables related to the well-being of the relatives. Design: Cross-sectional study. Setting: Outpatient hospital department and patients' and relatives' own homes. Subjects: Fifty-four patients one year after a stroke and their closest relatives. A reference population consisted of 419 elderly people drawn at random from the census files. Outcome measures: Emotional well-being was assessed with the General Health Questionnaire (GHQ-20), and the perceived burden attributed to the care of the patient with the Caregiver Strain Index (CSI). The personal and instrumental activities of daily life (PADL and IADL), motor and cognitive functions of the patients were assessed with standardized tests. Results: The relatives rated their well-being lower than the reference group rated theirs, the odds ratio (OR) being 5.6 (95% confidence interval (CI) 3.1-10) adjusted for age and gender. No association was found between the relatives' well-being and the motor, cognitive, PADL, IADL or other characteristics of the patients. Strong relationships were found between the CSI and the GHQ scores of the relatives, the OR (95% CI) for a poor GHQ score being 2.4 (1.6-3.7) for each unit increase in CSI, adjusted for gender. Conclusions: Emotional well-being is influenced when a close relative gets a stroke. This seems to relate more strongly to the perceived burden of care than to objective characteristics of the patient.