Of the estimated four million stroke survivors in the United States, approximately 66% live with moderate to severe impairment. Family caregivers have a major role in stroke survivors' recovery including all aspects of rehabilitation; however, caregivers may experience negative psychological and physical outcomes including increased risk of mortality. The effects of factors such as family functioning and characteristics of the stroke survivor (e.g. memory and behavior problems) on caregiver outcomes and stroke survivors' physical recovery are not well understood. Because of the variable trajectory of the stroke recovery process, a prospective longitudinal design based on the strength-vulnerability model will be used to study outcomes in a sample of 170 caregiver-stroke survivor dyads during the first year post stroke. This innovative proposal is a complementary sub-study to a national clinical trial, """"""""Extremity Constraint Induced Therapy Evaluation (EXCITE)"""""""" developed in response to RFA NR-4-00-003. The purposes of the sub-study are to: (1) determine relationships among family caregiver outcomes (depression, fatigue and overall health), family functioning, and stroke survivor physical function and memory/behavior problems over time, (2) determine predictors of caregiver outcomes approximately one year post-stroke, and (3) examine the interaction of family function and the EXCITE treatment group on stroke survivor functional recovery. Data will be collected at baseline (3-6 months post-stroke), and four and eight months later via in-person administration of questionnaires and a semi-structured interview. A cost-effective strategy will combine prospectively collected caregiver data with stroke survivor data collected for the EXCITE clinical trial. Identification of the most salient factors associated with caregiver depression, fatigue, and health status at different points in recovery is essential for future development and testing of interventions to improve outcomes of caregivers and stroke survivors.

Agency
National Institute of Health (NIH)
Institute
National Institute of Nursing Research (NINR)
Type
Research Project (R01)
Project #
5R01NR007612-03
Application #
6529359
Study Section
Special Emphasis Panel (ZNR1-REV-A (27))
Program Officer
Phillips, Janice
Project Start
2000-09-30
Project End
2005-08-31
Budget Start
2002-09-01
Budget End
2005-08-31
Support Year
3
Fiscal Year
2002
Total Cost
$152,000
Indirect Cost
Name
Emory University
Department
Other Health Professions
Type
Schools of Nursing
DUNS #
042250712
City
Atlanta
State
GA
Country
United States
Zip Code
30322
Klinedinst, N Jennifer; Gebhardt, Mary C; Aycock, Dawn M et al. (2009) Caregiver characteristics predict stroke survivor quality of life at 4 months and 1 year. Res Nurs Health 32:592-605
Clark, Patricia C; Dunbar, Sandra B; Aycock, Dawn M et al. (2009) Pros and woes of interdisciplinary collaboration with a national clinical trial. J Prof Nurs 25:93-100
Ko, Jean Y; Aycock, Dawn M; Clark, Patricia C (2007) A comparison of working versus nonworking family caregivers of stroke survivors. J Neurosci Nurs 39:217-25
Underwood, Julie; Clark, Patricia C; Blanton, Sarah et al. (2006) Pain, fatigue, and intensity of practice in people with stroke who are receiving constraint-induced movement therapy. Phys Ther 86:1241-50
Clark, Patricia C; Ashford, Susan; Burt, Rachel et al. (2006) Factor analysis of the Revised Piper Fatigue Scale in a caregiver sample. J Nurs Meas 14:71-8
Clark, Patricia C; Dunbar, Sandra B; Aycock, Dawn M et al. (2006) Caregiver perspectives of memory and behavior changes in stroke survivors. Rehabil Nurs 31:26-32
Nichols-Larsen, Deborah S; Clark, P C; Zeringue, Angelique et al. (2005) Factors influencing stroke survivors' quality of life during subacute recovery. Stroke 36:1480-4
Clark, Patricia C; Dunbar, Sandra B; Shields, Cleveland G et al. (2004) Influence of stroke survivor characteristics and family conflict surrounding recovery on caregivers' mental and physical health. Nurs Res 53:406-13
Aycock, Dawn M; Blanton, Sarah; Clark, Patricia C et al. (2004) What is constraint-induced therapy? Rehabil Nurs 29:114-5, 121
Clark, Patricia C; Shields, Cleveland G; Aycock, Dawn et al. (2003) Preliminary reliability and validity of a family caregiver conflict scale for stroke. Prog Cardiovasc Nurs 18:77-82, 92

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