Background: The interaction between self-care and caregiving
ability in home discharged stroke patients is unclear. Purpose: This
study investigates the interaction between caregiving ability and individual
self-care activities for post-stroke patients upon home
discharge based on their motor-Functional Independence Measure (m-FIM) score. Methods: A total of 2626 stroke
patients registered in the Japanese Rehabilitation Database were
retrospectively analyzed. Extracted data were divided into three groups based
on the m-FIM score at discharge and classified into two groups based on their
discharge destination (home discharge, non-home discharge). After the data were modified as mean-centered values, a
hierarchical multiple regression analysis evaluated the change in
variance amount (ΔR2) using discharge destination as the dependent
variable. Model 1 used two independent variables (Rankin Scale and cognitive
FIM score), model 2 used two independent variables
(caregiving ability and individual self-care), which were added to model
1, and model 3 used an interaction term value, which was added to model 2.
Furthermore, a simple slope analysis was performed for these interaction
effects. Results: The ΔR2 exhibited six and five self-care
items in the moderate and mild groups,
respectively. The interaction was significant on simple slope analysis in the
moderate group for six self-care items (except dressing upper body, toileting,
and bowel management) and in the mild group for three self-care items,
including dressing upper body, bladder management, and climbing
References
[1]
Matsuyama, A. (2018) Factors Associated with the Walking Ability of Hemiplegic Stroke Patients. The Open Nursing Journal, 8, 14-25.
https://doi.org/10.4236/ojn.2018.81002
[2]
Janice, J.E. and Tang, P.-F. (2007) Gait Training Strategies to Optimize Walking Ability in People with Stroke: A Synthesis of the Evidence. Expert Review of Neurotherapeutics, 24, 1417-1436. https://doi.org/10.1586/14737175.7.10.1417
[3]
van Wegen, E.E.H., Johannes, C.F.K., Heymans, M.W., et al. (2011) Early Prediction of Outcome of Activities of Daily Living after Stroke: A Systematic Review. Stroke, 42, 1482-1488. https://doi.org/10.1161/STROKEAHA.110.604090
[4]
White, C.L., Lauzon, S., Yaffe, M.J. and Wood-Dauphinee, S. (2004) Toward a Model of Quality of Life for Family Caregivers of Stroke Survivors. Quality of Life Research, 13, 625-638. https://doi.org/10.1023/B:QURE.0000021312.37592.4f
[5]
Ugur, H.G. and Erci, B. (2019) The Effect of Home Care for Stroke Patients and Education of Caregivers on the Caregiver Burden and Quality of Life. Acta Clinica Croatica, 58, 321-332.
[6]
Hesamzadeh, A., Dalvandi, A., Bagher, M.S., Fallahi, K.M., Ahmadi, F. and Mosavi, A.N. (2017) Family Caregivers’ Experience of Activities of Daily Living Handling in Older Adult with Stroke: A Qualitative Research in the Iranian Context. Scandinavian Journal of Caring Sciences, 31, 515-526. https://doi.org/10.1111/scs.12365
[7]
Xie, H., Cheng, C., Tao, Y., Zhang, J., Robert, D., et al. (2016) Quality of Life in Chinese Family Caregivers for Elderly People with Chronic Diseases. Health and Quality of Life Outcomes, 14, 99. https://doi.org/10.1186/s12955-016-0504-9
[8]
Watanabe, A., Fukuda, M., Suzuki, M., Kawaguchi, T., Habata, T., Akutsu, T., et al. (2014) Factors Decreasing Caregiver Burden to Allow Patients with Cerebrovascular Disease to Continue in Long-Term Home Care. Journal of Stroke and Cerebrovascular Diseases, 24, 424-430.
https://doi.org/10.1016/j.jstrokecerebrovasdis.2014.09.013
[9]
Menon, B., Salini, P., Habeeba, K., Conjeevaram, J. and Munisusmitha, K. (2017) Female Caregivers and Stroke Severity Determines Caregiver Stress in Stroke Patients. Annals of Indian Academy of Neurology, 20, 418-424.
https://doi.org/10.4103/aian.AIAN_203_17
[10]
Tsai, Y.H., Lou, M.F., Feng, T.H., Chu, T.L., Chen, Y.J. and Liu, H.E. (2018) Mediating Effects of Burden on Quality of Life for Caregivers of First-Time Stroke Patients Discharged from the Hospital within One Year. BMC Neurology, 18, Article No. 50. https://doi.org/10.1186/s12883-018-1057-9
[11]
Ostwald, S.K., Bernal, M.P., Cron, S.G. and Godwin, K.M. (2009) Stress Experienced by Stroke Survivors and Spousal Caregivers during the First Year after Discharge from Inpatient Rehabilitation. Topics in Stroke Rehabilitation, 16, 93-104.
https://doi.org/10.1310/tsr1602-93
[12]
Alexander, W., Michelle, T. and Sepideh, P. (2020) Factors Associated with Community versus Personal Care Home Discharges after Inpatient Stroke Rehabilitation: The Need for a Pre-Admission Predictive Model. Topics in Stroke Rehabilitation, 27, 173-180. https://doi.org/10.1080/10749357.2019.1682369
[13]
Clery, A., Bhalla, A., Bisquera, A., Skolarus, L.E., Marshall, I., et al. (2020) Long-Term Trends in Stroke Survivors Discharged to Care Homes: The South London Stroke Register. Stroke, 51, 179-185. https://doi.org/10.1161/STROKEAHA.119.026618
[14]
Everink, I.H., van Haastregt, J.C., van Hoof, S.J., Schols, J.M. and Kempen, G.I. (2016) Factors Influencing Home Discharge after Inpatient Rehabilitation of Older Patients: A Systematic Review. BMC Geriatrics, 16, Article No. 5.
https://doi.org/10.1186/s12877-016-0187-4
[15]
Kimura, T. (2021) Interaction between Self-Care and Caregiving Ability on Home Discharged Stroke Patients Based on Motor Functional Independence Measure Score in Recovery Ward. Open Journal of Therapy and Rehabilitation, 9, 42-56.
https://doi.org/10.4236/ojtr.2021.92004
[16]
Chen, H.F., Wu, C.Y., Lin, K.C., Chen, C.L., Huang, P.C., Hsieh, C.J., et al. (2013) Rasch Validation of a Combined Measure of Basic and Extended Daily Life Functioning after Stroke. Neurorehabilitation and Neural Repair, 27, 125-132.
https://doi.org/10.1177/1545968312457828
[17]
Lopes, P.G., Lopes, J.A., Brito, C.M., Alfieri, F.M. and Battistella, R.L. (2015) Relationships of Balance, Gait Performance, and Functional Outcome in Chronic Stroke Patients: A Comparison of Left and Right Lesions. Biomedical Research, 2015, Article ID: 716042. https://doi.org/10.1155/2015/716042
[18]
Jorgensen, H.S., Nakayama, H., Raaschou, H.O. and Olsen, T.S. (1995) Intracerebral Hemorrhage versus Infarction: Stroke Severity, Risk Factors, and Prognosis. Annals of Neurology, 38, 45-50. https://doi.org/10.1002/ana.410380110
[19]
Brankovic, M., Kardys, I., Steyerberg, E.W., Lemeshow, S., Markovic, M., Rizopoulos, D., et al. (2019) Understanding of Interaction [Subgroup] Analysis in Clinical Trials. European Journal of Clinical Investigation, 49, e13145.
https://doi.org/10.1111/eci.13145
[20]
Andersson, U., Cuervo-Cazurra, A. and Nielsen, B.B. (2014) Explaining Interaction Effects within and across Levels of Analysis. Journal of International Business Studies, 45, 1063-1071. https://doi.org/10.1057/jibs.2014.50
[21]
Mutai, H., Furukawa, T., Araki, K., Misawa, K. and Hanihara, T. (2012) Factors Associated with Functional Recovery and Home Discharge in Stroke Patients Admitted to a Convalescent Rehabilitation Ward. Geriatrics & Gerontology International, 12, 215-222. https://doi.org/10.1111/j.1447-0594.2011.00747.x
[22]
Miura, H., Shimizu, S., Noma, T., Ichinosawa, Y., Shimose, R., Tsunoda, S., et al. (2018) Post-Stroke Patients’ Activities of Daily Living Levels for Discharge to Return Home to Live Alone. The Kitasato Medical Journal, 48, 118-127.
[23]
Uno, Y., Kawato, M. and Suzuki, R. (1989) Formation and Control of Optimal Trajectory in Human Multijoint Arm Movement. Biological Cybernetics, 61, 89-101.
https://doi.org/10.1007/BF00204593
[24]
Yamamoto, H., Takeda, K., Koyama, S., Morishima, K., Hirakawa, Y., Motoya, I., et al. (2020) Relationship between Upper Limb Motor Function and Activities of Daily Living after Removing the Influence of Lower Limb Motor Function in Subacute Patients with Stroke: A Crosssectional Study. Hong Kong Journal of Occupational Therapy, 33, 12-17. https://doi.org/10.1177/1569186120926609
[25]
Kim, D. (2016) The Effects of Hand Strength on Upper Extremity Function and Activities of Daily Living in Stroke Patients, with a Focus on Right Hemiplegia. The Journal of Physical Therapy Science, 28, 2565-2567.
https://doi.org/10.1589/jpts.28.2565
[26]
Wee, S.K., Hughes, A.M., Warner, M.B., Brown, S., Cranny, A., Mazomenos, E.B., et al. (2015) Effect of Trunk Support on Upper Extremity Function in People with Chronic Stroke and People Who Are Healthy. Physical Therapy, 95, 1163-1171.
https://doi.org/10.2522/ptj.20140487
[27]
Song, B.K. (2011) The Effect of Upper Extremity Training with a Focus on Functional Reaching, on Trunk Control and ADL Performance in Post-Stroke Hemiplegic Patients. Journal of the Korean Society of Physical Medicine, 23, 71-77.
http://www.kptjournal.org/journal/download_pdf.php?spage=71&volume=23&number=3
[28]
Roberts, S.G.B. and Dunbar, R.I.M. (2011) Communication in Social Networks: Effects of Kinship, Network Size, and Emotional Closeness. Personal Relationships, 18, 439-452. https://doi.org/10.1111/j.1475-6811.2010.01310.x
[29]
Masanori, T. (2018) Two Types of Social Grooming Methods Depending on the Trade-Off between the Number and Strength of Social Relationships. Royal Society Open Science, 5, Article ID: 5180148. https://doi.org/10.1098/rsos.180148
[30]
Kwok, C., McIntyre, A., Janzen, S., Mays, R. and Teasell, R. (2015) Oral Care Post Stroke: A Scoping Review. Journal of Oral Science, 42, 65-74.
https://doi.org/10.1111/joor.12229
[31]
Dewey, H.M., Thrift, A.G., Mihalopoulos, C., Carter, R., Macdonell, R.A., McNil, J.J., et al. (2002) Informal Care for Stroke Survivors: Results from the North East Melbourne Stroke Incidence Study [NEMESIS]. Stroke, 33, 1028-1033.
https://doi.org/10.1161/01.STR.0000013067.24300.B0
[32]
Itoh, Y., Yamada, S., Konoeda, F., Koizumi, K., Nagata, H. and Oya, M. (2013) Burden of Overactive Bladder Symptom on Quality of Life in Stroke Patients. Neurourology and Urodynamics, 32, 428-434. https://doi.org/10.1002/nau.22336
[33]
Abrams, P., Cardozo, L., Fall, M., Griffiths, D., Rosier, P., Ulmsten, U., et al. (2002) The Standardization of Terminology of Lower Urinary Tract Function: Report from the Standardization Sub-Committee of the International Continence Society. Neurourology and Urodynamics, 21, 167-178. https://doi.org/10.1002/nau.10052
[34]
Coyne, K.S., Sexton, C.C., Irwin, D.E., Kopp, Z.S., Kelleher, C.J. and Milsom, I.T. (2008) The Impact of Overactive Bladder, Incontinence and Other Lower Urinary Tract Symptoms on Quality of Life, Work Productivity, Sexuality and Emotional Well-Being in Men and Women: Results from the EPIC Study. BJU International, 101, 1388-1395. https://doi.org/10.1111/j.1464-410X.2008.07601.x
[35]
Wein, A.J. and Rovner, E.S. (2002) Definition and Epidemiology of Overactive Bladder. Urology, 60, 7-12. https://doi.org/10.1016/S0090-4295(02)01784-3
[36]
Corrado, B., Giardulli, B., Polito, F., Aprea, S., Lanzano, M. and Dodaro, C. (2020) The Impact of Urinary Incontinence on Quality of Life: A Cross-Sectional Study in the Metropolitan City of Naples. Geriatrics, 5, 96.
https://doi.org/10.3390/geriatrics5040096
[37]
Aysegül, C. and Belgüzar, K. (2019) The Relationship between the Stroke Survivors’ Functional Status and Their Informal Caregivers’ Burden and Quality of Life. AIMS Medical Science, 6, 115-127. https://doi.org/10.3934/medsci.2019.1.115
[38]
Marcheschi, E., Von Koch, L., Pessah-Rasmussen, H. and Elf, M. (2018) Home Setting after Stroke, Facilitators and Barriers: A Systematic Literature Review. Health & Social Care in the Community, 26, e451-e459. https://doi.org/10.1111/hsc.12518
[39]
Oliva-Moreno, J., Aranda-Reneo, I., Vilaplana-Prieto, C., González-Domínguez, A. and Hidalgo-Vega, A. (2012) Economic Valuation of Informal Care in Cerebrovascular Accident Survivors in Spain. BMC Health Services Research, 13, Article No. 508. https://doi.org/10.1186/1472-6963-13-508
[40]
Kutzner, I., Heinlein, B., Graichen, F., Bender, A., Rohlmann, A., Halder, A., et al. (2010) Loading of the Knee Joint during Activities of Daily Living Measured in Vivo in Five Subjects. Journal of Biomechanics, 43, 2164-2173.
https://doi.org/10.1016/j.jbiomech.2010.03.046
[41]
Forster, A. and Young, J. (1995) Incidence and Consequences of Falls Due to Stroke: A Systematic Inquiry. BMJ, 311, 83-86. https://doi.org/10.1136/bmj.311.6997.83
