Caregiver strain and associated factors 12 months post stroke: impact of caregiver education

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS833–eS1237

Research Report Platform State of the Art Presentation Number: RR-PLSoA-944 Sunday 3 May 2015 10:45 Hall 406 CAREGIVER STRAIN AND ASSOCIATED FACTORS 12 MONTHS POST STROKE: IMPACT OF CAREGIVER EDUCATION W. Mudzi 1 , A. Stewart 1 , E. Musenge 2 1 University

of the Witwatersrand, Physiotherapy, Johannesburg, South Africa; 2 Universty of the Witwatersrand, Biostatistics and Epidemiology, Johannesburg, South Africa Background: Following stroke, more than 60% of survivors will need help with activities of daily living when at home and the help is mostly provided by informal caregivers, particularly in developing countries. In South Africa patients with stroke are discharged home to unprepared caregivers once they are medically stable, and there are minimal opportunities for further rehabilitation. The caregiver is usually either a close relative or a spouse and is affected by the patient’s illness from the onset. In their endeavour to improve the quality of life of the stroke survivor, caregivers experience a significant burden, which if excessive can lead to a breakdown in the support provided. Purpose: The aim of the study was to establish the level of and factors associated with caregiving strain 12 months post stroke and to establish the effect of caregiver education on the caregiver strain patterns. Methods: A randomized control trial consisting of two groups each with 100 patients and their caregivers was undertaken in Johannesburg, South Africa. Caregivers in the experimental group received individualised structured training on how to help the patient with stroke and those in the control group received existing usual care. Patients were followed up for 12 months post discharge. Data were collected using a demographic questionnaire, the Caregiver Strain Index (CSI), Barthel Index (BI), the Rivermead Mobility Index (RMI) and the EQ-5D (for quality of life). Descriptive statistics were used to analyse the data for the demographic information and levels of caregiver strain. The mean differences between the control group and experimental group caregivers’ level of strain at the different points of measurement were done using a two sample t test. The overall difference over the study period was tested using analysis of variance (ANOVA). A multivariate analysis was done to establish the factors that influenced caregiver strain. Ethical approval was sought and granted by the University of the Witwatersrand Human Research Ethics Committee. Results: At 12 months post discharge, 58% of the caregivers were strained, the control group (77.6%) more than the experimental group (43.1%). Low patient functioning ability was associated with increased caregiver strain. The caregivers of those patients in the experimental group were 71% less

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likely to be strained than those in the control group (OR: 0.29; C.I. 0.12–0.72). Conclusion(s): The high levels of caregiver strain shows that the current system of stroke management is not working and a more structured caregiver education programme with good support structures for post discharge care should be put in place to help alleviate the burden of caregiving. Caregiver training has the effect of significantly reducing caregiver stress possibly due to better ability to cope with caregiving duties. Caregiver strain was largely influenced by patient physical ability. Implications: The depression/anxiety associated with caregiving post stroke is treatable and hence early diagnosis with proper management of those diagnosed with it is important. Caregiver education can help reduce caregiving strain. Keywords: Stroke; Caregiver education; Caregiving strain Funding acknowledgements: University of the Witwatersrand and The Medical Research Council of South Africa. Ethics approval: Ethics for the study was granted by the University of the Witwatersrand Human Research Ethics Committee (Number M050328). http://dx.doi.org/10.1016/j.physio.2015.03.1935 Special Interest Report Platform Presentation Number: SI-PL-2566 Saturday 2 May 2015 11:07 Room 300–301 SUPPORTING OVERSEAS-QUALIFIED PHYSIOTHERAPISTS DURING THE TRANSITION PERIOD INTO UK PRACTICE B. Mueller-Winkler Chartered Society of Physiotherapy, Practice and Development, London, United Kingdom Background: In 2011, the Black and Ethnic Minorities Group of the Chartered Society of Physiotherapy (CSP) brought it to the organisation’s attention that a disproportionately high number of overseas-qualified physiotherapists had had complaints made against them, as indicated by fitness to practise data available from the UK regulator for physiotherapists, the Health & Care Professions Council (HCPC). Purpose: To identify the needs of physiotherapists who qualified overseas and who are new to the UK health care system, and to develop supportive resources that could meet this group’s identified needs. Methods: Details on fitness to practice cases were secured through freedom of information requests made to the HCPC to inform the key areas of the project. The target group was identified through the CSP member database and an onlinequestionnaire was sent by email to 2,500 overseas-qualified CSP members in October 2012 to gather insight into their