Stroke Rehabilitation Use and Caregiver Psychosocial Health Profiles in Singapore: A Latent Profile Transition Analysis

医学 萧条(经济学) 社会心理的 康复 潜在类模型 冲程(发动机) 物理疗法 精神科 数学 统计 宏观经济学 经济 工程类 机械工程
作者
Wayne Freeman Chong,Leong Hwee Ng,Ringo M-H. Ho,Gerald Choon‐Huat Koh,Helen Hoenig,David B. Matchar,Philip Yap,Narayanaswamy Venketasubramanian,Kelvin Bryan Tan,Ning Chou,Edward Menon,Hui Meng Chang,Deidre Anne De Silva,Kim En Lee,Boon Yeow Tan,Sherry H. Young,Yee Sien Ng,Tian Ming Tu,Yan Hoon Ang,Tseng Tsai Yeo,Reshma Aziz Merchant,Keng He Kong,Rajinder Singh,Yu Li Ng,Angela Cheong
出处
期刊:Journal of the American Medical Directors Association [Elsevier BV]
卷期号:22 (11): 2350-2357.e2 被引量:9
标识
DOI:10.1016/j.jamda.2021.02.036
摘要

Objectives To identify and describe caregiver profiles based on their psychosocial health characteristics over a 12-month period and transitions among these profiles, to determine if stroke rehabilitation use at 12 months post-stroke differed by caregiver profile transition patterns, and to investigate if caregiver profiles at 3 months post-stroke moderate the association of stroke rehabilitation use at 3 months and 12 months post-stroke after accounting for covariates. Design Latent profile transition analysis of caregiver psychosocial health with stroke rehabilitation use at 12 month post-stroke as outcome. Setting and Participants A total of 149 stroke patient-caregiver dyads from the Singapore Stroke Study. Methods Cross-sectional latent profile analyses were conducted on caregiver psychosocial health indicators of burden, depression, health status, quality of relationship with patient, and social support. Changes in latent profile classification over 3 time points (baseline, 3 months, and 12 months post-stroke) were analyzed using latent transition analysis. A transition model with stroke rehabilitation use at 12 months post-stroke as the outcome was tested after accounting for covariates. Results Two distinct caregiver psychosocial health latent profiles were found across time: nondistressed and distressed. Most caregivers were classified as nondistressed and remained nondistressed over time. Distressed caregivers at baseline were 76% likely to become nondistressed at 12 month post-stroke. Regardless of profile transition patterns, nondistressed caregivers at 12 months post-stroke tended to have cared for stroke rehabilitation nonusers at 12 months post-stroke. Patient depression explained profile classification at 3 months and 12 months post-stroke. After accounting for covariates, rehabilitation users at 3 months post-stroke tended to continue using rehabilitation at 12 months post-stroke only when they had nondistressed caregivers at 3 months post-stroke. Conclusions and Implications Whether caregiver adaptation explains the associations between the latent profile transition patterns and rehabilitation use at 12 months post-stroke should be examined. Early psychosocial health assessment and sustained support should be made available to stroke caregivers to enhance their well-being and subsequent patient rehabilitation participation.
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