Depression and dependency among stroke patients and strain on their caregivers in Rehabilitation Centers in Kathmandu

Abstract

Depression and Dependency Among Stroke Patients and Strain on Their Caregivers in Rehabilitation Centers in Kathmandu Introduction: Stroke is a leading cause of disability and death. Functional dependency and Post-Stroke Depression (PSD) are the major consequences following stroke. Functional dependency is defined as reduced ability to perform basic activities of daily living (ADLs). Stroke survivors often rely heavily on family members for care during rehabilitation, leading to considerable physical, emotional, and financial strain on caregivers. PSD, functional dependency, and caregiver strain are the key components of stroke recovery. A clearer understanding of these interrelated factors is essential for designing holistic and patient centered stroke rehabilitation strategies. Objectives: The main aim of the study is to assess the prevalence and severity of PSD and functional dependency among stroke survivors undergoing rehabilitation, and to evaluate the strain experienced by their caregivers and explore the association between PSD, dependency, and strain. Methods: A cross-sectional study design was conducted among 141 stroke survivors and their caregivers admitted to different rehabilitation centers inside Kathmandu valley. Convenience sampling was to select the participants. PSD, functional dependency, and caregiver strain were assessed using the Patient Health Questionnaire-9 (PHQ-9), Barthel Index (BI), and Modified Caregiver Strain Index (MCSI), respectively. Data were analyzed using SPSS 25.0. Depending on the normality of the data, parametric and non-parametric tests were used for analysis. Results: Mean age of patient and caregiver was 57.43 ± 14.51, and 40.52 ± 14.85. 98.65% were functionally dependent to some degree. About 69.5% of patients experienced depressive symptoms, with varying levels of severity. Mean caregiver strain was 12.93 ± 5.34, indicating a moderate to high level of caregiver strain. A weak. Statistically insignificant negative correlation was found between depression and dependency (p > 0.05). In contrast, caregiver strain demonstrated a significant negative correlation with functional dependency (r=-0.267, p< 0.05) and a significant positive correlation with post-stroke depression (ρ= 0.212, p< 0.05). there was a significant association between the duration of stroke and strain experienced by their caregiver, although no significant association was found between strain and the x relationship between patient and caregivers. Conclusion: This study reveals a high prevalence of depression and functional dependency among stroke survivors during the rehabilitation phase, and caregivers also experienced substantial strain. Although functional dependency and PSD were not significantly correlated, both PSD and functional dependency are significantly associated with the strain experienced by the caregivers. These findings suggest a complex interplay between psychological and functional outcome post stroke and emphasize the need for comprehensive rehabilitation strategies that address not only the physical and mental health of patients but also the well-being and support of caregivers. policies and interventions should prioritize well-being of both patient and caregivers throughout the rehabilitation phase to optimize recovery outcomes Keywords: caregiver strain, dependency, post-stroke depression, rehabilitation, stroke