Caregiver burden among informal caregivers of stroke survivors in Harare, Zimbabwe

Abstract

Background: Stroke presents significant challenges for both survivors and caregivers, particularly in resource-limited settings like Zimbabwe. Identifying factors contributing to caregiver burden strain (CBS) is crucial to enhance support strategies. Objectives: This longitudinal study identified caregiver and stroke survivor characteristics associated with CBS among caregivers in Harare, Zimbabwe. Method: Altogether 188 stroke survivors and their caregivers participated with CBS assessed at 3 months and 12 months using the Caregivers Strain Index. Multiple linear regression was used to evaluate the association of explanatory variables with CBS. Model fit was evaluated using the Akaike’s Information Criterion and R2. Results: Caregivers experiencing anxiety or depression showed increased CBS at 3 months (β = 2.46, p 0.001) and 12 months (β = 2.73, p = 0.016). Work adjustments were associated with higher CBS at 3 months (β = 3.84, p 0.001). Caregivers feeling overwhelmed had significantly higher CBS at 3 months (β = 3.36, p 0.001). Stroke survivors’ poor physical outcomes and reliance on health insurance were associated with CBS at 12 months (β = 4.34, p = 0.006). Caring for married stroke survivors was associated with reduced CBS (β = –2.83, p 0.001). Conclusion: Caregiver anxiety, depression, work adjustments and poor physical and social outcomes in stroke survivors contributed to increased CBS. Targeted interventions addressing mental health and social support are essential to reduce CBS. Clinical implications: Multifaceted interventions that address caregiver mental health and social support are vital to reduce CBS and improve outcomes in resource-constrained settings like Zimbabwe.

Keywords

• stroke
• caregiver burden strain
• longitudinal study
• stroke survivor outcomes
• anxiety
• depression
• zimbabwe