ABSTRACT
Background: A principal caregiver (CG) is directly affected by the patient's health problems leading to CG strain. In the present study, we evaluated the different factors related to increased CG burden in stroke survivors and assessed the relationship between patient's personal and clinical characteristics and CG's stress. Material and Methods: In this prospective, follow-up study, a total of 141 principle CGs of 164 First-ever stroke (FES) survivors were subjected to the Caregivers Strain Index (CSI) and Oberst Caregiving Burden Scale (OCBS) at 30 days (n = 141), 90 days (n = 129), and 6 months (n = 119) after informed consent. Patients were subjected to modified Rankin Scale (mRS) and Barthel index score assessment at the end of 30 days. Results: The mean age of CG was 49.8 ± 21.0 years, approximately 20 years lesser than that of the patients. 102 (72.34%) CGs were females. Urinary incontinence (p < 0.006) morbidity at 30 days, mRS (p = 0.004), and moderate to the severe neurological deficit on admission (p = 0.003) were the patient factors in FES cases leading to significant CGs stress. CG factors responsible for major stress were long caregiving hours (P < 0.001), anxiety (P < 0.001), disturbed night sleep (P < 0.001), financial stress (P < 0.001), younger age (P = 0.002), and CGs being daughters-in-law (P = 0.039). Conclusion: CG burden increases with increased severity of stroke. Integrated stroke rehabilitation services should also address CGs issues along with patients.
ABSTRACT
Rapid spread of COVID-19 infection reached Nepal in about 1 month of its first appearance in China in December 2019 and affected all spheres of life and society including health and education, like in other countries. We are unprepared for this new menace with many unknown facts and uncertainties when well developed set ups with advanced science and technology also seemed drowned. We attempt here to appraise our situation (condition, trend) and reflect on to the lessons (observations, and messages) that we draw in various major areas of the activities of B. P. Koirala Institute of Health Sciences. We become acutely aware about the adverse effects of this pandemic in its academic, service and research activities along with all other aspects. Amidst the challenges, we were forced to take steps in scattered and trial and error pattern. This pandemic has brought our deficiencies in health system into surface and is offering opportunity to review, revise and reform them. We all the stakeholders, i.e. students, patients, clients, teachers, faculties, staff and authorities are in the same boat;all need to be in healthy, balanced and functional state for fruitful travel. We have certain weaknesses, drawbacks, deficits;and some strengths that we now should realize to move ahead in this COVID era.