Functional dependence among stroke survivors: A concept analysis.

AIM: To report an analysis of the concept of functional dependence among stroke survivors. BACKGROUND: Functional dependence among stroke survivors is a focal stimulus that leads to caregiver burden and can be measured and applied to research and theory in different ways depending on the researcher's interpretation of the concept. DESIGN: A concept analysis was conducted using the method described by Walker and Avant. DATA SOURCE: A review of the literature was conducted using the CINAHL and PubMed databases. Lay literature, such as the Merriam-Webster dictionary was included. RESULTS: Through the identification and analysis of definitions and uses of the concept, the defining attributes were found to be (1) inability to perform regular functions and (2) dependence on a caregiver to perform regular functions which form the conceptual and operational definitions. A model, borderline, and the related case of the conceptual definition are provided. One antecedent, two consequences, and four empirical referents are identified, alongside the instruments used to measure the empirical referents. CONCLUSIONS: With functional dependence being so closely tied to caregiver burden, researchers and clinicians should take a dyadic approach to caring for this patient population to ensure both perspectives are considered, and optimal patient outcomes are achieved.

Impact of Stroke Survivors' Physical Disability on the Presence of Caregiver Burden: A Systematic Review.

ABSTRACT: BACKGROUND: Caregiver burden associated with caring for stroke survivors remains a prominent issue in nursing. With stroke being a leading cause of disability worldwide, it is essential that the impact of the stroke survivor's physical disability be analyzed so interventions can be developed to relieve related caregiver burden. The purpose of this systematic review is to review the existing nursing and allied-health literature aimed at the impact of stroke survivors' physical disability on the presence of caregiver burden. METHODS: A systematic review of the CINAHL® and PubMed databases was conducted using Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines (searched on June 16, 2021). Study inclusion criteria for this review were as follows: (1) publication in the last 5 years, (2) examined the impact of stroke survivors' physical disability on caregiver burden, (3) caregiver-survivor dyads 18 years or older, (4) published in English, and (5) longitudinal study designs (an exception for reports that present findings not demonstrated in longitudinal studies). Data extracted from articles included sample characteristics, study design, instruments, analyses, and results. RESULTS: A total of 7 studies met the inclusion criteria and were synthesized for use in this systematic review. These studies implemented a variety of instruments to assess for both physical disability in the stroke patient and caregiver burden. A positive correlation between physical disability and caregiver burden was universally reported. CONCLUSION: Further nursing research is warranted to explore the aspects of physical disability that contribute to caregiver burden and to develop interventions to improve the physical functioning of stroke survivors, include social determinants of health, and specifically address the greatest contributors to caregiver burden.