NEEDS OF HIGH-RISK PRIMARY CAREGIVERS HANDLING STROKE PATIENTS: A MIXED METHOD STUDY IN A TERTIARY CARE HOSPITAL OF RAWALPINDI

Abstract

Objective: To identify high-risk caregivers, understand their needs and explore the factors affecting the caregivers of stroke patients in a tertiary care hospital of Rawalpindi.

Study Design: A cross-sectional, mixed-method study.

Place and Duration of Study: The study was carried out in OPD of Pak Emirates Military Hospital, Rawalpindi from Jul 2019 till Dec 2018.

Material and Methods: A mixed-method approach was employed using non-probability convenience sampling followed by purposive sampling. The quantitative study was conducted on 71 caregivers, identified and approached through stroke patients in PEMH OPD. A pre-structured, pre-tested questionnaire was used to filter the caregivers with the high risk and determine their situation. Furthermore, a qualitative interview was conducted with nine high-risk caregivers to have a profound understanding of their needs. Frequencies and percentages were computed and chi-square and fisher exact was used to find associations between sociodemographic variables and variables of caregivers’ situation. Themes were identified from the qualitative data through thematic content analysis.

Results: The mean age of the participants was 35.25 years and the mean total duration of care giving was 27.50 months. Out of seventy one participants, 27 (38%) participants were recognized as high risk CGs whereas 5 (7%) CGs was at a very high risk. A significant association was found between caregiver’s risk and relationship with the CG (9.471 p-value 0.029) as well as duration of care giving (6.705 p-value 0.050). Further, the results also indicated that caregiver’s physical health, social activities, control on life and mental health was negatively affected by the care giving. Results of qualitative interviews identified six main themes including physical care, support and supervision, juggling responsibilities, financial cost of care giving, personal life, and future needs or demands.

Conclusion: In conclusion, the results indicated that physical health, social and mental health of the caregivers of stroke patients are adversely affected by their numerous responsibilities of care giving putting them at a very high risk of deteriorating quality of life and making them a public health concern. The research has great implication as it addresses and identifies the needs and demands of the caregivers of stroke patients.