The Effect of Functional Status of Stroke Individuals on Caregiver Pain

Year 2022, Volume: 16 Issue: 2, 274 - 285, 20.06.2022

Mehmet Duray , Pınar Yaşar

https://doi.org/10.21763/tjfmpc.994648

Cited By: 1

Abstract

Purpose: Functional deficiencies that occur after stroke cause individuals to become dependent on others. It is known that caregivers of stroke individuals with low functional level become vulnerable to musculoskeletal problems due to the physical load they are exposed to. The aim of this study is to examine the effect of the functional status of stroke individuals on the musculoskeletal pain of caregivers of these individuals. Material-method: The study included 45 stroke individuals whose clinical condition was stable for at least 8 weeks, and 45 caregivers who provided care for these individuals for at least 8 weeks. Persons with acute pain and paid care were excluded from the study. Modified Rankin Scale (MRS) was applied to determine the functional status of hemiplegic/hemiparetic individuals. The Cornell Musculoskeletal Discomfort Questionnaire was used to evaluate the musculoskeletal pain of caregivers. Pain severity was determined by the Visual Analogue Scale (VAS). According to the results of the evaluation, the caregivers were divided into two groups according to the functional level of the stroke individuals they care for, and musculoskeletal pain comparison was made between the groups. Results: It was observed that the groups were similar in terms of sociodemographic characteristics (p>0.05). It was determined that the severity and frequency of pain of low back pain were higher than the other region in the caregivers of the group with low functional status (p<0.05). Low back pain VAS value at rest and during activity was found to be significantly higher in the group with low functional status (p<0.05). Conclusion: The functional status of stroke individuals changes the need for care. The low functional level increases the musculoskeletal system burden of caregivers. For this reason, the spine-related symptoms of caregivers of stroke individuals with low functional level should be handled more meticulously.

Keywords

caregivers, functional status, musculoskeletal system, pain

İnmeli Bireylerin Fonksiyonel Durumlarının Bakım Veren Ağrısı Üzerine Etkisi

Abstract

Amaç: İnme sonrası meydana gelen fonksiyonel yetersizlikler bireylerin başkalarına bağımlı hale gelmelerine neden olmaktadır. Fonksiyonel düzeyi düşük inmeli bireylere bakım veren kişilerin maruz kaldıkları fiziksel yüklenmeye bağlı olarak kas iskelet sistemi problemlerine açık hale geldiği bilinmektedir. Bu çalışmanın amacı inmeli bireylerin fonksiyonel durumlarının bu bireylere bakım verenlerin kas iskelet sistemi ağrıları üzerine etkisini incelemektir. Yöntem: Çalışmaya en az 8 haftadır klinik durumu stabil olan 45 inmeli birey ve en az 8 haftadır bu bireylere bakım sağlayan 45 bakım veren katılımcı dahil edildi. Akut ağrısı olan ve ücretli bakım sağlayan kişiler çalışma dışında tutuldu. Hemiplejik/hemiparetik bireylerin fonksiyonel durumlarını belirlemek için Modifiye Rankin Skalası (MRS) uygulandı. Bakım veren bireylerin kas iskelet sistemi ağrısını değerlendirmek için Cornell Kas İskelet Sistemi Rahatsızlık Skalası kullanıldı. Ağrı şiddeti Görsel Analog Skalası (GAS) ile belirlendi. Değerlendirme sonucuna göre bakım verenler, bakım verdikleri inmeli bireylerin fonksiyonel seviyesine göre iki gruba ayrılarak gruplar arası kas iskelet sistemi ağrısı karşılaştırması yapıldı. Bulgular: Grupların sosyodemografik özellikleri bakımından benzer olduğu görüldü (p>0,05). Fonksiyonel seviyesi düşük olan grubun bakım verenlerinde bel ağrısı şiddet ve frekansının diğer vücut bölgelerinden daha yüksek olduğu tespit edildi (p<0,05). İstirahat ve aktivite sırasındaki bel ağrısı GAS değeri fonksiyonel düzeyi düşük olan grupta anlamlı düzeyde yüksek olduğu bulundu (p<0,05). Sonuç: İnmeli bireylerin fonksiyonel durumları, bakıma duyulan ihtiyacı değiştirmektedir. Fonksiyonel düzeyin düşük olması bakım verenlerin kas iskelet sistemi yüklenmelerini artırmaktadır. Bu nedenle, fonksiyonel düzeyi düşük olan inmeli bireylere bakım verenlerin sahip olduğu özellikle omurgaya yönelik semptomların daha titiz bir şekilde ele alınması gerekmektedir.

Keywords

bakım verenler, fonksiyonel durum, kas iskelet sistemi, ağrı

References

• 1. Organization WH. World Health Organization. 2011;3(27). Erişim tarihi: 10.09.2021. https://www.who.int/health-topics/cardiovascular-diseases#tab=tab_2.
• 2. Zhu W, Jiang Y. A Meta-analytic Study of Predictors for Informal Caregiver Burden in Patients With Stroke. J Stroke Cerebrovasc Dis. 2018;27(12):3636-3646.
• 3. Mei Y, Wilson S, Lin B, Li Y, Zhang Z. Benefit finding for Chinese family caregivers of community-dwelling stroke survivors: A cross-sectional study. J Clin Nurs. 2018;27(7-8):e1419-e1428.
• 4. Kars Fertelli T, Özkan Tuncay F. İnmeli Bireye Bakım Verenlerde Bakım Yükü, Sosyal Destek ve Yaşam Kalitesi Arasındaki İlişki. J Acad Res Nurs. 2019;5(2):107-115.
• 5. Kavga A, Kalemikerakis I, Faros A, et al. The Effects of Patients ’ and Caregivers ’ Characteristics on the Burden of Families Caring for Stroke Survivors. Int J Environ Res Public Heal Artic. 2021;18(14):7298.
• 6. Weir RL, Danilovich MK, Hoover DL. Systematic review of the effectiveness of caregiver training with functional mobility tasks for informal caregivers assisting patients with neurological diagnoses. Disabil Rehabil. Published online 2021:1-8.
• 7. Darragh AR, Sommerich CM, Lavender SA, Tanner KJ, Vogel K, Campo M. Musculoskeletal Discomfort , Physical Demand , and Caregiving Activities in Informal Caregivers. J Appl Gerontol. 2015;34(6):734-760.
• 8. Vincent-Onabajo G, Daniel H, Lawan A, Ali MU, Masta MA, Modu A. Musculoskeletal Symptoms among Family Caregivers Community-Dwelling Stroke Survivors in Nigeria. Tabriz Univ Med Sci. 2018;7(2):59-66.
• 9. Eminel AG, Kahraman T, Genç A. Physical workload during caregiving activities and related factors among the caregivers of children with cerebral palsy. Ir J Med Sci. 2021;190:701-709.
• 10. Suzuki K, Tamakoshi K, Sakakibara H. Caregiving activities closely associated with the development of low-back pain among female family caregivers. J Clin Nurs. 2016;25:2156-2167. 11. Jönsson A-C, Lindgren I, Hallström B, Norrving B, Lindgren A. Determinants of Quality of Life in Stroke Survivors and Their Informal Caregivers. Stroke. 2005;36(4):803-808.
• 12. Rahman M, Miah S, Sultana S, Rahman S. Prevalence of Musculoskeletal Disorders among Caregivers of Person with Disabilities in a Rehabilitaion Centre in Bangladesh. Bangladesh J Occup Ther Rehabil. 2017;1(2):62-68.
• 13. Fragala G, Fragala M. Improving the Safety of Patient Turning and Repositioning Tasks for Caregivers. Workplace Health Saf. 2014;62(7):268-273.
• 14. Limpawattana P, Intarasattakul N, Chindaprasirt J, Tiamkao S. Perceived Burden of Thai Caregivers for Older Adults After Stroke. Clin Gerontol. 2015;38(1):19-31.
• 15. Gomes NP, Pedreira LC, Nunes SFL, Alvarez AM, Siewert JS, Oliveira LMS de. Musculoskeletal disorders of older adults: an integrative literature review. Rev Bras Enferm. 2021;74(Suppl 2):e20200626.
• 16. Pajeemas K, Patpiya S, Preeda A, Siriwan SN. Factors Associated with Low Back Pain in Non-Professional Caregivers of Dependent Spinal Cord Lesion Patients. Int J Caring Sci. 2018;11(1):471-477.
• 17. Pucciarelli G, Vellone E, Savini S, et al. Roles of Changing Physical Function and Caregiver Burden on Quality of Life in Stroke: A Longitudinal Dyadic Analysis. Stroke. 2017;48(3):733-739.
• 18. Bamford JM, Sandercock PAG, Wariow CP, Slattery J. Interobserver agreement for the assessment of handicap in stroke patients: To the editor. Stroke. 1989;20(6):828.
• 19. Erdinç O, Hot K, Özkaya M. Cross-cultural adaptation, validity and reliability of Cornell Musculoskeletal Discomfort (CMDQ) in Turkish Language. Work. 2011;39(3):251-260.
• 20. Bijur PE, Silver W, Gallagher EJ. Reliability of the visual analog scale for measurement of acute pain. Acad Emerg Med. 2001;8(12):1153-1157.
• 21. Yalcinkaya EY, Önes K, Ayna AB, Turkyilmaz AK, Erden N. Low back pain prevalence and characteristics in caregivers of stroke patients: A pilot study. Top Stroke Rehabil. 2010;17(5):389-393.
• 22. Hu P, Yang Q, Kong L, Hu L, Zeng L. Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients. Med (United States). 2018;97(40):e12638.
• 23. Hultman MT, Everson-Rose SA, Tracy MF, Lindquist R, Hadidi NN. Associations between characteristics of stroke survivors and caregiver depressive symptoms: a critical review. Top Stroke Rehabil. 2019;26(7):528-537.
• 24. Yılmaz EB, Ata EE. Nörolojik Hastalığı Olan Bireylerin Bakım Vericilerinin Bakım Veren Yükü İle Stresle Başa Çıkma Biçimleri Arasındaki İlişkinin Belirlenmesi. Psikiyatr Hemşireliği Dergisi/Journal Psychiatr Nurs. 2017;8(3):145-149.
• 25. Achilike S, Beauchamp JES, Cron SG, et al. Caregiver Burden and Associated Factors among Informal Caregivers of Stroke Survivors. J Neurosci Nurs. 2020;52(6):277-283.
• 26. Bardak AN, Erhan B, Gündüz B. Low back pain among caregivers of spinal cord injured patients. J Rehabil Med. 2012;44:858-861. doi:10.2340/16501977-1043
• 27. Menon B, Salini P, Habeeba K, Conjeevaram J, Munisusmitha K. Female Caregivers and Stroke Severity Determines Caregiver Stress in Stroke Patients. Ann Indian Acad Neurol. 2017;20(4):418-424.
• 28. Vaz LCS, Oliveira Bernardes Santos K, Ferraz DD. Health and work conditions between caregivers of elderly. Rev Pesqui em Fisioter. 2018;8(3):319-329.
• 29. Terassi M, Rossetti ES, Luchesi BM, Gramani-Say K, Hortense P, Pavarini SCI. Factors associated with depressive symptoms in elderly caregivers with chronic pain. Rev Bras Enferm. 2020;73(1):e20170782.
• 30. Gomes NP, Pedreira LC, Gomes NP, Fonseca E de OS, dos Reis LA, Santos A de A. Health-related consequences of caring for dependent relatives in older adult caregivers. Rev da Esc Enferm. 2019;53:1-9.
• 31. de Araújo Freitas Moreira KL, Ábalos-Medina GM, Villaverde-Gutiérrez C, Gomes de Lucena NM, Belmont Correia de Oliveira A, Pérez-Mármol JM. Effectiveness of two home ergonomic programs in reducing pain and enhancing quality of life in informal caregivers of post-stroke patients: A pilot randomized controlled clinical trial. Disabil Health J. 2018;11:471-477.
• 32. Merisalu E, Oha K, Freimann T, Sirk T. Prevalance of Musculoskeletal Disorders Among Office Workers, Nurses And Caregivers in Estonia. Occup Env Med. 2011;68(Suppl 1):A1-A127.
• 33. Exel NJA Van, Koopmanschap MA, Berg B Van Den, Brouwer WBF, Bos GAM van den. Burden of Informal Caregiving for Stroke Patients. Cerebrovasc Dis. 2005;19:11-17.
• 34. Watanabe A, Fukuda M, Suzuki M, et al. Factors Decreasing Caregiver Burden to Allow Patients with Cerebrovascular Disease to Continue in Long-term Home Care. J Stroke Cerebrovasc Dis. 2015;24(2):424-430.