Background and Purpose:Depression and quality of life (QOL) have an interdependent and transactional nature in stroke survivor-caregiver dyads. While the strong relationship between depression and physical and emotional QOL in stroke survivor-caregiver dyads is well known, it is less clear if this relationship is moderated by caregiver preparedness, which could easily be targeted with interventions. In this study, we examined the moderating role of caregiver preparedness on the association between depression and QOL in stroke survivor-caregiver dyads.Methods:We used a longitudinal design with follow-ups every 3 months over a 1-year period. Considering the nonindependent nature of the data (survivors and their caregivers), we used multilevel modeling to analyze data at the dyad level. We implemented 4 longitudinal dyadic moderation models (one for each QOL domain: physical, psychological, social, and environmental) using hierarchical linear modeling.Results:A sample of 222 stroke survivor-caregiver dyads was analyzed. Stroke survivors were older (M=70.8, SD=11.9) than their caregivers (M=52.4, SD=13.1). Stroke survivors predominantly had an ischemic stroke, equally distributed by site. Caregivers were primarily female (66%), with a medium to high educational level (57%). Caregiver preparedness significantly moderated the association between survivor depression and survivor psychological (B=0.56, P<0.01) and environmental (B=0.58, P<0.01) QOL at baseline and social QOL over time (B=0.24, P<0.05). Similarly, caregiver preparedness significantly moderated the association between caregiver depression and caregiver physical (B=0.25, P<0.01) and environmental (B=0.18, P<0.05) QOL over time.Conclusions:Caregiver preparedness has a positive influence on both members of the dyad. Assessment of stroke-caregiver preparedness could be helpful to motivate clinicians to develop and implement interventions for stroke survivor-caregiver dyads.

中文翻译：

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照顾者准备对卒中患者抑郁与生活质量关系的保护作用

背景和目的：抑郁症和生活质量 (QOL) 在中风幸存者-照顾者二元组中具有相互依赖和相互影响的性质。虽然众所周知，中风幸存者-照顾者二元组中抑郁症与身体和情绪 QOL 之间的密切关系，但这种关系是否受到照顾者准备的调节则不太清楚，这很容易成为干预措施的目标。在这项研究中，我们检查了照顾者准备对中风幸存者-照顾者二元组中抑郁症和生活质量之间关联的调节作用。方法：我们使用纵向设计，在 1 年内每 3 个月进行一次随访。考虑到数据（幸存者及其照顾者）的非独立性，我们使用多级建模来分析二元级数据。我们使用分层线性模型实施了 4 个纵向二元调节模型（每个 QOL 域一个：身体、心理、社会和环境）。结果：分析了 222 个中风幸存者-照顾者二元组的样本。中风幸存者年龄较大（M =70.8, SD=11.9) 比他们的照顾者 ( M =52.4, SD=13.1)。中风幸存者主要患有缺血性中风，按部位平均分布。照顾者主要是女性（66%），具有中到高等教育水平（57%）。照顾者准备显着调节幸存者抑郁与幸存者心理（B = 0.56，P <0.01）和环境（B = 0.58，P <0.01）基线生活质量和社会生活质量（B = 0.24，P <0.05）之间的关联。同样，看护者的准备程度显着调节了看护者抑郁与看护者身体之间的关联（B = 0.25，P<0.01) 和环境 ( B =0.18, P <0.05) QOL 随着时间的推移。结论：照顾者的准备对二元组的两个成员都有积极的影响。评估中风-看护者的准备情况可能有助于激励临床医生为中风幸存者-看护者二元组制定和实施干预措施。