Coping and caring: support for family caregivers of stroke survivors.

AIMS AND OBJECTIVES: This study examines the physical and emotional burden experienced by caregivers of stroke survivors, compared with caregivers of patients having neurological diseases. BACKGROUND: Stroke survivors have residual neurological impairment, which requires long-term support and care. Anxiety, depression and poor physical health are common sequelae among family caregivers of stroke survivors. There is a reasonably consistent association between patients' levels of disability and emotional state and the emotional distress of their caregivers. DESIGN: A convenience sample of 47 families was recruited: of the 47 families, 23 had a member who suffered from stroke and 24 had a member with neurological disease. METHOD: Two interviews were conducted at three and six months after the occurrence of the index stroke or neurological disease. RESULTS: When the two groups of caregivers were compared for anxiety, depression and physical health status after care giving, the caregivers of stroke patients demonstrated higher levels of anxiety and depression than their counterparts in the neurological disease group (p < 0.001). However, there was no significant difference in physical health status between the two groups. Educational attainment, patient group and physical and cognitive impairment of the patients were the predictors of anxiety and the depressive status of the caregivers, while their age and level of depression contributed significantly to their physical health status. CONCLUSION: The physical and emotional well-being of two groups of family caregivers in a neurosurgical unit were compared in the caring context. The caregivers of stroke survivors are at a greater risk of developing poor physical and emotional health than the caregivers of patients having neurological diseases. RELEVANCE TO CLINICAL PRACTICE: The results illustrated that enhanced discharge planning and nurse follow-up sessions are considered essential in maintaining the well-being of the stroke caregivers and bridging the gap between the hospital and the community.

Extrusion of the peritoneal catheter of a VP shunt system through a gastrostomy wound.

BACKGROUND: A variety of complications can occur following ventriculoperitoneal shunt. We report a case of extrusion of the catheter tip through the old scar of the percutaneous endoscopic gastrostomy (PEG) wound. CASE DESCRIPTION: A 70-year-old male suffered from an intracerebral hemorrhage and then developed hydrocephalus. He required a ventriculoperitoneal shunt. This patient required a PEG for gastroenteric feeding. The PEG was removed 4 years after the insertion because of infection. The tip of the distal shunt tube extruded through the scar of the PEG wound 2 years later. CONCLUSION: The catheter end of VP shunt can extrude through the weak point of an old PEG scar. This kind of complication should be brought to mind while performing abdominal surgery in patients with VP shunts.