[Impact of the Post-Acute Care Program on Primary Caregiver Burden After Acute Stroke]

Stroke is a leading cause of disability and death. Taiwan has implemented a post-acute care (PAC) program for stroke since 2014. However, the impact of this program on primary caregiver burden remains inadequately investigated.

This study was conducted to compare the trajectories of family functioning and caregiver burden over the follow-up period between primary caregivers of patients with acute stroke in PAC and non-PAC groups (as tested using group × time interaction). The caregiver characteristics that may warrant clinical prioritization were also explored as potential hypothesis-generating signals for future research.

A quasi-experimental design was adopted. One hundred primary caregivers from a medical center in northern Taiwan were enrolled and allocated to either the PAC or non-PAC group (n = 50 each) based on whether the patient had received PAC. Two instruments, including the Family APGAR and Caregiver Burden Inventory, were administered once on hospital days 10-14, and at 1 and 3 months after discharge. Chi-square tests, t tests, and two-way repeated-measures ANOVA were used for analysis.

Baseline sociodemographic characteristics did not differ significantly between the PAC and non-PAC groups. Two-way repeated-measures ANOVA showed significant time effects, with caregiver physical, time, and developmental burdens decreasing over time (time main effect, p < .01). The Group × Time interaction was not significant. No significant between-group differences in trajectories were observed under the current design and data conditions. In the exploratory analysis of the overall sample, family function at 3 months post-discharge differed by age and educational level, and female participants reported higher emotional and developmental burden than their male counterparts. Interpretation of the intervention effect should consider the potential for unmeasured confounding variables.

Although caregiver burden declined over time, under the defined study design and data conditions, no significant difference in the trajectories of caregiver burden between the PAC and non-PAC groups was observed. The analytic focus in this study was on between-group differences in longitudinal change (trajectories) rather than cross-sectional differences at each time point. The findings of the exploratory analysis suggest associations between older age, lower educational attainment, and being female with less-favorable profiles on selected measures, warranting clinical prioritization as well as further validation in future studies to inform the development of more effective family-centered PAC support strategies.