Stroke rehabilitation use and caregiver psychosocial health profiles in Singapore: A latent profile transition analysis

Objectives: To identify and describe caregiver profiles based on their psychosocial health characteristics over a 12-month period and transitions among these profiles, to determine if stroke rehabilitation use at 12-month post-stroke differed by caregiver profile transition patterns, and to investigate if caregiver profiles at 3-month post-stroke moderate the association of stroke rehabilitation use at 3-month and 12-month post-stroke after accounting for covariates.Design: Latent profile transition analysis of caregiver psychosocial health with stroke rehabilitation use at 12-month post-stroke as outcome. Setting and Participants: 149 stroke patient-caregiver dyads from the Singapore Stroke Study.Methods: Cross-sectional latent profile analyses were conducted on caregiver psychosocial health indicators of burden, depression, health status, quality of relationship with patient, and social support. Changes in latent profile classification over three time points (baseline, 3-month, and 12-month post-stroke) were analysed using latent transition analysis. A transition model with stroke rehabilitation use at 12-month post-stroke as the outcome was tested after accounting for covariates.Results: Two distinct caregiver psychosocial health latent profiles were found across time: non-distressed and distressed. Most caregivers were classified as non-distressed and remained non-distressed over time. Distressed caregivers at baseline were 76% likely to become non-distressed at 12-month post-stroke. Regardless of profile transition patterns, non-distressed caregivers at 12-month post-stroke tended to have cared for stroke rehabilitation non-users at 12-month post-stroke. Patient depression explained profile classification at 3-month and 12-month post-stroke. After accounting for covariates, the association between stroke rehabilitation use at 3-month and 12-month post-stroke was present only when caregivers were non-distressed at 3-month post-stroke.Conclusions and Implications: Whether caregiver adaptation explain the associations between the latent profile transition patterns and rehabilitation use at 12-month post-stroke should be examined. Early psychosocial health assessment and sustained support should be made available to stroke caregivers to enhance their well-being and subsequent patient rehabilitation participation.