Relationships Between Informal Caregiver Burden and Psychological Distress Among Primary Family Caregivers of Stroke Patients

Relationships Between Informal Caregiver Burden and Psychological Distress Among Primary Family Caregivers of Stroke Patients | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research Article Relationships Between Informal Caregiver Burden and Psychological Distress Among Primary Family Caregivers of Stroke Patients SEVİL YILMAZ, Bilge Dalkiran This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.3.rs-7906385/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Introduction: This study was conducted to investigate the relationship between informal caregiver burden and psychological distress among primary family caregivers of stroke patients. Patients and Method : The design of this study is descriptive, relational, and cross-sectional. The population of the study consists of primary caregivers of stroke patients. The data were collected using a descriptive information form, the Caregiver Burden Scale and the Kessler Psychological Distress (K10) Scale. Results A total of 294 caregivers of stroke patients, 160 female and 134 male, completed the study questionnaires. The average age of those participating in the study was 42.59 ± 13.36 (minimum: 18, maximum: 69) years, and 54.4% of the caregivers were female family members. The average care burden score (minimum:33, maximum:108) was 69.38 ± 12.21, which is a medium level. The average distress score (minimum:10, maximum:49) was 24.28 ± 9.76, which is high. Conclusion Our study found that caregivers of stroke patients experienced high levels of distress and that this was highly correlated with care burden. Stroke informal care burden family caregiver distress older adult care nursing INTRODUCTION Stroke is one of the most serious neurological disorders, and is caused by decreased blood flow in certain areas of the brain due to vascular injuries. The most important health problems among older adults are cardiovascular diseases, cancer, and neurological (stroke) disorders, and stroke is the third leading cause of death in the world(Kazemi et al., 2021 ). The incidence and mortality rate of stroke vary among countries, geographic regions, and ethnic groups. Especially in high-income countries, emphasis is placed on developments in prevention, acute treatment, and neuro-rehabilitation, and efforts are made to reduce the burden of disease(Katan & Luft, 2021 ). After cerebrovascular injuries, patients’ activities of daily living (ADL) and autonomy are impaired (Kazemi et al., 2021 ; Ransmayr, 2021 ). Patients may need long-term care and the assistance of an informal caregiver when they are unable to manage motor, sensory, vegetative, cognitive, neuropsychiatric or behavioral disorders (Klietz, 2022 ; Ransmayr, 2021 ). Informal caregivers are usually family members. They do not receive any payment for care, but are the most involved in the social, mental and physical care of patients. Informal caregivers are mostly spouses, daughters or daughters-in-law, sons and parents or siblings, but they are usually women, and care is provided in the patients’ homes or in the caregiver’s home (Ransmayr, 2021 ). Informal care burden can be defined as the burden experienced by individuals caring for a chronically ill, disabled or older family member. The care burden includes important issues such as transportation, shopping, money management, basic health services, and daily personal care (dressing, nutrition, washing) (Badger et al., 2024 ; Boonsin et al., 2020 ; Caro et al., 2018 ; Hekmatpou et al., 2019 ; Kumar et al., 2022 ). Caregiving is often time and energy consuming and difficult for caregivers (Del-Pino-Casado et al., 2021 ). The patient’s age, male gender, body weight and height, health status, sleep quality, education, dependency, socioeconomic parameters, and caregiver resilience are important factors of caregiving burden (Ransmayr, 2021 ). In addition, frontal dysexecutive disorders (loss of insight, judgment, logical thinking, etc.), behavioral disorders (hyperactivity or apathy, aggression, lack of inhibition), and neuropsychiatric symptoms such as irritability, anxiety or depression, paranoid thoughts and hallucinations, and communication difficulties are also important factors of caregiving burden (Ransmayr, 2021 ). In addition, factors such as the caregiver’s own health problems, emotional problems (insomnia, social isolation, etc.) and economic problems (long working hours, cost burden, etc.) also increase the distress of informal caregivers (Boonsin et al., 2020 ; Caro et al., 2018 ; Hekmatpou et al., 2019 ; Kumar et al., 2022 ). Informal caregivers often complain of a decrease in quality of life and deterioration of physical and emotional health, as well as socioeconomic effects (Caro et al., 2018 ; Çelenk & Kumcağız, 2022 ; Hekmatpou et al., 2019 ; Klietz, 2022 ; Ransmayr, 2021 ; Zhang et al., 2024 ). Caregivers often experience inability to meet their own personal needs, and suffer tensions related to family and social life. In addition, caregivers report negative expectations and anxiety about the patient’s future, fatigue, sleep disturbance, financial distress, lack of information, feelings of guilt and inability to provide appropriate care, isolation, negative emotions (irritability, anger), and somatic and mental health problems (Caro et al., 2018 ; Hekmatpou et al., 2019 ). Lack of support from other family members, low levels of education and income, living with the patient, lack of leisure and entertainment and impaired health of caregivers are determinants of care burden(Kumar et al., 2022 ). Therefore, the care burden and distress level of caregivers should be examined, other factors affecting the care burden should be determined, caregivers should receive social support in line with their needs, possible mood changes should be prevented, and the quality of care provided to patients should be increased. When the literature is examined, it is seen that there are a limited number of studies examining the relationship between care burden and distress in neurodegenerative diseases. The aim of this study is to examine the relationship between care burden and distress in individuals caring for patients with neurological diseases. METHODS Design The design of this study is descriptive, relational, and cross-sectional. The population of the study consisted of primary caregivers of older patients who were hospitalized in the neurology departments of a tertiary university teaching hospital between May 1, 2024 and April 30, 2025. The sample of the study consisted of a total of 294 family members, 160 women and 134 men, who were providing care to patients over the age of 65. Inclusion and/or Exclusion Criteria The inclusion criteria of the study were (1) being an adult and participating voluntarily in the study, (2) being the immediate family of elderly patients receiving inpatient treatment (father, mother, sister, etc.), (3) having only one primary caregiver playing an active role in meeting the older person’s care needs, hospitalizations and check-ups, and (4) providing care to a stroke patient for at least 6 hours a day for at least 1 month, (5) the caregiver being over 18 years of age, and (6) being able to understand and speak Turkish. The exclusion criteria of the study were caregivers with psychological disorders and receiving treatment, those who were not primary caregivers, or who were disabled individuals or pregnant women. Data Collection Procedure Data were collected through face-to-face interviews with the caregivers of older patients receiving treatment in neurology clinics who agreed to participate in the study. The interviews lasted an average of 15 minutes. Medical information about the patients was obtained from patient records and healthcare professionals. In the research, a Personal Information Form, the Caregivers Burden Scale and the K10-Psychological Distress Scale were used. Personal Information Form The Personal Information Form is a form that researchers used to ascertain the demographic data of caregivers. Caregiver Burden Scale The Caregiver Burden Scale contains 22 items. Each item has a score ranging from 1 (never) to 4 (frequently). The scale consists of five sub-dimensions: general tension, isolation, frustration, emotional involvement, and environment. The general tension sub-dimension consists of eight items and the frustration sub-dimension consists of five items, while the isolation, emotional involvement, and environment sub-dimensions consist of three items each. Sub-dimension scores are calculated by adding the relevant items and dividing this score by the number of items in each sub-dimension. High scores indicate a high level of caregiver burden, while low scores indicate a low level of caregiver burden (Akinci & Pinar, 2012 ). In this study, the Cronbach’s Alpha value of the scale was determined to be 0.899. K10-Psychological Distress Scale The K10-Psychological distress scale was developed by Kessler and colleagues from Harvard Medical School with the support of the US National Center for Health Statistics. K10 is included in all national surveys in the WHO’s World Mental Health Initiative. Its adaptation to Turkish and validity and reliability testing were carried out by Altun et al. (Altun et al., 2019 ). It measures the frequency with which participants experience symptoms such as irritability, hopelessness, sadness, worthlessness and fatigue. It consists of 10 questions about non-specific psychological distress, and aims to measure the level of current depressive symptoms experienced by a person in the four weeks before the interview. Response options are based on a five-point Likert-type scale ranging from 1 (never) to 5 (always). The lowest score is 10 and the highest is 50. Scores can be divided into four levels: Scores of 10–15 are defined as low, 16–21 as medium, 22–29 as high, and 30–50 as very high. Higher scores indicate greater psychological distress (Altun et al., 2019 ). In this study, the Cronbach’s Alpha value of the scale was determined to be 0.940. Ethical Considerations The study was approved by the Non-Interventional Ethical Committee of XXX XXX XXXI in XXX (date March 21, 2024, approval number: 0168), and written permission was obtained for research from the university. Informed consent was obtained from all participants, and the purpose of the study was explained. Data Analysis All data were analyzed using IBM-SPSS (Statistical Package for Social Science) version 26 (IBM Corp, Armonk, New York, USA). Descriptive statistics were given as frequencies, percentages, means and standard deviations. The chi-square test was used to analyze the significant difference between demographic data. A p value of < 0.05 was considered statistically significant. Hypotheses For this purpose, the following questions were asked: Is there a significant relationship between the care burden and distress scores of the caregivers participating in the study? Is there a significant relationship between the care burden and distress scores of the caregivers participating in the study according to the descriptive findings? RESULTS Characteristics of the participants In all, 294 persons, 134 males and 160 females, completed the questionnaire. The average age of those participating in the study was 42.59 ± 13.36 (minimum: 18, maximum: 69) years. The study sample consisted of primary family members (54.4% female and 45.6% male) who were the caregivers of stroke patients over the age of 65. It was found that 48.3% of the primary caregivers were married, 67.3% were employed, 38.4% were primary school graduates and 57.1% had a moderate economic status. 73.8% of families experienced economic difficulties and 64.6% experienced family conflict. The mean caregiver burden score (minimum: 33, maximum: 108) was 69.38 ± 12.21, and the mean distress score (minimum: 10, maximum: 49) was 24.28 ± 9.76 (Table 1 ). Table 1 Characteristics of the Caregiver and Patients (N = 294) Frequency* n (%) Levene test statistics p- value Patients Age (years), mean ± SD 80.97 ± 8.07 (min:65, max:98) Age (years) 65–80 years 127(43.2) 0.027 0.871 80 + years 167(56.8) Gender Female 157(53.4) 0.115 0,734 Male 137(46.6 Caregiver Age (years), mean ± SD 42.59 ± 13.36 (min:18, max:69) Age (years) 18–35 years 125 (40.3) 0.183 0.833 36–55 years 126 (45.0) 55 + 43 (14.7) Gender Female 160 (54.4) 0.386 0.535 Male 134 (45.6) Marital status Married 142 (48.3) 1.129 0.325 Single 125 (42.5) Widowed 27 (9.2) Education Primary school 113 (38.4) 3.089 0.047 High school 105 (35.7) University 76 (25.9) Employment status Employed 198 (67.3) 0.916 0.339 Not working 96 (32.7) Socio-economic status Good 107 (36.4) 0.364 0.695 Medium 168 (57.1) Poor 19 (6.5) No. of children 0–2 198(67.3) 0.061 0.805 >3 96(32.7) Economic dificulties Yes 217(73.8) 0.020 0.888 No 77(26.2) Intra-family conflict Yes 190(64.6) 8.693 0.003 No 104(35.4) Relationship to patient Daughter 152(53.4) Son 130(44.2) Spouse 12(4.1) The total care burden score average of the primary caregiver family members participating in our study was 69.38 ± 12.21 (min: 33, max: 108), and they felt a medium level of care burden. When the care burden subscales and demographic data of the primary caregivers were compared in our study, the means related to disappointment were found to be statistically higher in women (t = 2.086, p = 0.038) (Table 2 ). When the emotional participation subscale of the care burden was compared according to socioeconomic status, it was found that family members who were in a bad situation felt a greater care burden (KW = 7.990, p = 0.018) (Table 2 ). When the care burden subscales and demographic data of the caregivers were compared in our study, the means related to disappointment were found to be statistically significant in the spouses of the patients ( KW = 10.367, p = 0.006)(Table 2 ). Table 2 Comparison of Care Burden Subscale Mean Scores According to Demographic Data General strain Isolation Disappointment Emotional involvement Environment n Mean + SD Mean + SD Mean + SD Mean + SD Mean + SD Patients Age (years) 65–80 years 127 2.99 ± 0.56 t=-0.552 3.21 ± 0.64 t=-1.063 3.27 ± 0.57 t=-0.637 3.10 ± 1.22 t = 0.197 3.21 ± 0.65 t = 0.243 80 + years 167 3.03 ± 0.65 p = 0.581 3.28 ± 0.59 p = 0.289 3.31 ± 0.52 p = 0.524 3.07 ± 0.71 p = 0.844 3.23 ± 0.57 p = 0.721 Gender Female 157 3.06 ± 0.60 t = 1.444 3.31 ± 0.57 t = 1.611 3.35 ± 0.54 t = 1.800 3.18 ± 1.08 t = 1.812 3.24 ± 0.56 t = 0.722 Male 137 2.96 ± 0.62 p = 0.150 3.19 ± 0.65 p = 0.108 3.24 ± 0.54 p = 0.073 2.98 ± 0.80 p = 0.071 3.19 ± 0.65 p = 0.471 Caregiver Age (years) 18–35 years 125 3.02 ± 0.56 3.30 ± 0.60 3.27 ± 0.59 3.16 ± 1.22 3.27 ± 0.60 36–55 years 126 2.97 ± 0.55 F = 1.145 3.21 ± 0.62 F = 0.816 3.32 ± 0.46 F = 0.298 3.01 ± 0.71 F = 0.766 3.17 ± 0.56 F = 0.810 55 + 43 3.13 ± 0.87 p = 0.320 3.20 ± 0.62 p = 0.443 3.30 ± 0.62 p = 0.742 3.11 ± 0.75 p = 0.466 3.21 ± 0.73 p = 0.446 Gender Female 160 3.07 ± 0.60 t = 1.746 3.31 ± 0.56 t = 1.787 3.36 ± 0.54 t = 2.086 3.18 ± 1.07 t = 1.946 3.25 ± 0.56 t = 1.044 Male 134 2.95 ± 0.62 p = 0.082 3.18 ± 0.65 p = 0.075 3.22 ± 0.54 p = 0.038 2.97 ± 0.80 p = 0.053 3.18 ± 0.65 p = 0.297 No. of children 0–2 198 2.99 ± 0.57 t=-0.907 3.24 ± 0.64 t=-0.486 3.26 ± 0.56 t=-1,645 3.10 ± 1.07 t = 0.419 3.22 ± 0.63 t=-0.160 > 3 96 3.06 ± 0.70 p = 0.365 3.28 ± 0.55 p = 0.628 3.37 ± 0.50 p = 0.101 3.05 ± 0.70 p = 0.675 3.23 ± 0.54 p = 0.183 Work status Yes 198 3.45 ± 0.55 t=-0.352 3.24 ± 0.59 t=-0.351 3.29 ± 0.52 t=-0.274 3.12 ± 1.06 t = 0.891 3.21 ± 0.60 t=-0.501 No 96 3.03 ± 0.72 p = 0.725 3.27 ± 0.64 p = 0.726 3.31 ± 0.59 p = 0.784 3.01 ± 0.73 p = 0.374 3.25 ± 0.61 p = 0.617 Mean rank Mean rank Mean rank Mean rank Mean rank Marital status Married 142 155.51 144.43 150.86 157.93 147.67 Single 125 135.36 KW = 4.571 146.63 KW = 1.838 142.34 KW = 0.847 137.05 KW = 4.318 147.93 KW = 0.037 Widowed 27 161.56 p = 0.102 167.65 p = 0.399 153.72 p = 0.655 141.02 p = 0.115 144.61 p = 0.982 Education Primary school 113 140.83 142.79 152.48 135.15 133.97 High school 105 155.14 KW = 1.555 144.96 KW = 1.721 143.00 KW = 0.714 154.47 KW = 4.016 158.53 KW = 4.098 University 76 146.86 p = 0.460 158.02 p = 0.423 146.31 p = 0.700 156.23 p = 0.134 152.38 p = 0.078 Socio-economic status Good 107 145.48 155.25 142.49 124.36 161.29 Medium 168 146.36 KW = 1.309 139.35 KW = 4.876 147.43 KW = 2.625 135.63 KW = 7.990 141.14 KW = 5.188 Poor 19 168.97 p = 0.520 175.87 p = 0.087 176.34 p = 0.269 157.45 p = 0.018 126.05 p = 0.075 Relationship to patient Daughter 152 152.65 150.20 155.47 151.27 148.34 Son 130 137.62 KW = 5.247 140.76 KW = 3.731 133.09 KW = 10.367 139.15 KW = 4.740 143.70 KW = 1.910 Spouse 12 189.33 p = 0.073 186.38 p = 0.155 202.58 p = 0.006 190.29 p = 0.093 178.08 p = 0.385 The total distress mean score of the primary caregiver family members participating in our study was 24.28 + 9.76 (min: 10, max: 49), and they felt a high level of distress (Table 3 ). In addition, the age (F = 10.381)(p = 0.000), education status (F = 3.262, p = 0.040), number of children (t = 4.150, p = 0.000), socio-economic status (KW = 7.595, P = 0.022) and marital status (KW = 13.021, P = 0.001) of the primary caregivers also statistically significantly affected the distress levels (Table 3 ). Table 3 Comparison of Scores of Psychological Distress n Mean + SD F/t/KW/p Patients Age (years) 65–80 years 127 25.14 ± 9.90 t = 1.318 80 + years 167 23.62 ± 9.63 p = 0.189 Gender Female 157 23.52 ± 10.12 t=-1.420 Male 137 25.14 ± 9.29 p = 0.153 Caregiver Age (years) 18–35 years 125 26.79 ± 9.20 36–55 years 126 23.42 ± 9.67 F = 10.381 55 + 43 19.51 ± 9.60 p = 0.000 Gender Female 160 23.45 ± 10.06 t=-1.590 Male 134 25.26 ± 9.32 p = 0.113 No. of children 0–2 198 25.88 ± 9.46 t = 4.150 > 3 96 20.97 ± 9.58 p = 0.000 Work status Working 198 24.56 ± 9.54 t = 0.714 Not working 96 23.69 ± 10.21 p = 0.476 Mean rank Educational level Primary school 113 125.26 High school 105 160.48 KW = 12.616 University 76 162.64 p = 0.002 Marital status Married 142 150.32 Single 125 156.28 KW = 13.021 Widowed 27 92.00 p = 0.001 Economic status Good 107 157.09 Average 168 146.89 KW = 7.595 Poor 19 98.89 p = 0.022 Relationship to patient Daughter 152 143.28 Son 130 156.28 KW = 4.657 Spouse 12 105.79 p = 0.097 T = Independent Samples Test, F = One way Anova, KW: Kruskal-Wallis Test Table 4 shows that there was a statistical relationship between the families’ informal care burden and perceived distress. Table 4 Correlations Among Caregiver burden and Psychological Distress General strain Isolation Disappointment Emotional involvement Environment Psychological Distress General strain 1 0.000** 0.000** 0.000** 0.000** 0.000** Isolation 0.000** 1 0.000** 0.000** 0.000** 0.000** Disappointment 0.000** 0.000** 1 0.000** 0.000** 0.000** Emotional involvement 0.000** 0.000** 0.000** 1 0.000** 0.000** Environment 0.000** 0.000** 0.000** 0.000** 1 0.000** Psychological Distress 0.000** 0.000** 0.000** 0.000** 0.000** 1 **. Correlation is significant at the 0.01 level DISCUSSION This study was conducted to examine the relationship between the care burden and distress level of primary family members who were providing informal care to stroke patients, and to determine the affecting factors. Comparison of Outcomes: Informal Care Burden The primary caregiver family members who participated in our study felt a moderate level of care burden. Studies in the literature examining the caregiver burden of informal family caregivers of stroke patients have reported that caregivers generally experienced a moderate level of caregiver burden (Caro et al., 2018 ; Hekmatpou et al., 2019 ; Hu et al., 2018 ; Kazemi et al., 2021 ). Our study supports the findings of previous studies. In terms of sex, according to the disappointment subscale of care burden, female caregivers who were primary caregivers experience more care burden than males. In previous studies, when the factors affecting the care burden of family members were examined, it was reported that women felt more care burden than men (Badger et al., 2024 ; Çelenk & Kumcağız, 2022 ; Choi & Lee, 2025 ; Kol & Yılmaz Karabulutlu, 2021 ; Kumar et al., 2022 ; Unsar et al., 2021 ). This situation can be explained by both a cultural tendency to prefer women for family care and women being more fragile and emotional than men. In our study, in terms of socio-demographics, 73.8% of families experienced economic difficulties and 64.6% experienced family conflict. Due to reasons such as increased costs of health care after stroke, decreased family income, sharing of resources, and multiple responsibility conflicts, patients and caregivers may experience economic difficulties, caregiver burden may increase, and the quality of life of caregivers may decrease (Badger et al., 2024 ; Caro et al., 2018 ; Gabriel et al., 2019 ; Gbiri et al., 2015 ). Liu et al. showed that the main reasons for caregiver burden are insufficient financial resources, multiple responsibility conflicts, and lack of social activities (Z. Liu et al., 2020 ). Previous studies in the literature have frequently reported varying degrees of economic problems faced by caregivers under economic pressure (Gabriel et al., 2019 ; Hansen et al., 2017 ; Yoon et al., 2014 ). Our findings support the literature. In our study, those among the primary caregivers with low socioeconomic status felt more emotional burden. At the same time, there are previous studies in the literature showing that low socioeconomic status of families increases the burden of care (Caro et al., 2018 ; Hekmatpou et al., 2019 ; Kumar et al., 2022 ). Our findings support the literature. The reason why the participants in our sample were mostly high- and middle-income may be due to the fact that the hospital where the study was conducted is one of the best regional public hospitals in the country. The results of this study are consistent with previous findings on factors affecting caregiver burden among family caregivers of older adults receiving long-term care. In our study, spouses of caregivers experience higher levels of disappointment burden care. Some studies have stated that brides are more affected by the care burden (Çelenk & Kumcağız, 2022 ; Kumar et al., 2022 ). Comparison of Outcomes: Psychological Distress The primary caregiver family members who participated in our study felt high levels of distress. Factors such as the age, marital status, education level, number of children and socioeconomic status of the family members affect the level of distress. In a study conducted by Limonero et al., 54% of the family caregivers of advanced cancer patients were found to have high levels of distress (Limonero et al., 2023 ). In a study conducted by Abreu et al. with the families of advanced dementia patients, high levels of distress were reported (Abreu et al., 2020 ). In terms of age, in our study, it was found that family caregivers between the ages of 18 and 35 experienced more stress. Similar to our study, Kumar et al. found that, in the relatives of stroke patients, being young increased the stress of the caregivers in their study (Kumar et al., 2022 ). However, in a study conducted by Unsar et al., it was found that the distress level of the older family caregivers of cancer patients was higher (Unsar et al., 2021 ). The relationship between age and psychological distress is mixed, with some studies showing higher psychological distress among younger caregivers(Kumar et al., 2022 ), while others showing higher distress among older caregivers (Iovino et al., 2020 ; Oechsle et al., 2020 ; Unsar et al., 2021 ). In our study, the distress level of caregivers who were single was found to be higher. In the study conducted by Hekmatpour et al., it was determined that marital status affected the distress of family caregivers (Hekmatpou et al., 2019 ). However, in the study conducted by Çelenk and Kumcağız, the anxiety level was found to be higher in married family members who were providing care to elderly patients (Çelenk & Kumcağız, 2022 ). According to education status, in our study, as the education level of caregivers increased, the stress experienced by family members also increased. However, in the study conducted by Kumar et al., it was found that the education level of the relatives of paralyzed patients did not affect the stress of caregivers(Kumar et al., 2022 ). In the study examining the care burden and distress by Mirjana Mikulic et al. no difference was found regarding the level of education of caregivers (Mikulić et al., 2023 ). In the study conducted by Pudelewicz et al. with a group of caregivers of Alzheimer’s patients, it was concluded that education level did not affect the care burden (Pudelewicz et al., 2018 ). In the study by Hekmatpour et al. examining the care burden of stroke patients, it was determined that patient care education improved care stress (Hekmatpou et al., 2019 ). There is mixed information in the literature regarding education status. This may vary depending on cultural differences, countries, and the number of sample groups. In our study, it was found that family members with poor socioeconomic status experienced more stress. Previous studies have emphasized that socioeconomic status affects the distress of caregivers (Çelenk & Kumcağız, 2022 ; Hekmatpou et al., 2019 ; Kumar et al., 2022 ). In the study conducted by Kumar et al. with caregivers of paralyzed patients, it was found that they were affected by poor socioeconomic status (Kumar et al., 2022 ). Our study also supports these studies. In our study, the distress of family members who were caring for paralyzed patients with 0–2 children was higher. However, in the study conducted by Çelenk and Kumcağız with family members who were caring for elderly patients, it was found that having children did not affect the caregivers (Çelenk & Kumcağız, 2022 ). In the study examining care burden and distress by Mirjana Mikulić et al., it was reported that having 3 or more children is a risk factor for care burden (Mikulić et al., 2023 ). Correlations Among Caregiver burden and Psychological Distress Psychological distress (depression and anxiety) is a major contributor to caregiver burden (Badger et al., 2024 ; Geng et al., 2018 ; Kaufman et al., 2019 ) A recent systematic review reported high rates of psychological distress among caregivers of cancer patients (Geng et al., 2018 ).Some studies have found that two in five caregivers worldwide experience depression, with prevalence rates of psychological distress approximately three times higher than in the general population (Bedaso et al., 2022 ). In our study, as the care burden of family members providing care to stroke patients increased, the distress score also increased. In the study conducted by Unsar et al. with caregivers of cancer patients, it was observed that as the care burden of caregivers increased, their anxiety and depression levels also increased (Unsar et al., 2021 ). In the study conducted by Çelenk et al. with caregivers of elderly patients, it was determined that as the care burden score averages increased, the state anxiety and trait anxiety scores increased (Çelenk & Kumcağız, 2022 ). In the study conducted by Liu et al., a positive correlation was obtained between the psychological stress of caregivers and their care burden (C. hsiu Liu et al., 2022 ). Previous studies have determined that caregivers experiencing negative psychological symptoms such as depression and anxiety tend to have higher caregiver burden (Çelenk & Kumcağız, 2022 ; C. hsiu Liu et al., 2022 ; Unsar et al., 2021 ). Our study also supports previous research. CONCLUSION This study found that informal family caregivers of stroke patients had moderate care burden and high distress. Factors such as gender and socioeconomic status contributed to the care burden of informal family caregivers of stroke patients, while factors such as age, marital status, education, socioeconomic status, and number of children were found to contribute to psychological distress. Strategies are urgently needed to alleviate and prevent the care burden and distress of informal caregivers. For this purpose, the family caregiver burden should be assessed before the patient is discharged from the hospital. Family nurses should work with a multidisciplinary team to develop online or mobile applications where families can access up-to-date evidence on caregiving, and they can consider innovative approaches to care through virtual support groups to reduce informal care burden and distress. Since the time required for weekly care and caregiving is more demanding for individuals with stroke, more socioeconomic support can be provided than to others. Taking adequate support measures to protect caregivers from care burden and health problems can contribute to the maintenance of high-quality care and the improvement of the quality of caregivers. Limitations The current study has several limitations. This study focused only on caregivers of hospitalized elderly patients with stroke history lasting longer than 6 months. Therefore, the findings cannot be extended to caregivers of all older patients. Second, since this study was conducted on Turkish family caregivers, it may be difficult to generalize the findings to other countries or cultures. Declarations Ethical considerations The study was approved by the Non-Interventional Ethical Committee of Izmir Katip Celebi University in Turkey (date 21 March 2024, approval number: 0168), and written permission was obtained for research from the universities. Informed consent was obtained from all participants, and the purpose of the study was explained. The study has not previously been presented in elsewhere. There are no people or facilities that make up the work. We would like to thank the caregiver and their institutions who voluntarily participated in our studies. Artificial intelligence was not used at any stage of our study. Conflict of interest disclosure There is no conflict of interest regarding the study. Acknowledgements We thank all the patients with stroke and their family caregivers in the neurology units who participated in our study, as well as the hospital clinical staff, for their help and support. Funding statement: Our work is not funded by any organization. Author Satatement Sevil Yilmaz : Conceptualization, Methodology, Data curation, Bilge Dalkıran : Software, Writing- Original draft preparation. Bilge Dalkıran : Visualization, Investigation. Sevil Yilmaz : Supervision. Sevil Yilmaz : Software, Validation. Sevil Yilmaz : Writing- Reviewing and Editing, References Abreu, W., Tolson, D., Jackson, G. A., & Costa, N. (2020). A cross-sectional study of family caregiver burden and psychological distress linked to frailty and functional dependency of a relative with advanced dementia. Dementia , 19 (2), 301–318. https://doi.org/10.1177/1471301218773842 Akinci, A. C., & Pinar, R. (2012). Validity and reliability of Turkish Caregiver Burden Scale among family caregivers of haemodialysis patients . 352–360. https://doi.org/10.1111/j.1365-2702.2012.04235.x Altun, Y., Özen, M., & Kuloğlu, M. M. (2019). Turkish adaptation of kessler psychological distress scale: Validity and reliability study. Anadolu Psikiyatri Dergisi , 21 , 23–31. https://doi.org/10.5455/apd.12801 Badger, T., Segrin, C., Crane, T., Morrill, K., & Sikorskii, A. (2024). Social determinants of health, psychological distress, and caregiver burden among informal cancer caregivers of cancer survivors during treatment. Journal of Psychosocial Oncology , 42 (3), 333–350. https://doi.org/10.1080/07347332.2023.2248486 Bedaso, A., Dejenu, G., & Duko, B. (2022). Depression among caregivers of cancer patients: Updated systematic review and meta-analysis. Psycho-Oncology , 31 (11), 1809–1820. https://doi.org/10.1002/pon.6045 Boonsin, S., Deenan, A., & Wacharasin, C. (2020). Factors influencing the burden of family caregiving for survivors of stroke. Pacific Rim International Journal of Nursing Research , 25 (1), 102–113. Caro, C. C., Costa, J. D., & Da Cruz, D. M. C. (2018). Burden and Quality of Life of Family Caregivers of Stroke Patients. Occupational Therapy in Health Care , 32 (2), 154–171. https://doi.org/10.1080/07380577.2018.1449046 Çelenk, Z., & Kumcağız, H. (2022). Yaşlı Hastaya Bakım Verenlerin Bakım Yükü ve Anksiyete Düzeyleri Arasındaki İlişkinin İncelenmesi. İstanbul Gelişim Üniversitesi Sosyal Bilimler Dergisi , 9 (2), 628–645. Choi, J. Y., & Lee, S. H. (2025). Exploring Factors Influencing Caregiver Burden: A Systematic Review of Family Caregivers of Older Adults with Chronic Illness in Local Communities. Healthcare (Switzerland) , 12 (1002). Del-Pino-Casado, R., Priego-cubero, E., Lo, C., & Orgeta, V. (2021). Subjective caregiver burden and anxiety in informal caregivers: A systematic review and . https://doi.org/10.1371/journal.pone.0247143 Gabriel, I. O., Aluko, J. O., & Okeme, M. I. (2019). Caregiver Burden Among Informal Caregivers of Women with Breast Cancer. Biomedical Journal of Scientific & Technical Research , 15 (3), 11384–11392. https://doi.org/10.26717/bjstr.2019.15.002704 Gbiri, C. A., Olawale, O. A., & Isaac, S. O. (2015). Stroke management: Informal caregivers’ burdens and strians of caring for stroke survivors. Annals of Physical and Rehabilitation Medicine , 58 (2), 98–103. https://doi.org/10.1016/j.rehab.2014.09.017 Geng, H., mei, Chuang, D., mei, Yang, F., Yang, Y., Liu, W., Liu, L. hui, & Tian, H. (2018). Prevalence and determinants of depression in caregivers of cancer patients: A systematic review and meta-analysis. Medicine (United States) , 97 (39). https://doi.org/10.1097/MD.0000000000011863 Hansen, L., Rosenkranz, S. J., Wherity, K., & Sasaki, A. (2017). Living with hepatocellular carcinoma near the end of life: Family caregivers’ perspectives. Oncology Nursing Forum , 44 (5), 562–570. https://doi.org/10.1188/17.ONF.562-570 Hekmatpou, D., Baghban, E. M., & Dehkordi, L. M. (2019). The effect of patient care education on burden of care and the quality of life of caregivers of stroke patients. Journal of Multidisciplinary Healthcare , 12 , 211–217. https://doi.org/10.2147/JMDH.S196903 Hu, P., Yang, Q., Kong, L., Hu, L., & Zeng, L. (2018). Relationship between the anxiety/depression and care burden of the major caregiver of stroke patients . 0 (April). Iovino, P., Maria, M., De, Ausili, D., Riegel, B., Matarese, M., & Vellone, E. (2020). Depression and self-care in older adults with multiple chronic conditions: A multivariate analysis . March , 1668–1678. https://doi.org/10.1111/jan.14385 Katan, M., & Luft, A. (2021). Global Burden of Stroke. Seminars in Neurology , 38 , 208–211. https://doi.org/10.1016/B978-0-323-69424-7.00014-4 Kaufman, J. E., Lee, Y., Vaughon, W., Unuigbe, A., & Gallo, W. T. (2019). Depression Associated With Transitions Into and Out of Spousal Caregiving. International Journal of Aging and Human Development , 88 (2), 127–149. https://doi.org/10.1177/0091415018754310 Kazemi, A., Azimian, J., Mafi, M., Allen, K. A., & Motalebi, S. A. (2021). Caregiver burden and coping strategies in caregivers of older patients with stroke. BMC Psychology , 1–9. https://doi.org/10.1186/s40359-021-00556-z Klietz, M. (2022). Caregiver Burden in Movement Disorders and Neurodegenerative Diseases: Editorial. Brain Sciences , 12 (9), 10–13. https://doi.org/10.3390/brainsci12091184 Kol, R., & Yılmaz Karabulutlu, E. (2021). Kronik Hastalığı Olan Bireylere Bakım Verenlerin Bakım Yükü ve İyilik Halinin Değerlendirilmesi Examination of The Care Burden and Well-Being of Caregivers of İndividuals with Chronic Disease. Kocaeli Med , 10 (1), 119–127. Kumar, A., Kumar, A. Y., Singh, V., Pathak, K., Chaurasia, A., Mishra, R. N., V. N., & Joshi, D. (2022). Caregiver Burden in Caregivers of Stroke Survivors: A Hospital–Based Study. Annals of Indian Academy of Neurology , 25 (6), 1092–1098. https://doi.org/10.4103/aian.AIAN Limonero, J. T., Maté-Méndez, J., Gómez-Romero, M. J., Mateo-Ortega, D., González-Barboteo, J., Bernaus, M., López-Postigo, M., Sirgo, A., Viel, S., Sánchez-Julve, C., Bayés, R., Gómez-Batiste, X., & Tomás-Sábado, J. (2023). Family caregiver emotional distress in advanced cancer: The DME-C scale psychometric properties. BMJ Supportive and Palliative Care , 13 (e1), E177–E184. https://doi.org/10.1136/bmjspcare-2020-002608 Liu, C., Chen, Y. J., Chen, J. S., Fan, C. W., Hsieh, M. T., Lin, C. Y., & Pakpour, A. H. (2022). Burdens on caregivers of patients with stroke during a pandemic: relationships with support satisfaction, psychological distress, and fear of COVID-19. BMC Geriatrics , 22 (1), 1–8. https://doi.org/10.1186/s12877-022-03675-3 Liu, Z., Heffernan, C., & Tan, J. (2020). Caregiver burden: A concept analysis. International Journal of Nursing Sciences , 7 (4), 438–445. https://doi.org/10.1016/j.ijnss.2020.07.012 Mikulić, M., Ćavar, I., Jurišić, D., Jelinčić, I., & Degmečić, D. (2023). Burden and Psychological Distress in Caregivers of Persons with Addictions. Challenges , 14 (2), 24. https://doi.org/10.3390/challe14020024 Oechsle, K., Ullrich, A., Marx, G., Benze, G., Wowretzko, F., Zhang, Y., Dickel, L., Heine, J., Wendt, K. N., Nauck, F., Bokemeyer, C., & Bergelt, C. (2020). Prevalence and Predictors of Distress, Anxiety, Depression, and Quality of Life in Bereaved Family Caregivers of Patients With Advanced Cancer . 37 (3), 201–213. https://doi.org/10.1177/1049909119872755 Pudelewicz, A., Talarska, D., & Bazczyk, G. (2018). Burden of caregivers of patients with Alzheimer ’ s disease. Scandinavian Journal of Caring Sciences , 5 , 336–341. https://doi.org/10.1111/scs.12626 Ransmayr, G. (2021). Challenges of caregiving to neurological patients. Wiener Medizinische Wochenschrift , 171 (11–12), 282–288. https://doi.org/10.1007/s10354-021-00844-8 Unsar, S., Erol, O., & Ozdemir, O. (2021). Caregiving burden, depression, and anxiety in family caregivers of patients with cancer. European Journal of Oncology Nursing , 50 (April 2020), 101882. https://doi.org/10.1016/j.ejon.2020.101882 Yoon, S. J., Kim, J. S., Jung, J. G., Kim, S. S., & Kim, S. (2014). Modifiable factors associated with caregiver burden among family caregivers of terminally ill Korean cancer patients. Supportive Care in Cancer , 22 (5), 1243–1250. https://doi.org/10.1007/s00520-013-2077-z Zhang, Y., Li, J., Zhang, Y., Chen, C., Guan, C., Zhou, L., Zhang, S., Chen, X., & Hu, X. (2024). Mediating effect of social support between caregiver burden and quality of life among family caregivers of cancer patients in palliative care units. European Journal of Oncology Nursing , 68 (April 2023), 102509. https://doi.org/10.1016/j.ejon.2024.102509 Additional Declarations No competing interests reported. Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. Our growing team is made up of researchers and industry professionals working together to solve the most critical problems facing scientific publishing. Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-7906385","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":532574849,"identity":"82914fd7-bb0a-4389-9156-7f91da6de0b8","order_by":0,"name":"SEVİL YILMAZ","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAA7klEQVRIiWNgGAWjYJCCAw8YGHj4QKwPBgkgyoCwFqA6HjYgg3EGXEsCAT0geZAWZh4GIrTIt/cYAm05LMMmdvjxZ5uCNHkG9uZtEow/7uHUYnDmjAFICw+bdJqBcY5BjmEDz7EyCYaEYtxaJNISoFoSDJJzDCoSGCRyzIBacLtMfv4zmJb0D4ctQFrk3+DXwnCD+QBUS45hM4NBDtAWHvxaDM4kA7UYpIO0FDP2GKQZtvGkFVskpOFxWPvB5g8fKqzt+aXTN3/48SdZnp/98MYbH2zwOAxiVzOCDYoggjEJBHWElYyCUTAKRsHIBQDBiUpwH9GUFgAAAABJRU5ErkJggg==","orcid":"","institution":"Izmir Kâtip Çelebi University","correspondingAuthor":true,"prefix":"","firstName":"SEVİL","middleName":"","lastName":"YILMAZ","suffix":""},{"id":532574850,"identity":"440c69d6-700f-42a8-8309-12ac7a003df8","order_by":1,"name":"Bilge Dalkiran","email":"","orcid":"","institution":"Ege University","correspondingAuthor":false,"prefix":"","firstName":"Bilge","middleName":"","lastName":"Dalkiran","suffix":""}],"badges":[],"createdAt":"2025-10-20 13:53:26","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-7906385/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-7906385/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":94058534,"identity":"0433abd8-9ac1-48fc-9ffb-09cf3fe18747","added_by":"auto","created_at":"2025-10-22 05:42:35","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":81630,"visible":true,"origin":"","legend":"","description":"","filename":"MainDocumentwithoutAuthorDetails.docx","url":"https://assets-eu.researchsquare.com/files/rs-7906385/v1/7ce5d839f5d05564c0c6f2b9.docx"},{"id":94058533,"identity":"965b3a69-9d0e-4c98-98ce-6a4cf359b826","added_by":"auto","created_at":"2025-10-22 05:42:35","extension":"docx","order_by":1,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":50998,"visible":true,"origin":"","legend":"","description":"","filename":"Tables.docx","url":"https://assets-eu.researchsquare.com/files/rs-7906385/v1/0c7f7bc30db9ae18b2a78efc.docx"},{"id":94058252,"identity":"8d7e5a8c-302f-450c-a07b-20a5f2b6cac8","added_by":"auto","created_at":"2025-10-22 05:34:35","extension":"json","order_by":2,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":3951,"visible":true,"origin":"","legend":"","description":"","filename":"18615c79cebf47c5a0fc6df6fd3eb689.json","url":"https://assets-eu.researchsquare.com/files/rs-7906385/v1/b466849a942c2af22ffc137a.json"},{"id":94058253,"identity":"060e16c3-e20b-4ef4-ab62-aaadf3e73c7f","added_by":"auto","created_at":"2025-10-22 05:34:35","extension":"docx","order_by":3,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":18731,"visible":true,"origin":"","legend":"","description":"","filename":"Titlepage.docx","url":"https://assets-eu.researchsquare.com/files/rs-7906385/v1/f98e2fe2fcd1d0789255d66e.docx"},{"id":94058535,"identity":"004fcbe7-62c8-4eb4-95b0-b8dcbae6f4cb","added_by":"auto","created_at":"2025-10-22 05:42:35","extension":"xml","order_by":4,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":152009,"visible":true,"origin":"","legend":"","description":"","filename":"18615c79cebf47c5a0fc6df6fd3eb6891enriched.xml","url":"https://assets-eu.researchsquare.com/files/rs-7906385/v1/e49294c91f2647ec91e4f89c.xml"},{"id":94058254,"identity":"b6af5f71-f0c6-43d2-b3d0-0e73ce78c77c","added_by":"auto","created_at":"2025-10-22 05:34:35","extension":"xml","order_by":5,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":149188,"visible":true,"origin":"","legend":"","description":"","filename":"18615c79cebf47c5a0fc6df6fd3eb6891structuring.xml","url":"https://assets-eu.researchsquare.com/files/rs-7906385/v1/b305d15e6aa98388a4766966.xml"},{"id":94058256,"identity":"ab4b6da2-c9c3-461c-823f-f877b28a2b3e","added_by":"auto","created_at":"2025-10-22 05:34:35","extension":"html","order_by":6,"title":"","display":"","copyAsset":false,"role":"acdc-reference","size":158614,"visible":true,"origin":"","legend":"","description":"","filename":"earlyproof.html","url":"https://assets-eu.researchsquare.com/files/rs-7906385/v1/92869fc84d75c89892c78137.html"},{"id":94469613,"identity":"95363a9f-13ca-4bc8-a82f-b0de20e6982c","added_by":"auto","created_at":"2025-10-27 15:30:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1483835,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-7906385/v1/7231fb5a-8a17-47ee-8ed4-3889ab53cabe.pdf"}],"financialInterests":"No competing interests reported.","formattedTitle":"Relationships Between Informal Caregiver Burden and Psychological Distress Among Primary Family Caregivers of Stroke Patients","fulltext":[{"header":"INTRODUCTION","content":"\u003cp\u003eStroke is one of the most serious neurological disorders, and is caused by decreased blood flow in certain areas of the brain due to vascular injuries. The most important health problems among older adults are cardiovascular diseases, cancer, and neurological (stroke) disorders, and stroke is the third leading cause of death in the world(Kazemi et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The incidence and mortality rate of stroke vary among countries, geographic regions, and ethnic groups. Especially in high-income countries, emphasis is placed on developments in prevention, acute treatment, and neuro-rehabilitation, and efforts are made to reduce the burden of disease(Katan \u0026amp; Luft, \u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAfter cerebrovascular injuries, patients\u0026rsquo; activities of daily living (ADL) and autonomy are impaired (Kazemi et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Ransmayr, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Patients may need long-term care and the assistance of an informal caregiver when they are unable to manage motor, sensory, vegetative, cognitive, neuropsychiatric or behavioral disorders (Klietz, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Ransmayr, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Informal caregivers are usually family members. They do not receive any payment for care, but are the most involved in the social, mental and physical care of patients. Informal caregivers are mostly spouses, daughters or daughters-in-law, sons and parents or siblings, but they are usually women, and care is provided in the patients\u0026rsquo; homes or in the caregiver\u0026rsquo;s home (Ransmayr, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eInformal care burden can be defined as the burden experienced by individuals caring for a chronically ill, disabled or older family member. The care burden includes important issues such as transportation, shopping, money management, basic health services, and daily personal care (dressing, nutrition, washing) (Badger et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Boonsin et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Caro et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eCaregiving is often time and energy consuming and difficult for caregivers (Del-Pino-Casado et al., \u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The patient\u0026rsquo;s age, male gender, body weight and height, health status, sleep quality, education, dependency, socioeconomic parameters, and caregiver resilience are important factors of caregiving burden (Ransmayr, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). In addition, frontal dysexecutive disorders (loss of insight, judgment, logical thinking, etc.), behavioral disorders (hyperactivity or apathy, aggression, lack of inhibition), and neuropsychiatric symptoms such as irritability, anxiety or depression, paranoid thoughts and hallucinations, and communication difficulties are also important factors of caregiving burden (Ransmayr, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn addition, factors such as the caregiver\u0026rsquo;s own health problems, emotional problems (insomnia, social isolation, etc.) and economic problems (long working hours, cost burden, etc.) also increase the distress of informal caregivers (Boonsin et al., \u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Caro et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eInformal caregivers often complain of a decrease in quality of life and deterioration of physical and emotional health, as well as socioeconomic effects (Caro et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; \u0026Ccedil;elenk \u0026amp; Kumcağız, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Klietz, \u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Ransmayr, \u003cspan citationid=\"CR30\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Zhang et al., \u003cspan citationid=\"CR33\" class=\"CitationRef\"\u003e2024\u003c/span\u003e). Caregivers often experience inability to meet their own personal needs, and suffer tensions related to family and social life. In addition, caregivers report negative expectations and anxiety about the patient\u0026rsquo;s future, fatigue, sleep disturbance, financial distress, lack of information, feelings of guilt and inability to provide appropriate care, isolation, negative emotions (irritability, anger), and somatic and mental health problems (Caro et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). Lack of support from other family members, low levels of education and income, living with the patient, lack of leisure and entertainment and impaired health of caregivers are determinants of care burden(Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eTherefore, the care burden and distress level of caregivers should be examined, other factors affecting the care burden should be determined, caregivers should receive social support in line with their needs, possible mood changes should be prevented, and the quality of care provided to patients should be increased. When the literature is examined, it is seen that there are a limited number of studies examining the relationship between care burden and distress in neurodegenerative diseases. The aim of this study is to examine the relationship between care burden and distress in individuals caring for patients with neurological diseases.\u003c/p\u003e"},{"header":"METHODS","content":"\u003cdiv id=\"Sec3\" class=\"Section2\"\u003e\u003ch2\u003eDesign\u003c/h2\u003e\u003cp\u003eThe design of this study is descriptive, relational, and cross-sectional. The population of the study consisted of primary caregivers of older patients who were hospitalized in the neurology departments of a tertiary university teaching hospital between May 1, 2024 and April 30, 2025. The sample of the study consisted of a total of 294 family members, 160 women and 134 men, who were providing care to patients over the age of 65.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eInclusion and/or Exclusion Criteria\u003c/h3\u003e\n\u003cp\u003eThe inclusion criteria of the study were (1) being an adult and participating voluntarily in the study, (2) being the immediate family of elderly patients receiving inpatient treatment (father, mother, sister, etc.), (3) having only one primary caregiver playing an active role in meeting the older person\u0026rsquo;s care needs, hospitalizations and check-ups, and (4) providing care to a stroke patient for at least 6 hours a day for at least 1 month, (5) the caregiver being over 18 years of age, and (6) being able to understand and speak Turkish. The exclusion criteria of the study were caregivers with psychological disorders and receiving treatment, those who were not primary caregivers, or who were disabled individuals or pregnant women.\u003c/p\u003e\n\u003ch3\u003eData Collection Procedure\u003c/h3\u003e\n\u003cp\u003eData were collected through face-to-face interviews with the caregivers of older patients receiving treatment in neurology clinics who agreed to participate in the study. The interviews lasted an average of 15 minutes. Medical information about the patients was obtained from patient records and healthcare professionals. In the research, a Personal Information Form, the Caregivers Burden Scale and the K10-Psychological Distress Scale were used.\u003c/p\u003e\n\u003ch3\u003ePersonal Information Form\u003c/h3\u003e\n\u003cp\u003eThe Personal Information Form is a form that researchers used to ascertain the demographic data of caregivers.\u003c/p\u003e\n\u003ch3\u003eCaregiver Burden Scale\u003c/h3\u003e\n\u003cp\u003eThe Caregiver Burden Scale contains 22 items. Each item has a score ranging from 1 (never) to 4 (frequently). The scale consists of five sub-dimensions: general tension, isolation, frustration, emotional involvement, and environment. The general tension sub-dimension consists of eight items and the frustration sub-dimension consists of five items, while the isolation, emotional involvement, and environment sub-dimensions consist of three items each. Sub-dimension scores are calculated by adding the relevant items and dividing this score by the number of items in each sub-dimension. High scores indicate a high level of caregiver burden, while low scores indicate a low level of caregiver burden (Akinci \u0026amp; Pinar, \u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2012\u003c/span\u003e). In this study, the Cronbach\u0026rsquo;s Alpha value of the scale was determined to be 0.899.\u003c/p\u003e\u003cdiv id=\"Sec8\" class=\"Section2\"\u003e\u003ch2\u003eK10-Psychological Distress Scale\u003c/h2\u003e\u003cp\u003eThe K10-Psychological distress scale was developed by Kessler and colleagues from Harvard Medical School with the support of the US National Center for Health Statistics. K10 is included in all national surveys in the WHO\u0026rsquo;s World Mental Health Initiative. Its adaptation to Turkish and validity and reliability testing were carried out by Altun et al. (Altun et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). It measures the frequency with which participants experience symptoms such as irritability, hopelessness, sadness, worthlessness and fatigue. It consists of 10 questions about non-specific psychological distress, and aims to measure the level of current depressive symptoms experienced by a person in the four weeks before the interview. Response options are based on a five-point Likert-type scale ranging from 1 (never) to 5 (always). The lowest score is 10 and the highest is 50. Scores can be divided into four levels: Scores of 10\u0026ndash;15 are defined as low, 16\u0026ndash;21 as medium, 22\u0026ndash;29 as high, and 30\u0026ndash;50 as very high. Higher scores indicate greater psychological distress (Altun et al., \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). In this study, the Cronbach\u0026rsquo;s Alpha value of the scale was determined to be 0.940.\u003c/p\u003e\u003c/div\u003e\n\u003ch3\u003eEthical Considerations\u003c/h3\u003e\n\u003cp\u003eThe study was approved by the Non-Interventional Ethical Committee of XXX XXX XXXI in XXX (date March 21, 2024, approval number: 0168), and written permission was obtained for research from the university. Informed consent was obtained from all participants, and the purpose of the study was explained.\u003c/p\u003e\u003cdiv id=\"Sec10\" class=\"Section2\"\u003e\u003ch2\u003eData Analysis\u003c/h2\u003e\u003cp\u003eAll data were analyzed using IBM-SPSS (Statistical Package for Social Science) version 26 (IBM Corp, Armonk, New York, USA). Descriptive statistics were given as frequencies, percentages, means and standard deviations. The chi-square test was used to analyze the significant difference between demographic data. A p value of \u0026lt;\u0026thinsp;0.05 was considered statistically significant.\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec11\" class=\"Section2\"\u003e\u003ch2\u003eHypotheses\u003c/h2\u003e\u003cp\u003eFor this purpose, the following questions were asked:\u003c/p\u003e\u003cp\u003e\u003col\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eIs there a significant relationship between the care burden and distress scores of the caregivers participating in the study?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003cspan\u003e\u003cli\u003e\u003cp\u003eIs there a significant relationship between the care burden and distress scores of the caregivers participating in the study according to the descriptive findings?\u003c/p\u003e\u003c/li\u003e\u003c/span\u003e\u003c/ol\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"RESULTS","content":"\u003cdiv id=\"Sec13\" class=\"Section2\"\u003e\u003ch2\u003eCharacteristics of the participants\u003c/h2\u003e\u003cp\u003eIn all, 294 persons, 134 males and 160 females, completed the questionnaire. The average age of those participating in the study was 42.59\u0026thinsp;\u0026plusmn;\u0026thinsp;13.36 (minimum: 18, maximum: 69) years. The study sample consisted of primary family members (54.4% female and 45.6% male) who were the caregivers of stroke patients over the age of 65. It was found that 48.3% of the primary caregivers were married, 67.3% were employed, 38.4% were primary school graduates and 57.1% had a moderate economic status. 73.8% of families experienced economic difficulties and 64.6% experienced family conflict. The mean caregiver burden score (minimum: 33, maximum: 108) was 69.38\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;12.21, and the mean distress score (minimum: 10, maximum: 49) was 24.28\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.76 (Table\u0026nbsp;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e1\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab1\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 1\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCharacteristics of the Caregiver and Patients (N\u0026thinsp;=\u0026thinsp;294)\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"5\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFrequency*\u003c/p\u003e\u003cp\u003e\u003cem\u003en\u003c/em\u003e (%)\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eLevene test statistics\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003ep-\u003c/em\u003evalue\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"6\" rowspan=\"7\"\u003e\u003cp\u003e\u003cb\u003ePatients\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAge (years), mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e80.97\u0026thinsp;\u0026plusmn;\u0026thinsp;8.07 (min:65, max:98)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e65\u0026ndash;80 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e127(43.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.027\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003e0.871\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e80\u0026thinsp;+\u0026thinsp;years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e167(56.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e157(53.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.115\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003e0,734\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e137(46.6\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"35\" rowspan=\"36\"\u003e\u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAge (years), mean\u0026thinsp;\u0026plusmn;\u0026thinsp;SD\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colspan=\"2\" nameend=\"c4\" namest=\"c3\"\u003e\u003cp\u003e42.59\u0026thinsp;\u0026plusmn;\u0026thinsp;13.36 (min:18, max:69)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e18\u0026ndash;35 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e125 (40.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.183\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cem\u003e0.833\u003c/em\u003e\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e36\u0026ndash;55 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e126 (45.0)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e55 +\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e43 (14.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e160 (54.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.386\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.535\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e134 (45.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e142 (48.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1.129\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.325\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e125 (42.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eWidowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e27 (9.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePrimary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e113 (38.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e3.089\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.047\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e105 (35.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eUniversity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e76 (25.9)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eEmployment status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eEmployed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e198 (67.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.916\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.339\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNot working\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e96 (32.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eSocio-economic status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e107 (36.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.364\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.695\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eMedium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e168 (57.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e19 (6.5)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eNo. of children\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0\u0026ndash;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e198(67.3)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.061\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.805\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u0026gt;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e96(32.7)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eEconomic dificulties\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e217(73.8)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.020\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.888\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e77(26.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eIntra-family conflict\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e190(64.6)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e8.693\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.003\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e104(35.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eRelationship to patient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eDaughter\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e152(53.4)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSon\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e130(44.2)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e12(4.1)\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe total care burden score average of the primary caregiver family members participating in our study was 69.38\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;12.21 (min: 33, max: 108), and they felt a medium level of care burden. When the care burden subscales and demographic data of the primary caregivers were compared in our study, the means related to disappointment were found to be statistically higher in women (t\u0026thinsp;=\u0026thinsp;2.086, p\u0026thinsp;=\u0026thinsp;0.038) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). When the emotional participation subscale of the care burden was compared according to socioeconomic status, it was found that family members who were in a bad situation felt a greater care burden (KW\u0026thinsp;=\u0026thinsp;7.990, p\u0026thinsp;=\u0026thinsp;0.018) (Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e). When the care burden subscales and demographic data of the caregivers were compared in our study, the means related to disappointment were found to be statistically significant in the spouses of the patients ( KW\u0026thinsp;=\u0026thinsp;10.367, p\u0026thinsp;=\u0026thinsp;0.006)(Table\u0026nbsp;\u003cspan refid=\"Tab2\" class=\"InternalRef\"\u003e2\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab2\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 2\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Care Burden Subscale Mean Scores According to Demographic Data\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"14\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c8\" colnum=\"8\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c9\" colnum=\"9\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c10\" colnum=\"10\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c11\" colnum=\"11\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c12\" colnum=\"12\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c13\" colnum=\"13\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c14\" colnum=\"14\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c6\" namest=\"c5\"\u003e\u003cp\u003eGeneral strain\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c8\" namest=\"c7\"\u003e\u003cp\u003eIsolation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c10\" namest=\"c9\"\u003e\u003cp\u003eDisappointment\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c12\" namest=\"c11\"\u003e\u003cp\u003eEmotional involvement\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colspan=\"2\" nameend=\"c14\" namest=\"c13\"\u003e\u003cp\u003eEnvironment\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMean\u0026thinsp;+\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003eMean\u0026thinsp;+\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003eMean\u0026thinsp;+\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003eMean\u0026thinsp;+\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003eMean\u0026thinsp;+\u0026thinsp;SD\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003ePatients\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e65\u0026ndash;80 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e127\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.99\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-0.552\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.21\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et=-1.063\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.27\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003et=-0.637\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.10\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;1.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.197\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.21\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.243\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e80\u0026thinsp;+\u0026thinsp;years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.03\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.581\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.28\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.289\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.31\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.524\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.07\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.844\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.23\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.721\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e157\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.06\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.444\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.31\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.611\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.35\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.800\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.18\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;1.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.812\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.24\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.722\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.96\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.150\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.19\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.108\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.24\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.073\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2.98\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.071\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.19\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.471\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"21\" rowspan=\"22\"\u003e\u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18\u0026ndash;35 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.02\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.30\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.27\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.16\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;1.22\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.27\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36\u0026ndash;55 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.97\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;1.145\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.21\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;0.816\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.32\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;0.298\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.01\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.71\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;0.766\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.17\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;0.810\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55 +\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.13\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.320\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.20\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.443\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.30\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.742\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.11\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.75\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.466\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.21\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.446\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.07\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.746\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.31\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.787\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.36\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;2.086\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.18\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.946\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.25\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.044\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.95\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.082\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.18\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.075\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.22\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.038\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e2.97\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.80\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.053\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.18\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.297\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"1\" rowspan=\"2\"\u003e\u003cp\u003e\u003cb\u003eNo. of children\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u0026ndash;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e198\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e2.99\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.57\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-0.907\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.24\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et=-0.486\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.26\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003et=-1,645\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.10\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;1.07\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.419\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.22\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003et=-0.160\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.06\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.365\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.28\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.628\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.37\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.50\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.101\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.05\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.675\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.23\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.183\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eWork status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eYes\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e198\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.45\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.55\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-0.352\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.24\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003et=-0.351\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.29\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.52\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003et=-0.274\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.12\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;1.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.891\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.21\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003et=-0.501\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNo\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e3.03\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.725\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e3.27\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.726\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e3.31\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.59\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.784\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e3.01\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.73\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.374\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e3.25\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;0.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.617\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e\u003cb\u003eMean rank\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e\u003cb\u003eMean rank\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e\u003cb\u003eMean rank\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e\u003cb\u003eMean rank\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e\u003cb\u003eMean rank\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e142\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e155.51\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e144.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e150.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e157.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e147.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e135.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;4.571\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e146.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;1.838\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e142.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;0.847\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e137.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;4.318\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e147.93\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;0.037\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWidowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e161.56\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.102\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e167.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.399\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e153.72\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.655\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e141.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.115\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e144.61\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.982\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eEducation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePrimary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e113\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e140.83\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e142.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e152.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e135.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e133.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e155.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;1.555\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e144.96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;1.721\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e143.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;0.714\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e154.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;4.016\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e158.53\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;4.098\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUniversity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e146.86\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.460\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e158.02\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.423\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e146.31\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.700\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e156.23\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e152.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.078\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eSocio-economic status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e145.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e155.25\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e142.49\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e124.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e161.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMedium\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e168\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e146.36\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;1.309\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e139.35\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;4.876\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e147.43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;2.625\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e135.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;7.990\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e141.14\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;5.188\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e168.97\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.520\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e175.87\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.087\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e176.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.269\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e157.45\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.018\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e126.05\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.075\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\" morerows=\"2\" rowspan=\"3\"\u003e\u003cp\u003e\u003cb\u003eRelationship to patient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDaughter\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e152\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e152.65\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e150.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e155.47\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e151.27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e148.34\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSon\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e137.62\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;5.247\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e140.76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;3.731\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e133.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;10.367\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e139.15\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;4.740\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e143.70\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;1.910\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e189.33\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.073\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e186.38\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c8\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.155\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c9\"\u003e\u003cp\u003e202.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c10\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.006\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c11\"\u003e\u003cp\u003e190.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c12\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.093\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c13\"\u003e\u003cp\u003e178.08\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c14\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.385\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eThe total distress mean score of the primary caregiver family members participating in our study was 24.28\u0026thinsp;+\u0026thinsp;9.76 (min: 10, max: 49), and they felt a high level of distress (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e). In addition, the age (F\u0026thinsp;=\u0026thinsp;10.381)(p\u0026thinsp;=\u0026thinsp;0.000), education status (F\u0026thinsp;=\u0026thinsp;3.262, p\u0026thinsp;=\u0026thinsp;0.040), number of children (t\u0026thinsp;=\u0026thinsp;4.150, p\u0026thinsp;=\u0026thinsp;0.000), socio-economic status (KW\u0026thinsp;=\u0026thinsp;7.595, P\u0026thinsp;=\u0026thinsp;0.022) and marital status (KW\u0026thinsp;=\u0026thinsp;13.021, P\u0026thinsp;=\u0026thinsp;0.001) of the primary caregivers also statistically significantly affected the distress levels (Table\u0026nbsp;\u003cspan refid=\"Tab3\" class=\"InternalRef\"\u003e3\u003c/span\u003e).\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab3\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 3\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eComparison of Scores of Psychological Distress\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"6\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"char\" char=\".\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003en\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMean\u0026thinsp;+\u0026thinsp;SD\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eF/t/KW/p\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"3\" rowspan=\"4\"\u003e\u003cp\u003e\u003cb\u003ePatients\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e65\u0026ndash;80 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e127\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25.14\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.90\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;1.318\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e80\u0026thinsp;+\u0026thinsp;years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e167\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23.62\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.63\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.189\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e157\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23.52\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;10.12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-1.420\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e137\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25.14\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.29\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.153\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eCaregiver\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eAge (years)\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e18\u0026ndash;35 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e26.79\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.20\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\" morerows=\"20\" rowspan=\"21\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e36\u0026ndash;55 years\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e126\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23.42\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.67\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eF\u0026thinsp;=\u0026thinsp;10.381\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e55 +\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e43\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e19.51\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.60\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eGender\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eFemale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e160\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23.45\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;10.06\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et=-1.590\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMale\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e134\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25.26\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.113\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eNo. of children\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0\u0026ndash;2\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e198\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e25.88\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.46\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;4.150\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e\u0026gt;\u0026thinsp;3\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e20.97\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.58\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.000\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eWork status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWorking\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e198\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e24.56\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.54\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003et\u0026thinsp;=\u0026thinsp;0.714\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eNot working\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e96\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e23.69\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;10.21\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.476\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003eMean rank\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eEducational level\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePrimary school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e113\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e125.26\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eHigh school\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e105\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e160.48\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;12.616\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eUniversity\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e76\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e162.64\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.002\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eMarital status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eMarried\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e142\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e150.32\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSingle\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e125\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e156.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;13.021\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eWidowed\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e27\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e92.00\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.001\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eEconomic status\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eGood\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e107\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e157.09\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eAverage\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e168\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e146.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;7.595\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003ePoor\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e19\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e98.89\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.022\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e\u003cb\u003eRelationship to patient\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eDaughter\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e152\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e143.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u0026nbsp;\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSon\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e130\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e156.28\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003eKW\u0026thinsp;=\u0026thinsp;4.657\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u0026nbsp;\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003eSpouse\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"char\" char=\".\" colname=\"c4\"\u003e\u003cp\u003e12\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e105.79\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003ep\u0026thinsp;=\u0026thinsp;0.097\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"6\"\u003eT\u0026thinsp;=\u0026thinsp;Independent Samples Test, F\u0026thinsp;=\u0026thinsp;One way Anova, KW: Kruskal-Wallis Test\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003cp\u003eTable\u0026nbsp;\u003cspan refid=\"Tab4\" class=\"InternalRef\"\u003e4\u003c/span\u003e shows that there was a statistical relationship between the families\u0026rsquo; informal care burden and perceived distress.\u003c/p\u003e\u003cp\u003e\u003cdiv class=\"gridtable\"\u003e\u003ctable float=\"Yes\" id=\"Tab4\" border=\"1\"\u003e\u003ccaption language=\"En\"\u003e\u003cdiv class=\"CaptionNumber\"\u003eTable 4\u003c/div\u003e\u003cdiv class=\"CaptionContent\"\u003e\u003cp\u003eCorrelations Among Caregiver burden and Psychological Distress\u003c/p\u003e\u003c/div\u003e\u003c/caption\u003e\u003ccolgroup cols=\"7\"\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c1\" colnum=\"1\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c2\" colnum=\"2\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c3\" colnum=\"3\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c4\" colnum=\"4\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c5\" colnum=\"5\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c6\" colnum=\"6\"\u003e\u003c/div\u003e\u003cdiv align=\"left\" class=\"colspec\" colname=\"c7\" colnum=\"7\"\u003e\u003c/div\u003e\u003cthead\u003e\u003ctr\u003e\u003cth align=\"left\" colname=\"c1\"\u003e\u0026nbsp;\u003c/th\u003e\u003cth align=\"left\" colname=\"c2\"\u003e\u003cp\u003eGeneral strain\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c3\"\u003e\u003cp\u003eIsolation\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c4\"\u003e\u003cp\u003eDisappointment\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c5\"\u003e\u003cp\u003eEmotional involvement\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c6\"\u003e\u003cp\u003eEnvironment\u003c/p\u003e\u003c/th\u003e\u003cth align=\"left\" colname=\"c7\"\u003e\u003cp\u003ePsychological Distress\u003c/p\u003e\u003c/th\u003e\u003c/tr\u003e\u003c/thead\u003e\u003ctbody\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eGeneral strain\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eIsolation\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eDisappointment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEmotional involvement\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003eEnvironment\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003ctr\u003e\u003ctd align=\"left\" colname=\"c1\"\u003e\u003cp\u003e\u003cb\u003ePsychological Distress\u003c/b\u003e\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c2\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c3\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c4\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c5\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c6\"\u003e\u003cp\u003e0.000**\u003c/p\u003e\u003c/td\u003e\u003ctd align=\"left\" colname=\"c7\"\u003e\u003cp\u003e1\u003c/p\u003e\u003c/td\u003e\u003c/tr\u003e\u003c/tbody\u003e\u003c/colgroup\u003e\u003ctfoot\u003e\u003ctr\u003e\u003ctd colspan=\"7\"\u003e**. Correlation is significant at the 0.01 level\u003c/td\u003e\u003c/tr\u003e\u003c/tfoot\u003e\u003c/table\u003e\u003c/div\u003e\u003c/p\u003e\u003c/div\u003e"},{"header":"DISCUSSION","content":"\u003cp\u003eThis study was conducted to examine the relationship between the care burden and distress level of primary family members who were providing informal care to stroke patients, and to determine the affecting factors.\u003c/p\u003e\u003cdiv id=\"Sec15\" class=\"Section2\"\u003e\u003ch2\u003eComparison of Outcomes: Informal Care Burden\u003c/h2\u003e\u003cp\u003eThe primary caregiver family members who participated in our study felt a moderate level of care burden. Studies in the literature examining the caregiver burden of informal family caregivers of stroke patients have reported that caregivers generally experienced a moderate level of caregiver burden (Caro et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Hu et al., \u003cspan citationid=\"CR16\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Kazemi et al., \u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Our study supports the findings of previous studies.\u003c/p\u003e\u003cp\u003eIn terms of sex, according to the disappointment subscale of care burden, female caregivers who were primary caregivers experience more care burden than males. In previous studies, when the factors affecting the care burden of family members were examined, it was reported that women felt more care burden than men (Badger et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; \u0026Ccedil;elenk \u0026amp; Kumcağız, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Choi \u0026amp; Lee, \u003cspan citationid=\"CR9\" class=\"CitationRef\"\u003e2025\u003c/span\u003e; Kol \u0026amp; Yılmaz Karabulutlu, \u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e2021\u003c/span\u003e; Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Unsar et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). This situation can be explained by both a cultural tendency to prefer women for family care and women being more fragile and emotional than men.\u003c/p\u003e\u003cp\u003eIn our study, in terms of socio-demographics, 73.8% of families experienced economic difficulties and 64.6% experienced family conflict. Due to reasons such as increased costs of health care after stroke, decreased family income, sharing of resources, and multiple responsibility conflicts, patients and caregivers may experience economic difficulties, caregiver burden may increase, and the quality of life of caregivers may decrease (Badger et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Caro et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Gabriel et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Gbiri et al., \u003cspan citationid=\"CR12\" class=\"CitationRef\"\u003e2015\u003c/span\u003e). Liu et al. showed that the main reasons for caregiver burden are insufficient financial resources, multiple responsibility conflicts, and lack of social activities (Z. Liu et al., \u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e2020\u003c/span\u003e). Previous studies in the literature have frequently reported varying degrees of economic problems faced by caregivers under economic pressure (Gabriel et al., \u003cspan citationid=\"CR11\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Hansen et al., \u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e2017\u003c/span\u003e; Yoon et al., \u003cspan citationid=\"CR32\" class=\"CitationRef\"\u003e2014\u003c/span\u003e). Our findings support the literature.\u003c/p\u003e\u003cp\u003eIn our study, those among the primary caregivers with low socioeconomic status felt more emotional burden. At the same time, there are previous studies in the literature showing that low socioeconomic status of families increases the burden of care (Caro et al., \u003cspan citationid=\"CR7\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Our findings support the literature. The reason why the participants in our sample were mostly high- and middle-income may be due to the fact that the hospital where the study was conducted is one of the best regional public hospitals in the country. The results of this study are consistent with previous findings on factors affecting caregiver burden among family caregivers of older adults receiving long-term care.\u003c/p\u003e\u003cp\u003eIn our study, spouses of caregivers experience higher levels of disappointment burden care. Some studies have stated that brides are more affected by the care burden (\u0026Ccedil;elenk \u0026amp; Kumcağız, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec16\" class=\"Section2\"\u003e\u003ch2\u003eComparison of Outcomes: Psychological Distress\u003c/h2\u003e\u003cp\u003eThe primary caregiver family members who participated in our study felt high levels of distress.\u003c/p\u003e\u003cp\u003eFactors such as the age, marital status, education level, number of children and socioeconomic status of the family members affect the level of distress. In a study conducted by Limonero et al., 54% of the family caregivers of advanced cancer patients were found to have high levels of distress (Limonero et al., \u003cspan citationid=\"CR24\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In a study conducted by Abreu et al. with the families of advanced dementia patients, high levels of distress were reported (Abreu et al., \u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e2020\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn terms of age, in our study, it was found that family caregivers between the ages of 18 and 35 experienced more stress. Similar to our study, Kumar et al. found that, in the relatives of stroke patients, being young increased the stress of the caregivers in their study (Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). However, in a study conducted by Unsar et al., it was found that the distress level of the older family caregivers of cancer patients was higher (Unsar et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). The relationship between age and psychological distress is mixed, with some studies showing higher psychological distress among younger caregivers(Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e), while others showing higher distress among older caregivers (Iovino et al., \u003cspan citationid=\"CR17\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Oechsle et al., \u003cspan citationid=\"CR28\" class=\"CitationRef\"\u003e2020\u003c/span\u003e; Unsar et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn our study, the distress level of caregivers who were single was found to be higher. In the study conducted by Hekmatpour et al., it was determined that marital status affected the distress of family caregivers (Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). However, in the study conducted by \u0026Ccedil;elenk and Kumcağız, the anxiety level was found to be higher in married family members who were providing care to elderly patients (\u0026Ccedil;elenk \u0026amp; Kumcağız, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eAccording to education status, in our study, as the education level of caregivers increased, the stress experienced by family members also increased. However, in the study conducted by Kumar et al., it was found that the education level of the relatives of paralyzed patients did not affect the stress of caregivers(Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In the study examining the care burden and distress by Mirjana Mikulic et al. no difference was found regarding the level of education of caregivers (Mikulić et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2023\u003c/span\u003e). In the study conducted by Pudelewicz et al. with a group of caregivers of Alzheimer\u0026rsquo;s patients, it was concluded that education level did not affect the care burden (Pudelewicz et al., \u003cspan citationid=\"CR29\" class=\"CitationRef\"\u003e2018\u003c/span\u003e). In the study by Hekmatpour et al. examining the care burden of stroke patients, it was determined that patient care education improved care stress (Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e). There is mixed information in the literature regarding education status. This may vary depending on cultural differences, countries, and the number of sample groups.\u003c/p\u003e\u003cp\u003eIn our study, it was found that family members with poor socioeconomic status experienced more stress. Previous studies have emphasized that socioeconomic status affects the distress of caregivers (\u0026Ccedil;elenk \u0026amp; Kumcağız, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Hekmatpou et al., \u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e2019\u003c/span\u003e; Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In the study conducted by Kumar et al. with caregivers of paralyzed patients, it was found that they were affected by poor socioeconomic status (Kumar et al., \u003cspan citationid=\"CR23\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Our study also supports these studies.\u003c/p\u003e\u003cp\u003eIn our study, the distress of family members who were caring for paralyzed patients with 0\u0026ndash;2 children was higher. However, in the study conducted by \u0026Ccedil;elenk and Kumcağız with family members who were caring for elderly patients, it was found that having children did not affect the caregivers (\u0026Ccedil;elenk \u0026amp; Kumcağız, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In the study examining care burden and distress by Mirjana Mikulić et al., it was reported that having 3 or more children is a risk factor for care burden (Mikulić et al., \u003cspan citationid=\"CR27\" class=\"CitationRef\"\u003e2023\u003c/span\u003e).\u003c/p\u003e\u003c/div\u003e\u003cdiv id=\"Sec17\" class=\"Section2\"\u003e\u003ch2\u003eCorrelations Among Caregiver burden and Psychological Distress\u003c/h2\u003e\u003cp\u003ePsychological distress (depression and anxiety) is a major contributor to caregiver burden (Badger et al., \u003cspan citationid=\"CR4\" class=\"CitationRef\"\u003e2024\u003c/span\u003e; Geng et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2018\u003c/span\u003e; Kaufman et al., \u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e2019\u003c/span\u003e) A recent systematic review reported high rates of psychological distress among caregivers of cancer patients (Geng et al., \u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e2018\u003c/span\u003e).Some studies have found that two in five caregivers worldwide experience depression, with prevalence rates of psychological distress approximately three times higher than in the general population (Bedaso et al., \u003cspan citationid=\"CR5\" class=\"CitationRef\"\u003e2022\u003c/span\u003e).\u003c/p\u003e\u003cp\u003eIn our study, as the care burden of family members providing care to stroke patients increased, the distress score also increased. In the study conducted by Unsar et al. with caregivers of cancer patients, it was observed that as the care burden of caregivers increased, their anxiety and depression levels also increased (Unsar et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). In the study conducted by \u0026Ccedil;elenk et al. with caregivers of elderly patients, it was determined that as the care burden score averages increased, the state anxiety and trait anxiety scores increased (\u0026Ccedil;elenk \u0026amp; Kumcağız, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). In the study conducted by Liu et al., a positive correlation was obtained between the psychological stress of caregivers and their care burden (C. hsiu Liu et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e). Previous studies have determined that caregivers experiencing negative psychological symptoms such as depression and anxiety tend to have higher caregiver burden (\u0026Ccedil;elenk \u0026amp; Kumcağız, \u003cspan citationid=\"CR8\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; C. hsiu Liu et al., \u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e2022\u003c/span\u003e; Unsar et al., \u003cspan citationid=\"CR31\" class=\"CitationRef\"\u003e2021\u003c/span\u003e). Our study also supports previous research.\u003c/p\u003e\u003c/div\u003e"},{"header":"CONCLUSION","content":"\u003cp\u003eThis study found that informal family caregivers of stroke patients had moderate care burden and high distress.\u003c/p\u003e\u003cp\u003eFactors such as gender and socioeconomic status contributed to the care burden of informal family caregivers of stroke patients, while factors such as age, marital status, education, socioeconomic status, and number of children were found to contribute to psychological distress.\u003c/p\u003e\u003cp\u003eStrategies are urgently needed to alleviate and prevent the care burden and distress of informal caregivers. For this purpose, the family caregiver burden should be assessed before the patient is discharged from the hospital.\u003c/p\u003e\u003cp\u003eFamily nurses should work with a multidisciplinary team to develop online or mobile applications where families can access up-to-date evidence on caregiving, and they can consider innovative approaches to care through virtual support groups to reduce informal care burden and distress.\u003c/p\u003e\u003cp\u003eSince the time required for weekly care and caregiving is more demanding for individuals with stroke, more socioeconomic support can be provided than to others.\u003c/p\u003e\u003cp\u003eTaking adequate support measures to protect caregivers from care burden and health problems can contribute to the maintenance of high-quality care and the improvement of the quality of caregivers.\u003c/p\u003e\u003cdiv id=\"Sec19\" class=\"Section2\"\u003e\u003ch2\u003eLimitations\u003c/h2\u003e\u003cp\u003eThe current study has several limitations. This study focused only on caregivers of hospitalized elderly patients with stroke history lasting longer than 6 months. Therefore, the findings cannot be extended to caregivers of all older patients. Second, since this study was conducted on Turkish family caregivers, it may be difficult to generalize the findings to other countries or cultures.\u003c/p\u003e\u003c/div\u003e"},{"header":"Declarations","content":"\u003cp\u003e\u003cstrong\u003eEthical considerations\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThe study was approved by the Non-Interventional Ethical Committee of Izmir Katip Celebi University in Turkey (date 21 March 2024, approval number: 0168), and written permission was obtained for research from the universities. Informed consent was obtained from all participants, and the purpose of the study was explained.\u003c/p\u003e\n\u003cp\u003eThe study has not previously been presented in elsewhere.\u003c/p\u003e\n\u003cp\u003eThere are no people or facilities that make up the work.\u003c/p\u003e\n\u003cp\u003eWe would like to thank the caregiver and their institutions who voluntarily participated in our studies.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eArtificial intelligence was not used at any stage of our study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConflict of interest disclosure\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eThere is no conflict of interest regarding the study.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAcknowledgements\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eWe thank all the patients with stroke and their family caregivers in the neurology units who participated in our study, as well as the hospital clinical staff, for their help and support.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eFunding\u0026nbsp;statement:\u003c/strong\u003e Our work is not funded by any organization.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eAuthor Satatement\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSevil Yilmaz\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Conceptualization, Methodology, Data curation,\u0026nbsp;\u003cstrong\u003eBilge Dalkıran\u003c/strong\u003e: Software, Writing- Original draft preparation.\u0026nbsp;\u003cstrong\u003eBilge Dalkıran\u003c/strong\u003e: Visualization, Investigation.\u0026nbsp;\u003cstrong\u003eSevil Yilmaz\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Supervision.\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003cstrong\u003eSevil Yilmaz\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Software, Validation.\u0026nbsp;\u003cstrong\u003eSevil Yilmaz\u003c/strong\u003e\u003cstrong\u003e:\u003c/strong\u003e Writing- Reviewing and Editing,\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\u003cli\u003e\u003cspan\u003eAbreu, W., Tolson, D., Jackson, G. A., \u0026amp; Costa, N. (2020). A cross-sectional study of family caregiver burden and psychological distress linked to frailty and functional dependency of a relative with advanced dementia. \u003cem\u003eDementia\u003c/em\u003e, \u003cem\u003e19\u003c/em\u003e(2), 301\u0026ndash;318. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/1471301218773842\u003c/span\u003e\u003cspan address=\"10.1177/1471301218773842\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAkinci, A. C., \u0026amp; Pinar, R. (2012). \u003cem\u003eValidity and reliability of Turkish Caregiver Burden Scale among family caregivers of haemodialysis patients\u003c/em\u003e. 352\u0026ndash;360. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/j.1365-2702.2012.04235.x\u003c/span\u003e\u003cspan address=\"10.1111/j.1365-2702.2012.04235.x\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eAltun, Y., \u0026Ouml;zen, M., \u0026amp; Kuloğlu, M. M. (2019). Turkish adaptation of kessler psychological distress scale: Validity and reliability study. \u003cem\u003eAnadolu Psikiyatri Dergisi\u003c/em\u003e, \u003cem\u003e21\u003c/em\u003e, 23\u0026ndash;31. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.5455/apd.12801\u003c/span\u003e\u003cspan address=\"10.5455/apd.12801\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBadger, T., Segrin, C., Crane, T., Morrill, K., \u0026amp; Sikorskii, A. (2024). Social determinants of health, psychological distress, and caregiver burden among informal cancer caregivers of cancer survivors during treatment. \u003cem\u003eJournal of Psychosocial Oncology\u003c/em\u003e, \u003cem\u003e42\u003c/em\u003e(3), 333\u0026ndash;350. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/07347332.2023.2248486\u003c/span\u003e\u003cspan address=\"10.1080/07347332.2023.2248486\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBedaso, A., Dejenu, G., \u0026amp; Duko, B. (2022). Depression among caregivers of cancer patients: Updated systematic review and meta-analysis. \u003cem\u003ePsycho-Oncology\u003c/em\u003e, \u003cem\u003e31\u003c/em\u003e(11), 1809\u0026ndash;1820. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1002/pon.6045\u003c/span\u003e\u003cspan address=\"10.1002/pon.6045\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eBoonsin, S., Deenan, A., \u0026amp; Wacharasin, C. (2020). Factors influencing the burden of family caregiving for survivors of stroke. \u003cem\u003ePacific Rim International Journal of Nursing Research\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(1), 102\u0026ndash;113.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eCaro, C. C., Costa, J. D., \u0026amp; Da Cruz, D. M. C. (2018). Burden and Quality of Life of Family Caregivers of Stroke Patients. \u003cem\u003eOccupational Therapy in Health Care\u003c/em\u003e, \u003cem\u003e32\u003c/em\u003e(2), 154\u0026ndash;171. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1080/07380577.2018.1449046\u003c/span\u003e\u003cspan address=\"10.1080/07380577.2018.1449046\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003e\u0026Ccedil;elenk, Z., \u0026amp; Kumcağız, H. (2022). Yaşlı Hastaya Bakım Verenlerin Bakım Y\u0026uuml;k\u0026uuml; ve Anksiyete D\u0026uuml;zeyleri Arasındaki İlişkinin İncelenmesi. \u003cem\u003eİstanbul Gelişim \u0026Uuml;niversitesi Sosyal Bilimler Dergisi\u003c/em\u003e, \u003cem\u003e9\u003c/em\u003e(2), 628\u0026ndash;645.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eChoi, J. Y., \u0026amp; Lee, S. H. (2025). Exploring Factors Influencing Caregiver Burden: A Systematic Review of Family Caregivers of Older Adults with Chronic Illness in Local Communities. \u003cem\u003eHealthcare (Switzerland)\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(1002).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eDel-Pino-Casado, R., Priego-cubero, E., Lo, C., \u0026amp; Orgeta, V. (2021). \u003cem\u003eSubjective caregiver burden and anxiety in informal caregivers: A systematic review and\u003c/em\u003e. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1371/journal.pone.0247143\u003c/span\u003e\u003cspan address=\"10.1371/journal.pone.0247143\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGabriel, I. O., Aluko, J. O., \u0026amp; Okeme, M. I. (2019). Caregiver Burden Among Informal Caregivers of Women with Breast Cancer. \u003cem\u003eBiomedical Journal of Scientific \u0026amp; Technical Research\u003c/em\u003e, \u003cem\u003e15\u003c/em\u003e(3), 11384\u0026ndash;11392. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.26717/bjstr.2019.15.002704\u003c/span\u003e\u003cspan address=\"10.26717/bjstr.2019.15.002704\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGbiri, C. A., Olawale, O. A., \u0026amp; Isaac, S. O. (2015). Stroke management: Informal caregivers\u0026rsquo; burdens and strians of caring for stroke survivors. \u003cem\u003eAnnals of Physical and Rehabilitation Medicine\u003c/em\u003e, \u003cem\u003e58\u003c/em\u003e(2), 98\u0026ndash;103. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.rehab.2014.09.017\u003c/span\u003e\u003cspan address=\"10.1016/j.rehab.2014.09.017\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eGeng, H., mei, Chuang, D., mei, Yang, F., Yang, Y., Liu, W., Liu, L. hui, \u0026amp; Tian, H. (2018). Prevalence and determinants of depression in caregivers of cancer patients: A systematic review and meta-analysis. \u003cem\u003eMedicine (United States)\u003c/em\u003e, \u003cem\u003e97\u003c/em\u003e(39). \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1097/MD.0000000000011863\u003c/span\u003e\u003cspan address=\"10.1097/MD.0000000000011863\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHansen, L., Rosenkranz, S. J., Wherity, K., \u0026amp; Sasaki, A. (2017). Living with hepatocellular carcinoma near the end of life: Family caregivers\u0026rsquo; perspectives. \u003cem\u003eOncology Nursing Forum\u003c/em\u003e, \u003cem\u003e44\u003c/em\u003e(5), 562\u0026ndash;570. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1188/17.ONF.562-570\u003c/span\u003e\u003cspan address=\"10.1188/17.ONF.562-570\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHekmatpou, D., Baghban, E. M., \u0026amp; Dehkordi, L. M. (2019). The effect of patient care education on burden of care and the quality of life of caregivers of stroke patients. \u003cem\u003eJournal of Multidisciplinary Healthcare\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e, 211\u0026ndash;217. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.2147/JMDH.S196903\u003c/span\u003e\u003cspan address=\"10.2147/JMDH.S196903\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eHu, P., Yang, Q., Kong, L., Hu, L., \u0026amp; Zeng, L. (2018). \u003cem\u003eRelationship between the anxiety/depression and care burden of the major caregiver of stroke patients\u003c/em\u003e. \u003cem\u003e0\u003c/em\u003e(April).\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eIovino, P., Maria, M., De, Ausili, D., Riegel, B., Matarese, M., \u0026amp; Vellone, E. (2020). \u003cem\u003eDepression and self-care in older adults with multiple chronic conditions: A multivariate analysis\u003c/em\u003e. \u003cem\u003eMarch\u003c/em\u003e, 1668\u0026ndash;1678. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/jan.14385\u003c/span\u003e\u003cspan address=\"10.1111/jan.14385\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKatan, M., \u0026amp; Luft, A. (2021). Global Burden of Stroke. \u003cem\u003eSeminars in Neurology\u003c/em\u003e, \u003cem\u003e38\u003c/em\u003e, 208\u0026ndash;211. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/B978-0-323-69424-7.00014-4\u003c/span\u003e\u003cspan address=\"10.1016/B978-0-323-69424-7.00014-4\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKaufman, J. E., Lee, Y., Vaughon, W., Unuigbe, A., \u0026amp; Gallo, W. T. (2019). Depression Associated With Transitions Into and Out of Spousal Caregiving. \u003cem\u003eInternational Journal of Aging and Human Development\u003c/em\u003e, \u003cem\u003e88\u003c/em\u003e(2), 127\u0026ndash;149. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/0091415018754310\u003c/span\u003e\u003cspan address=\"10.1177/0091415018754310\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKazemi, A., Azimian, J., Mafi, M., Allen, K. A., \u0026amp; Motalebi, S. A. (2021). Caregiver burden and coping strategies in caregivers of older patients with stroke. \u003cem\u003eBMC Psychology\u003c/em\u003e, 1\u0026ndash;9. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s40359-021-00556-z\u003c/span\u003e\u003cspan address=\"10.1186/s40359-021-00556-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKlietz, M. (2022). Caregiver Burden in Movement Disorders and Neurodegenerative Diseases: Editorial. \u003cem\u003eBrain Sciences\u003c/em\u003e, \u003cem\u003e12\u003c/em\u003e(9), 10\u0026ndash;13. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/brainsci12091184\u003c/span\u003e\u003cspan address=\"10.3390/brainsci12091184\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKol, R., \u0026amp; Yılmaz Karabulutlu, E. (2021). Kronik Hastalığı Olan Bireylere Bakım Verenlerin Bakım Y\u0026uuml;k\u0026uuml; ve İyilik Halinin Değerlendirilmesi Examination of The Care Burden and Well-Being of Caregivers of İndividuals with Chronic Disease. \u003cem\u003eKocaeli Med\u003c/em\u003e, \u003cem\u003e10\u003c/em\u003e(1), 119\u0026ndash;127.\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eKumar, A., Kumar, A. Y., Singh, V., Pathak, K., Chaurasia, A., Mishra, R. N., V. N., \u0026amp; Joshi, D. (2022). Caregiver Burden in Caregivers of Stroke Survivors: A Hospital\u0026ndash;Based Study. \u003cem\u003eAnnals of Indian Academy of Neurology\u003c/em\u003e, \u003cem\u003e25\u003c/em\u003e(6), 1092\u0026ndash;1098. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.4103/aian.AIAN\u003c/span\u003e\u003cspan address=\"10.4103/aian.AIAN\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLimonero, J. T., Mat\u0026eacute;-M\u0026eacute;ndez, J., G\u0026oacute;mez-Romero, M. J., Mateo-Ortega, D., Gonz\u0026aacute;lez-Barboteo, J., Bernaus, M., L\u0026oacute;pez-Postigo, M., Sirgo, A., Viel, S., S\u0026aacute;nchez-Julve, C., Bay\u0026eacute;s, R., G\u0026oacute;mez-Batiste, X., \u0026amp; Tom\u0026aacute;s-S\u0026aacute;bado, J. (2023). Family caregiver emotional distress in advanced cancer: The DME-C scale psychometric properties. \u003cem\u003eBMJ Supportive and Palliative Care\u003c/em\u003e, \u003cem\u003e13\u003c/em\u003e(e1), E177\u0026ndash;E184. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1136/bmjspcare-2020-002608\u003c/span\u003e\u003cspan address=\"10.1136/bmjspcare-2020-002608\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiu, C., Chen, Y. J., Chen, J. S., Fan, C. W., Hsieh, M. T., Lin, C. Y., \u0026amp; Pakpour, A. H. (2022). Burdens on caregivers of patients with stroke during a pandemic: relationships with support satisfaction, psychological distress, and fear of COVID-19. \u003cem\u003eBMC Geriatrics\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(1), 1\u0026ndash;8. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1186/s12877-022-03675-3\u003c/span\u003e\u003cspan address=\"10.1186/s12877-022-03675-3\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eLiu, Z., Heffernan, C., \u0026amp; Tan, J. (2020). Caregiver burden: A concept analysis. \u003cem\u003eInternational Journal of Nursing Sciences\u003c/em\u003e, \u003cem\u003e7\u003c/em\u003e(4), 438\u0026ndash;445. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ijnss.2020.07.012\u003c/span\u003e\u003cspan address=\"10.1016/j.ijnss.2020.07.012\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eMikulić, M., Ćavar, I., Jurišić, D., Jelinčić, I., \u0026amp; Degmečić, D. (2023). Burden and Psychological Distress in Caregivers of Persons with Addictions. \u003cem\u003eChallenges\u003c/em\u003e, \u003cem\u003e14\u003c/em\u003e(2), 24. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.3390/challe14020024\u003c/span\u003e\u003cspan address=\"10.3390/challe14020024\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eOechsle, K., Ullrich, A., Marx, G., Benze, G., Wowretzko, F., Zhang, Y., Dickel, L., Heine, J., Wendt, K. N., Nauck, F., Bokemeyer, C., \u0026amp; Bergelt, C. (2020). \u003cem\u003ePrevalence and Predictors of Distress, Anxiety, Depression, and Quality of Life in Bereaved Family Caregivers of Patients With Advanced Cancer\u003c/em\u003e. \u003cem\u003e37\u003c/em\u003e(3), 201\u0026ndash;213. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1177/1049909119872755\u003c/span\u003e\u003cspan address=\"10.1177/1049909119872755\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003ePudelewicz, A., Talarska, D., \u0026amp; Bazczyk, G. (2018). Burden of caregivers of patients with Alzheimer \u0026rsquo; s disease. \u003cem\u003eScandinavian Journal of Caring Sciences\u003c/em\u003e, \u003cem\u003e5\u003c/em\u003e, 336\u0026ndash;341. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1111/scs.12626\u003c/span\u003e\u003cspan address=\"10.1111/scs.12626\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eRansmayr, G. (2021). Challenges of caregiving to neurological patients. \u003cem\u003eWiener Medizinische Wochenschrift\u003c/em\u003e, \u003cem\u003e171\u003c/em\u003e(11\u0026ndash;12), 282\u0026ndash;288. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s10354-021-00844-8\u003c/span\u003e\u003cspan address=\"10.1007/s10354-021-00844-8\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eUnsar, S., Erol, O., \u0026amp; Ozdemir, O. (2021). Caregiving burden, depression, and anxiety in family caregivers of patients with cancer. \u003cem\u003eEuropean Journal of Oncology Nursing\u003c/em\u003e, \u003cem\u003e50\u003c/em\u003e(April 2020), 101882. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ejon.2020.101882\u003c/span\u003e\u003cspan address=\"10.1016/j.ejon.2020.101882\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eYoon, S. J., Kim, J. S., Jung, J. G., Kim, S. S., \u0026amp; Kim, S. (2014). Modifiable factors associated with caregiver burden among family caregivers of terminally ill Korean cancer patients. \u003cem\u003eSupportive Care in Cancer\u003c/em\u003e, \u003cem\u003e22\u003c/em\u003e(5), 1243\u0026ndash;1250. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1007/s00520-013-2077-z\u003c/span\u003e\u003cspan address=\"10.1007/s00520-013-2077-z\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003cli\u003e\u003cspan\u003eZhang, Y., Li, J., Zhang, Y., Chen, C., Guan, C., Zhou, L., Zhang, S., Chen, X., \u0026amp; Hu, X. (2024). Mediating effect of social support between caregiver burden and quality of life among family caregivers of cancer patients in palliative care units. \u003cem\u003eEuropean Journal of Oncology Nursing\u003c/em\u003e, \u003cem\u003e68\u003c/em\u003e(April 2023), 102509. \u003cspan class=\"ExternalRef\"\u003e\u003cspan class=\"RefSource\"\u003ehttps://doi.org/10.1016/j.ejon.2024.102509\u003c/span\u003e\u003cspan address=\"10.1016/j.ejon.2024.102509\" targettype=\"DOI\" class=\"RefTarget\"\u003e\u003c/span\u003e\u003c/span\u003e\u003c/span\u003e\u003c/li\u003e\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":true,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Stroke, informal care burden, family caregiver, distress, older adult care, nursing","lastPublishedDoi":"10.21203/rs.3.rs-7906385/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-7906385/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003ch2\u003eIntroduction:\u003c/h2\u003e\u003cp\u003eThis study was conducted to investigate the relationship between informal caregiver burden and psychological distress among primary family caregivers of stroke patients.\u003c/p\u003e\u003ch2\u003ePatients and\u003c/h2\u003e\u003cp\u003e\u003cb\u003eMethod\u003c/b\u003e: The design of this study is descriptive, relational, and cross-sectional. The population of the study consists of primary caregivers of stroke patients. The data were collected using a descriptive information form, the Caregiver Burden Scale and the Kessler Psychological Distress (K10) Scale.\u003c/p\u003e\u003ch2\u003eResults\u003c/h2\u003e\u003cp\u003eA total of 294 caregivers of stroke patients, 160 female and 134 male, completed the study questionnaires. The average age of those participating in the study was 42.59\u0026thinsp;\u0026plusmn;\u0026thinsp;13.36 (minimum: 18, maximum: 69) years, and 54.4% of the caregivers were female family members. The average care burden score (minimum:33, maximum:108) was 69.38\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;12.21, which is a medium level. The average distress score (minimum:10, maximum:49) was 24.28\u0026thinsp;\u003cspan type=\"Underline\" class=\"Underline\" name=\"Emphasis\"\u003e\u0026plusmn;\u003c/span\u003e\u0026thinsp;9.76, which is high.\u003c/p\u003e\u003ch2\u003eConclusion\u003c/h2\u003e\u003cp\u003eOur study found that caregivers of stroke patients experienced high levels of distress and that this was highly correlated with care burden.\u003c/p\u003e","manuscriptTitle":"Relationships Between Informal Caregiver Burden and Psychological Distress Among Primary Family Caregivers of Stroke Patients","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2025-10-22 05:34:30","doi":"10.21203/rs.3.rs-7906385/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"a68fe399-f4d9-4fc9-bdcd-8fbde2cab61f","owner":[],"postedDate":"October 22nd, 2025","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[],"tags":[],"updatedAt":"2025-10-27T13:57:47+00:00","versionOfRecord":[],"versionCreatedAt":"2025-10-22 05:34:30","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-7906385","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-7906385","identity":"rs-7906385","version":["v1"]},"buildId":"8U1c8b4HqxoKbykW_rLl7","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}