Diversity & Equality in Health and Care Open Access

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British Indian carers of stroke survivors experience higher levels of anxiety and depression than White British carers: findings of a prospective observational study

Mark RD Johnson, Lisa Manning, Savita Katbamna, Amit Mistri, Thompson Robinson

Carers of stroke survivors face significant burdens, and increased carer strain has negative implications for both the stroke survivor and the carer. There are limited data on carer strain in the British Indian UK population. In a prospective cohort of White British and British Indian stroke survivors and their carers, we report the incidence of carer strain in each ethnicgroup, describe patient and carer characteristics, and identify predictors of increased carer strain. Forty-nine participants and their carers were of White British origin and 24 of Indian ethnic origin, whose first language was Gujarati or Punjabi.Multidimensional outcome measures were used to assess the physical and cognitive function in stroke survivors at one month and 3–6 months (final follow-up) from stroke onset. Levels of carer strain were assessed at the same time points using the Carer Strain Index and the Hospital Anxiety and Depression Scale. Statistical significance for difference in patient and carer characteristics between White British and British Indian groups was assessed. Logistic regression models were used to identify predictors of carer strain. British Indian stroke survivors had poorer scores on cognitive assessment (Mini Mental State Examination median 21, IQR 10.5–26.5 in British Indian, versus median 28.5, IQR 20–30, p=0.001) at one month. British Indian carers were younger, and reported higher levels of anxiety and depression at one month (medianHospital Anxiety and Depression Scale subscore depression 3.5 in White British, versus 7 in British Indian, P=0.002, median hospital anxiety and depression score total 10, versus 14, P=0.012). Twenty-four percent of all carers showed evidence of elevated carer strain (CSI>6) at one month, and 30% at final follow-up. There were no differences in levels of carer strain between the two ethnic groups. These findings will inform future research, and in turn, may help to guide population-targeted interventions aimed at reducing carer strain.