Family Caregiving Behavior and its Correlation with Stroke Severity among Patients with Stroke

Ratna Yunita Sari; Riska Rohmawati; Imamatul Faizah; Dyah Ika Krisnawati; Siti Nur Hasina; Duong Thi To Anh; Tsung-Rong Kuo

doi:10.30994/jnp.v9i3.1072

Authors

Ratna Yunita Sari Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia https://orcid.org/0000-0002-1714-1163
Riska Rohmawati Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia https://orcid.org/0000-0002-6212-1137
Imamatul Faizah Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia https://orcid.org/0000-0001-7568-4572
Dyah Ika Krisnawati Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia https://orcid.org/0000-0003-1707-5191
Siti Nur Hasina Department of Nursing, Faculty of Nursing and Midwifery, Universitas Nahdlatul Ulama Surabaya, Surabaya, Indonesia https://orcid.org/0000-0001-5873-0602
Duong Thi To Anh Thai Nguyen University of Medicine and Pharmacy, Thai Nguyen University, 284 Luong Ngoc Quyen Street, Phan Dinh Phung Ward, Thai Nguyen Province, Vietnam https://orcid.org/0009-0001-4955-7913
Tsung-Rong Kuo National Taiwan Normal University, Taipei Medical University https://orcid.org/0000-0003-4937-951X

DOI:

https://doi.org/10.30994/jnp.v9i3.1072

Keywords:

Family Behavior, Severity, Stroke

Abstract

Background: Stroke is a disease that requires intensive family care. Suboptimal family care can worsen a stroke patient's condition.

Purpose: This study aimed to determine family caregiving behaviours, based on the severity of the stroke, at PHC Hospital Surabaya.

Methods: The study design employed analytical observation using a cross-sectional method, with a study population of 170 respondents and a sample of 120 selected via simple purposive sampling. The independent variable in this study was family behavior, and the dependent variable was tingkat keparahan pasien stroke. The instruments used were National Institutes of Health Stroke Scale (NIHSS) Questionnaire and the Family Behaviour Questionnaire. Data analysis utilised the Spearman rank test.

Results: The results of the study showed that almost half (49.2%) had adequate behavior in caring for stroke patients and nearly half (44.2%) had severe stroke severity with a value of ρ = 0.014 correlation coefficient of 1.000, which means there is a relationship between family behavior in caring for stroke patients and the severity of stroke patients at PHC Hospital Surabaya with a robust correlation.

Conclusion: Family caregiving behavior is significantly associated with stroke severity. Improving education and guidance for families of stroke patients is crucial to supporting successful patient care and rehabilitation.

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References

Bai, J., & Chen, K. (2025). Advances in nursing care for post-stroke limb dysfunction rehabilitation. Frontiers in Neurology, 16, 1615500. https://doi.org/10.3389/fneur.2025.1615500.

Blake, J. A., Long, D. L., Knight, A. J., Goodin, B. R., Crowe, M., Judd, S. E., Rhodes, J. D., Roth, D. L., & Clay, O. J. (2024). Stroke Severity, Caregiver Feedback, and Cognition in the REGARDS‐CARES Study. Journal of the American Heart Association, 13(15), e033375. https://doi.org/10.1161/JAHA.123.033375.

Comer, A. R., Templeton, E., Glidden, M., Bartlett, S., D’Cruz, L., Nemati, D., Zabel, S., & Slaven, J. E. (2022). National Institutes of Health Stroke Scale (NIHSS) scoring inconsistencies between neurologists and emergency room nurses. Frontiers in Neurology, 13, 1093392. https://doi.org/10.3389/fneur.2022.1093392.

Devereux, N., & Berns, A. M. (2023). Evaluation & Treatment of Psychological Effects of Stroke. Delaware Journal of Public Health, 9(3), 62–69. https://doi.org/10.32481/djph.2023.08.011.

EldiningtyasL, S. P. F. (2019). Analisis Faktor yang Berhubungan dengan Perilaku Keluarga dalam Merawat Pasien Pasca Stroke di Rumah. Universitas Airlangga.

Feigin, V. L., Brainin, M., Norrving, B., Martins, S. O., Pandian, J., Lindsay, P., F Grupper, M., & Rautalin, I. (2025). World Stroke Organization: Global Stroke Fact Sheet 2025. International Journal of Stroke : Official Journal of the International Stroke Society, 20(2), 132–144. https://doi.org/10.1177/17474930241308142.

Gurková, E., Bartoníčková, D., Šaňák, D., Šaňáková, Š., Zapletalová, J., & Štureková, L. (2025). Relationship between social support, functional outcomes and health-related quality of life in working-aged adults at three months after ischemic stroke: results from the FRAILTY study. Health and Quality of Life Outcomes, 23(1), 8. https://doi.org/10.1186/s12955-025-02337-3.

Hilditch, M., Brand, C., Devlin, S., Boyd, A., & Venema, E. (2025). BE-FAST vs FAST in prehospital stroke recognition: a systematic review. British Journal of Community Nursing, 30(9), 439–447. https://doi.org/10.12968/bjcn.2025.0119.

Kaylor, S. A., & Singh, S. A. (2023). Clinical outcomes associated with speech, language and swallowing difficulties post-stroke. The South African Journal of Communication Disorders = Die Suid-Afrikaanse Tydskrif Vir Kommunikasieafwykings, 70(1), e1–e15. https://doi.org/10.4102/sajcd.v70i1.957.

Madu, C. S., & Ajibade, V. M. (2025). Acute Stroke Management and Nursing Intervention. Cureus, 17(6), e86820. https://doi.org/10.7759/cureus.86820.

Maggio, M. G., Corallo, F., De Francesco, M., De Cola, M. C., De Luca, R., Manuli, A., Quartarone, A., Rizzo, A., & Calabrò, R. S. (2024). Understanding the family burden and caregiver role in stroke rehabilitation: insights from a retrospective study. Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology, 45(11), 5347–5353. https://doi.org/10.1007/s10072-024-07668-5.

Muhrodji, P., Wicaksono, H. D. A., Satiti, S., Trisnantoro, L., Setyopranoto, I., & Vidyanti, A. N. (2021). Roles and Problems of Stroke Caregivers: A Qualitative Study in Yogyakarta, Indonesia. F1000Research, 10, 380. https://doi.org/10.12688/f1000research.52135.2.

Nooreddini, A., Sadeghian, E., Borzou, S. R., Ghiasian, M., & Sotanian, A. (2025). Family Caregiver’s Perception of Resilience in Caring for Stroke Patients: A Qualitative Research. Iranian Journal of Nursing and Midwifery Research, 30(4), 561–571. https://doi.org/10.4103/ijnmr.ijnmr_106_24.

Notoadmodjo. (2018). Promosi Kesehatan: Teori dan Aplikasi. Rineka Cipta.

Samuthpongtorn, C., Jereerat, T., & Suwanwela, N. C. (2021). Stroke risk factors, subtypes and outcome in elderly Thai patients. BMC Neurology, 21(1), 322. https://doi.org/10.1186/s12883-021-02353-y.

Simmons, C. A., Poupore, N., & Nathaniel, T. I. (2023). Age Stratification and Stroke Severity in the Telestroke Network. Journal of Clinical Medicine, 12(4). https://doi.org/10.3390/jcm12041519.

So, J., & Park, M.-H. (2024). Family’s Caregiving Status and Post-Stroke Functional Recovery During Subacute Period from Discharge to Home: A Retrospective Study. Journal of Clinical Medicine, 13(22). https://doi.org/10.3390/jcm13226923.

Soto-Cámara, R., González-Bernal, J. J., González-Santos, J., Aguilar-Parra, J. M., Trigueros, R., & López-Liria, R. (2020). Knowledge on Signs and Risk Factors in Stroke Patients. Journal of Clinical Medicine, 9(8). https://doi.org/10.3390/jcm9082557.

Sun, X., Shi, Y., Liu, C., Wang, S., Li, D., Zhu, X., Pan, K., Wang, H., & Zhang, H. (2025). Experience and needs of stroke patients in physical rehabilitation: a systematic review and meta-synthesis. BMC Health Services Research, 25(1), 1062. https://doi.org/10.1186/s12913-025-13213-7.

Terrill, A. L., Gordon, S., Sparks, C., Baucom, B. B., Cardell, B., MacKenzie, J. J., Majersik, J. J., Reblin, M., & Richards, L. G. (2025). Resilience in Stroke survivor-care-partner Dyads (ReStoreD): a study protocol for a randomized-control trial. Trials, 26(1), 195. https://doi.org/10.1186/s13063-025-08891-x.

Tiwari, S., Joshi, A., Rai, N., & Satpathy, P. (2021). Impact of Stroke on Quality of Life of Stroke Survivors and Their Caregivers: A Qualitative Study from India. Journal of Neurosciences in Rural Practice, 12(4), 680–688. https://doi.org/10.1055/s-0041-1735323.

Venketasubramanian, N., Yudiarto, F. L., & Tugasworo, D. (2022). Stroke Burden and Stroke Services in Indonesia. In Cerebrovascular diseases extra (Vol. 12, Issue 1, pp. 53–57). https://doi.org/10.1159/000524161.

Wang, X., Hu, C.-X., Lin, M.-Q., Liu, S.-Y., Zhu, F.-Y., & Wan, L.-H. (2022). Family Functioning is Associated with Post-Stroke Depression in First-Ever Stroke Survivors: A Longitudinal Study. Neuropsychiatric Disease and Treatment, 18, 3045–3054. https://doi.org/10.2147/NDT.S393331.

Wu, X., Zhou, Q., Jiang, X., Fan, F., Wang, W., Wang, J., Zhou, G., Wan, F., & Xia, G. (2025). Stroke knowledge and attitudes influence early hospital arrival in acute ischemic stroke: a multicenter cross-sectional survey from Hubei Province, China. Frontiers in Neurology, 16, 1669361. https://doi.org/10.3389/fneur.2025.1669361.

Yamanie, N., Felistia, Y., Susanto, N. H., Lamuri, A., Sjaaf, A. C., Miftahussurur, M., & Santoso, A. (2024). Prognostic model of in-hospital ischemic stroke mortality based on an electronic health record cohort in Indonesia. PLOS ONE, 19(6), e0305100. https://doi.org/10.1371/journal.pone.0305100.

Zainuddin, A. A., Kadir, R. R. A., Kuswanto, H., Tammasse, J., Qalby, N., Abdullah, A. A., Junaidi, A. A., & Asyary, A. (2025). The major risk factor of stroke across Indonesia; a nationwide geospatial analysis of universal health coverage program. Archives of Public Health = Archives Belges de Sante Publique, 83(1), 169. https://doi.org/10.1186/s13690-025-01613-4.

Zang, J., Bai, Q., Xiong, X., He, P., Sun, J., & Gong, X. (2025). Early identification of stroke symptoms and risk factors using the BE FAST method: benefits of early intervention in high-risk populations. Frontiers in Neurology, 16, 1630384. https://doi.org/10.3389/fneur.2025.1630384.

Zhang, L., Shu, Y., Han, C., & Liu, J. (2023). Correlation Between Family Functioning and Health Beliefs in Patients with Stroke in Beijing, China. Journal of Multidisciplinary Healthcare, 16, 1067–1074. https://doi.org/10.2147/JMDH.S394396.

Zhou, J., Chen, Q.-L., Li, Q.-Q., Liu, L.-M., Lei, Y., Yang, X., Mou, W.-X., He, C.-Y., & Li, F.-M. (2025). Correlation Between the Quality of Life of Stroke Caregivers and the Readiness of Patients and Caregivers for Hospital Discharge. Patient Preference and Adherence, 19, 569–582. https://doi.org/10.2147/PPA.S497604

Zhu, R., Huang, H., Yu, Y., Bao, S., Lin, N., & Shu, M. (2024). Post-stroke fatigue and its correlation with family functioning in patients who have experienced a first episode of stroke. Frontiers in Aging Neuroscience, 16, 1440163. https://doi.org/10.3389/fnagi.2024.1440163.