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Psychosocial functioning of spouses of patients with stroke from initial inpatient rehabilitation to 3 years poststroke: course and relations with coping strategies.

Journal article
Authors Anne Visser-Meily
Marcel Post
Ingrid van de Port
Cora Maas
Gunilla Forsberg-Wärleby
Eline Lindeman
Published in Stroke; a journal of cerebral circulation
Volume 40
Issue 4
Pages 1399-404
ISSN 1524-4628
Publication year 2009
Published at Institute of Neuroscience and Physiology, Department of Clinical Neuroscience and Rehabilitation
Pages 1399-404
Language en
Links dx.doi.org/10.1161/STROKEAHA.108.51...
Keywords Adaptation, Psychological, Caregivers, psychology, Cost of Illness, Depression, psychology, Family Health, Female, Follow-Up Studies, Humans, Male, Middle Aged, Quality of Life, Social Behavior, Spouses, psychology, Stroke, psychology, rehabilitation
Subject categories Neurology, Occupational Therapy, Applied Psychology, Family research, Disability research

Abstract

BACKGROUND AND PURPOSE: Few studies have focused on long-term changes in the caregiving experience after stroke. This study assessed changes in the psychosocial functioning of spouses (burden, depressive symptoms, harmony in the relationship between patient and spouse, and social relations) during the first 3 years after stroke and identified predictors of the course of spouses' psychosocial functioning based on the characteristics of patients and spouses with special emphasis on coping style. METHODS: We examined 211 couples shortly after the patient's admission to a rehabilitation center, 197 2 months after discharge, 187 1 year poststroke, and 121 3 years poststroke. Burden was assessed using the Caregiver Strain Index, depressive symptoms with the Goldberg Depression Scale, harmony in the relationship with the Interactional Problem Solving Inventory, and social relations with the Social Support List. Multilevel regression analyses were performed. RESULTS: A significant effect of time (P<0.01) was found for all 4 aspects of spouses' psychosocial functioning. Although burden decreased, harmony in the relationship and social relations also decreased. The depression score showed a nonlinear pattern with an initial decrease but a long-term increase. All outcomes were significantly related to caregiver coping strategies. A total of 15% to 27% of the variance in psychosocial functioning could be explained. CONCLUSIONS: Follow-up of spouses of patients with stroke requires not only assessment of burden, but also other aspects of psychosocial functioning like harmony in the relationship, depression, and social relations, because our results show negative long-term consequences of stroke for these aspects of caregiver quality of life.

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