Psychosocial Functioning of Spouses of Patients With Stroke From Initial Inpatient Rehabilitation to 3 Years Poststroke

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 (PϽ0.01) 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.

Burden and modifications in life from the perspective of caregivers for patients after stroke

“…A previous study (25) , like the present study, did not identify any association of the age or sex of the carer with the presence of overload. There was, however, an association between the presence of psychiatric symptoms and the increase in overload.…”

Quality of Life of Stroke Patients and their Caregivers

“…Older patients report stroke having a greater impact on physical functioning. Further, female caregivers had a significantly lower QoL than male caregivers, similar to the findings of other authors [4,22]. In a sample of 215 caregivers, Marco et al2 found that the negative impact of caring for a stroke patient is greater in middle-aged female caregivers, and that depression and musculoskeletal pain in the caregiver, time spent caring and degree of disability of the care recipient are influential factors in this deterioration in QoL.…”

“…This reality has a negative impact on the quality of life (QoL) of patients and also of their relatives, who usually become their main caregivers [2]. Taking on the caregiving role is a significant source of stress, increasing the caregivers' risk of developing various physical and mental health problems [3,4].…”

ImPACT: a multifaceted implementation for conversation partner training in aphasia in Dutch rehabilitation settings

“…This figure underlines the extent of the burden of care that partners carry [26] [27]. Particularly partners who face the loss of communication abilities in their family member due to aphasia may struggle [28].…”

“…Partners are sharing the hope for recovery and want to contribute to this improvement by promoting this treatment or even by becoming co-therapists. Hallé and Le Dorze [33] concluded that partners who were interviewed around three months post stroke, were seeking information to satisfy their caregiver needs, but disregarded their personal needs or relational needs, such as good 27 communication with their aphasic partner. Interestingly, the partners recruited in our study had been living with someone with aphasia for an average of 11.5 months and their perspective had changed.…”