Subjective Change in Emotive, Cognition and Behaviour After Stroke: Factors Affecting the Perception of Patients and Partners

Abstract

The presence and severity of changes in emotion and cognition experienced by left- and right-sided stroke patients and observed by their partners were compared at 3 months poststroke. The results showed that, regardless of the side of stroke, several changes were reported by half of the stroke patients and their partners. It appeared that while left hemisphere stroke patients agreed with their partners on the number and severity of most changes, partners of right hemisphere patients reported more frequent and more severe changes than the patients themselves. The level of observability of the altered behaviour, distress of the partner, distress of left-sided stroke patients and hemispatial neglect of right-sided stroke patients emerged as factors related to disagreement between stroke patient and partner.

The association between discrepancy in illness representations on distress in stroke patients and carers

“…This finding is in keeping with research into other illnesses, including heart disease [38]. Carers were generally more pessimistic than patients, a finding that is in keeping with earlier research in stroke [39,40]. One contribution to this association may be carers' lack of knowledge [41] or the sense that they feel ill equipped to cope with the additional responsibilities associated with caring [42].…”

Actual and desired information provision after a stroke

“…General practitioners in the North of the Netherlands and the stroke unit of University Hospital Groningen enclosed patients with a recent, first, non-haemorrhaging, unilateral stroke as part of CognitiVA, a longitudinal community-based study of cognitive disorders and quality of life after a stroke [36]. Between April 1998 and May 2000, these stroke patients and caregivers (wife or husband, partner, or daughter) received a (free) copy of the Guide from one of the CognitiVA researchers 3 months after suffering a stroke.…”

Does Hemispheric Lateralization Influence Functional and Cardiovascular Outcomes After Stroke?

“…35 Although some evidence suggests there may not be a substantial difference in the presence and severity of emotional and cognitive changes between survivors of rightand left-hemisphere stroke overall, those with righthemisphere stroke underestimate these changes compared with their partners' observations. 36 Previous evidence suggests that patients with righthemisphere stroke are less likely to be admitted to hospital, treated with tPA, or offered carotid endarterectomy compared with patients with left-hemisphere stroke. [1][2][3] In contrast, we found no difference in the number of patients recruited with right-hemisphere stroke compared with left-hemisphere stroke in this cohort representing patients from 3 randomized trials of acute stroke therapy, nor any difference in onset to treatment time.…”