Spouses’ Quality of Life 1 Year after Stroke: Prediction at the Start of Clinical Rehabilitation

Background and Purpose: The purpose of this prospective study was to identify early predictors of spouses’ quality of life at 1 year after stroke. Methods: At the start of clinical rehabilitation patient and caregiver characteristics, psychological factors, harmony in the relationship and social support were assessed. One year after stroke, caregiver burden (Caregiver Strain Index), life satisfaction (Life Satisfaction Checklist) and depressive symptoms (Goldberg Depression Scale) were assessed in 187 participants. Multiple regression analyses were performed. Results: About 80% of the spouses reported low quality of life on one or more of the measures; 52% reported depressive symptoms, 54% significant strain and only 50% was satisfied with life as a whole. The regression analysis identified ‘passive coping strategy of the caregiver’ as the most important predictor. ADL dependency was the only baseline patient characteristic significantly related to burden and life satisfaction, but explained just 0–4% of the variance. Conclusions: A large proportion of caregivers perceive impaired quality of life 1 year after stroke. Caregivers at risk should be identified at the start of rehabilitation by means of coping measurement instruments or selected anamneses on coping.

[1]  C. Blomstrand,et al.  Psychological well-being of spouses of stroke patients during the first year after stroke , 2004, Clinical rehabilitation.

[2]  M. Limburg,et al.  The burden of caregiving in partners of long-term stroke survivors. , 1998, Stroke.

[3]  R. Langton-Hewer,et al.  Identification of stroke carers 'at risk': a preliminary study of the predictors of carers' psychological well-being at one year post stroke , 1996 .

[4]  C. V. van Heugten,et al.  Intervention studies for caregivers of stroke survivors: a critical review. , 2005, Patient education and counseling.

[5]  N. Matson,et al.  Coping, caring and stress: a study of stroke carers and carers of older confused people. , 1994, The British journal of clinical psychology.

[6]  S. Folstein,et al.  "Mini-mental state". A practical method for grading the cognitive state of patients for the clinician. , 1975, Journal of psychiatric research.

[7]  L. Kalra,et al.  Training carers of stroke patients: randomised controlled trial , 2004, BMJ : British Medical Journal.

[8]  K. Laake,et al.  Acute Phase Predictors of Subsequent Psychosocial Burden in Carers of Elderly Stroke Patients , 2001, Cerebrovascular Diseases.

[9]  J. Hanley,et al.  Evolution of the caregiving experience in the initial 2 years following stroke. , 2003, Research in nursing & health.

[10]  A. Fugl-Meyer,et al.  Happiness and domain-specific life satisfaction in adult northern Swedes , 1991 .

[11]  C. Bugge,et al.  Stroke patients' informal caregivers. Patient, caregiver, and service factors that affect caregiver strain. , 1999, Stroke.

[12]  D. Wade,et al.  Measurement in neurological rehabilitation. , 1992, Current opinion in neurology and neurosurgery.

[13]  M. Kaste,et al.  Depression Among Caregivers of Stroke Survivors , 2005, Stroke.

[14]  R. Sanderman,et al.  Risk factors for burn-out in caregivers of stroke patients, and possibilities for intervention , 2001, Clinical rehabilitation.

[15]  P. Langhorne,et al.  Impact and Influences on Caregiver Outcomes at One Year Post-Stroke , 2004, Cerebrovascular Diseases.

[16]  L. D. de Witte,et al.  Quality of life and the ICIDH: towards an integrated conceptual model for rehabilitation outcomes research , 1999, Clinical rehabilitation.

[17]  S. Thompson,et al.  The Caregivers of Stroke Patients: An Investigation of Factors Associated with Depression , 1990 .

[18]  R. Schulz,et al.  Post-stroke depression in primary support persons: predicting those at risk. , 1988, Journal of consulting and clinical psychology.

[19]  N. Lincoln,et al.  Caregiver strain in spouses of stroke patients , 2003, Clinical rehabilitation.

[20]  Gwyn McClelland.  Survivors , 1891, The Hospital.

[21]  R. Schulz,et al.  A longitudinal study of the psychosocial impact of stroke on primary support persons. , 1988, Psychology and aging.

[22]  N. Chumbler,et al.  The sense of coherence, burden, and depressive symptoms in informal caregivers during the first month after stroke , 2004, International journal of geriatric psychiatry.

[23]  R. Schulz,et al.  A longitudinal study of the psychosocial impact of stroke on primary support persons. , 1988, Psychology and aging.

[24]  C. Warlow,et al.  A quantitative study of the emotional outcome of people caring for stroke survivors. , 1998, Stroke.

[25]  A. Lange,et al.  Statusverschillen, traditionaliteit en harmonie binnen het huwelijk. , 1990 .

[26]  S. Rubenach,et al.  A randomized controlled trial of an education and counselling intervention for families after stroke , 2003, Clinical rehabilitation.

[27]  M. Koopmanschap,et al.  Burden of Informal Caregiving for Stroke Patients , 2005, Cerebrovascular Diseases.

[28]  Ingrid I Riphagen,et al.  Measures used to assess burden among caregivers of stroke patients: a review , 2004, Clinical rehabilitation.

[29]  C. Blomstrand,et al.  Life satisfaction in spouses of patients with stroke during the first year after stroke. , 2004, Journal of rehabilitation medicine.

[30]  M. Ketelaar,et al.  Children's adjustment to a parent's stroke: determinants of health status and psychological problems, and the role of support from the rehabilitation team. , 2005, Journal of rehabilitation medicine.

[31]  P. Duncan-Jones,et al.  Detecting anxiety and depression in general medical settings. , 1988, BMJ.