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(Stroke. 2009;40:1399.)
© 2009 American Heart Association, Inc.

Original Contributions

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

Course and Relations With Coping Strategies

Anne Visser-Meily, MD, PhD; Marcel Post, PhD; Ingrid van de Port, PhD; Cora Maas, PhD; Gunilla Forstberg-Wärleby, PhD Eline Lindeman, MD, PhD

From the Department of Rehabilitation Medicine (A.V.M., M.P., I.v.d.P., E.L.), Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht and the Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands; the Department of Methodology and Statistics (C.M.), Utrecht University, Utrecht, The Netherlands; and the Institute of Neuroscience and Physiology (G.F.-W.), Sahlrenska Academy and Göteborg University, Göteborg, Sweden.

Correspondence to Anne Visser-Meily, MD, PhD, Rudolf Magnus Institute of Neuroscience, Department of Rehabilitation and Sports Medicine, University Medical Center Utrecht, PO Box 85500, 3508 GA Utrecht, The Netherlands. E-mail j.m.a.visser-meily{at}umcutrecht.nl

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.

Key Words: burden • depression • quality of life • stroke care