title: When a parent has a stroke: clinical course and prediction of mood, behavior problems, and health status of their young children.
abstract: OBJECTIVE
  The purpose of this research was to describe the clinical course of children's functioning (depression, behavioral problems, and health status) during the first year after parental stroke and to determine which patient-, spouse-, or child-related factors at the start of inpatient rehabilitation can predict children's functioning after parental stroke at 1-year poststroke.
  
  
  METHODS
  Interviews with 82 children (4 to 18 years of age) and their parents (n=55) shortly after admission to a rehabilitation center, 2 months after discharge from inpatient rehabilitation, and 1 year after stroke. Depression was assessed using the Children Depression Inventory, behavioral problems with the Child Behavior Check List, and health status with the Functional Status II. Potential predictors were gender and age (child), activities of daily living disability and communication ability (patient), and spouse's depression and perception of the marital relationship.
  
  
  RESULTS
  At the start of the stroke patient's rehabilitation, 54% of the children had > or =1 subclinical or clinical problems, which improved to 29% 1 year after stroke. Children's functioning 1 year after stroke could best be predicted by their functioning at the start of rehabilitation. Spouse depression and perception of marital relationship were also significant predictors. A total of 28% to 58% of the variance in children's functioning could be explained.
  
  
  CONCLUSIONS
  Children's functioning after parental stroke improved during the first year after stroke. Identifying children at risk for problems 1 year after stroke requires assessment of children's functioning and the healthy spouse's depressive symptoms and perception of the marital relationship at the start of rehabilitation. This demonstrates the need for a family-centered approach in stroke rehabilitation.
authors.affiliation: Rehabilitation Center De Hoogstraat, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands. a.visser@dehoogstraat.nl
authors.forename: Anne
authors.initials: A
authors.lastname: Visser-Meily
authors.forename: Marcel
authors.initials: M
authors.lastname: Post
authors.forename: Anne Marie
authors.initials: AM
authors.lastname: Meijer
authors.forename: Ingrid
authors.initials: I
authors.lastname: van de Port
authors.forename: Cora
authors.initials: C
authors.lastname: Maas
authors.forename: Eline
authors.initials: E
authors.lastname: Lindeman
mesh_terms: D000203:Activities of Daily Living; D000223:Adaptation, Psychological; D000293:Adolescent; D000339:Affect; D000368:Aged; D002648:Child; D002652:Child Behavior; D016241:Child of Impaired Parents; D002675:Child, Preschool; D015331:Cohort Studies; D003866:Depressive Disorder / Q000209:etiology; D005190:Family; D005192:Family Health; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D010287:Parent-Child Relations; D012306:Risk; D012737:Sex Factors; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation; D013997:Time Factors; D016896:Treatment Outcome