title: Rehabilitation of stroke patients needs a family-centred approach.
abstract: OBJECTIVE
  To highlight the importance of the spouse in stroke rehabilitation. Stroke not only affects the patients, but also their families, but rehabilitation practice is still primarily focused on the patient only.
  
  
  METHODS
  Analysis of the position of the spouse and possible consequences of stroke for the spouse, based on the literature.
  
  
  RESULTS
  Three roles of spouses are described: (i) the role of caregiver, as the spouse often provides extensive and comprehensive care for the patient; (ii) the role of client, as this informal care may lead to physical and emotional strain; and (iii) the role of family member, as the stroke affects the interpersonal relationships within the family system, not least the emotional and sexual relationship between the partners. This analysis provides an understanding of problems experienced by spouses as roles conflict and identifies topics for assessment and interventions directed at the spouse in the acute phase, rehabilitation phase and chronic phase of stroke.
  
  
  CONCLUSIONS
  We support a family-centred approach in which the strengths and needs of all family members, the patient with stroke included, are considered throughout all phases of the rehabilitation process.
authors.affiliation: Department of Rehabilitation, University Medical Centre, Utrecht, The Netherlands. a.visser@dehoogsraat.nl
authors.forename: Anne
authors.initials: A
authors.lastname: Visser-Meily
authors.forename: Marcel
authors.initials: M
authors.lastname: Post
authors.forename: Jan Willem
authors.initials: JW
authors.lastname: Gorter
authors.forename: Steven Berdenis V
authors.initials: SB
authors.lastname: Berlekom
authors.forename: Trudi
authors.initials: T
authors.lastname: Van Den Bos
authors.forename: Eline
authors.initials: E
authors.lastname: Lindeman
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers; D006801:Humans; D011787:Quality of Health Care; D012046:Rehabilitation / Q000379:methods; D018454:Spouses; D000071939:Stroke Rehabilitation