title: Psychosocial functioning of spouses of patients with stroke from initial inpatient rehabilitation to 3 years poststroke: course and relations with coping strategies.
abstract: OBJECTIVE
  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.
authors.affiliation: Department of Rehabilitation Medicine, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht and the Rehabilitation Center De Hoogstraat, Utrecht, The Netherlands. j.m.a.visser-meily@umcutrecht.nl
authors.forename: Anne
authors.initials: A
authors.lastname: Visser-Meily
authors.forename: Marcel
authors.initials: M
authors.lastname: Post
authors.forename: Ingrid
authors.initials: I
authors.lastname: van de Port
authors.forename: Cora
authors.initials: C
authors.lastname: Maas
authors.forename: Gunilla
authors.initials: G
authors.lastname: Forstberg-Wärleby
authors.forename: Eline
authors.initials: E
authors.lastname: Lindeman
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D017281:Cost of Illness; D003863:Depression / Q000523:psychology; D005192:Family Health; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011788:Quality of Life; D012919:Social Behavior; D018454:Spouses / Q000523:psychology*; D020521:Stroke / Q000523:psychology*; D000071939:Stroke Rehabilitation