title: A problem-solving early intervention for stroke caregivers: one year follow-up.
abstract: OBJECTIVE
  The study purposes were to assess the efficacy of a caregiver problem-solving intervention (CPSI) on stroke caregiver physical and psychosocial adaptation compared with a wait-list control (WLC) treatment, and to assess the mediation effects of coping on outcomes.
  
  
  METHODS
  A stress and coping model guided the study design. Outcomes were depression, anxiety, preparedness, life changes, and family functioning. CPSI started during acute rehabilitation and continued 3 months postdischarge. Data were collected at baseline (T1), postintervention (T2), and 6 (T3) and 12 months postdischarge (T4).
  
  
  RESULTS
  Of 255 caregivers, 75% were depressed at baseline. Repeated measures ANOVA of study completers (n = 121) indicated improved T2 depression, life change, and health (ps < .04) favoring the CPSI group. Improvements faded by 6 months. Although no group differences in outcomes were found in the intention-to-treat analysis, growth curve modeling indicated a difference in depression rate of change, favoring the CPSI (p = .04). Perceived health, threat appraisal and rational problem-solving were significant mediators (ps < .05).
  
  
  CONCLUSIONS
  Findings provide direction for future interventions to promote and sustain healthy caregiver adaptation.
authors.affiliation: Northwestern University Feinberg School of Medicine, Department of Physical Medicine & Rehabilitation, Chicago, IL, USA. rbking@northwestern.edu
authors.forename: Rosemarie B
authors.initials: RB
authors.lastname: King
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Hartke
authors.forename: Timothy
authors.initials: T
authors.lastname: Houle
authors.forename: Jungwha
authors.initials: J
authors.lastname: Lee
authors.forename: Gioia
authors.initials: G
authors.lastname: Herring
authors.forename: Bonita S
authors.initials: BS
authors.lastname: Alexander-Peterson
authors.forename: Jason
authors.initials: J
authors.lastname: Raad
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology*; D022143:Family Nursing / Q000379:methods; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011340:Problem Solving; D019145:Rehabilitation Nursing / Q000379:methods*; D013315:Stress, Psychological / Q000451:nursing / Q000523:psychology / Q000534:rehabilitation; D020521:Stroke / Q000451:nursing* / Q000523:psychology; D000071939:Stroke Rehabilitation; D055815:Young Adult