title: Effects of Self-esteem, Optimism, and Perceived Control on Depressive Symptoms in Stroke Survivor-Spouse Dyads.
abstract: BACKGROUND
  Depressive symptoms are common in stroke survivors and their family caregivers. Given the interdependent relationship between the members of dyads in poststroke management, improving depressive symptoms in dyads may depend on their partner's characteristics. Self-esteem, optimism, and perceived control, all known to be associated with depressive symptoms in an individual, may also contribute to their partner's depressive symptoms.
  
  
  OBJECTIVE
  The purpose of this study is to examine actor and partner effects of self-esteem, optimism, and perceived control on depression in stroke survivors and their spousal caregivers.
  
  
  METHODS
  A total of 112 ischemic stroke survivors (78% white, 34% women; mean age, 62.5 ± 12.3 years) and their spouses (mean age, 60.6 ± 12.9 years) completed surveys in which depressive symptoms, self-esteem, optimism, and perceived control were assessed using the Patient Health Questionnaire, the Rosenberg Self-esteem Scale, the Revised Life Orientation Test, and the Sense of Control Scale. Multilevel modeling, actor-partner interdependence model regression was used to determine influences on depressive symptoms within the dyad.
  
  
  RESULTS
  Individuals with lower self-esteem, optimism, and perceived control had higher levels of depressive symptoms. Stroke survivors whose spouses had lower levels of self-esteem (B = -0.338, P < .001) and optimism (B = -0.361, P < .027) tended to have higher levels of depressive symptoms. Spouses whose stroke survivors had lower levels of self-esteem (B = -0.047, P = .036) also had higher levels of depressive symptoms.
  
  
  CONCLUSIONS
  We found significant partner effects of self-esteem on depression for both members and partner effect of optimism on patient's depressive symptoms. These findings suggest that further research is needed to determine if dyadic interventions may help to improve self-esteem, optimism, and depressive symptoms in both patients and their caregivers.
authors: Misook L. Chung, PhD, RN, FAHA, FAAN Associate Professor, Codirector, RICH Heart Program, College of Nursing, University of Kentucky, Lexington. Tamilyn Bakas, PhD, RN, FAHA, FAAN Professor and Chair, Department of Science of Nursing Care, School of Nursing, Indiana University, Indianapolis. Laura D. Plue, MA Indiana University School of Medicine and Qualitative Research Coordinator, Stroke QUERI Center for Health Information and Communications, Richard L. Roudebusch Veterans Administration Medical Center, Indianapolis. Linda S. Williams, MD, FAHA, FAAN Professor of Neurology, Indiana University School of Medicine and Richard L. Roudebusch Veterans Administration Medical Center, Indianapolis.
authors: Misook L
authors: ML
authors: Chung
authors: Tamilyn
authors: T
authors: Bakas
authors: Laura D
authors: LD
authors: Plue
authors: Linda S
authors: LS
authors: Williams
mesh_terms: D000223:Adaptation, Psychological; D000368:Aged; D017028:Caregivers / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000067656:Optimism; D011788:Quality of Life; D012649:Self Concept; D018454:Spouses / Q000523:psychology*; D020521:Stroke / Q000523:psychology*; D017741:Survivors / Q000523:psychology*