title: Roles of Changing Physical Function and Caregiver Burden on Quality of Life in Stroke: A Longitudinal Dyadic Analysis.
abstract: The purpose of this study was to examine changes in stroke survivor and caregiver quality of life (QOL) and to determine whether changes in survivor physical functioning and caregiver burden (ie, the impact of the physical, psychological, and social demands of caregiving) influence changes in QOL.
  
  
  
  Longitudinal design with 226 stroke survivor-caregiver dyads enrolled at survivor discharge from rehabilitation hospitals. Data collection was performed over 12 months. We measured survivor physical functioning, caregiver burden, and QOL (physical, psychological, social, and environmental) in both survivor and caregiver. Multilevel modeling was used to control for the interdependence of the data.
  
  
  
  Survivors (50% male sex) and caregivers (66% female sex) were 70.8 (SD=11.9) and 52.4 (SD=13.1) years old, respectively. Over the 12 months, stroke survivor's physical (γ=1.59;P<0.001) and psychological (γ=0.86;P<0.05) QOL significantly improved; social and environmental QOL did notP>0.05. Caregiver QOL, on average, did not significantly change over timeP>0.05. Improvements in survivor physical functioning were associated with increases in survivor and caregiver physical and psychological QOL and survivor environmental QOL. Decreases in caregiver burden were significantly associated with improvements in caregiver physical, psychological, and environmental QOL but not with survivor QOL.
  
  
  
  QOL of stroke survivors and caregivers covaries and is greatly impacted by the physical function changes of the survivor. Dyadic approaches to stroke rehabilitation that acknowledge the interdependence of dyads are needed.
authors.affiliation: From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.). g.pucciarelli81@gmail.com.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Pucciarelli
authors.affiliation: From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
authors.forename: Ercole
authors.initials: E
authors.lastname: Vellone
authors.affiliation: From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
authors.forename: Serenella
authors.initials: S
authors.lastname: Savini
authors.affiliation: From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
authors.forename: Silvio
authors.initials: S
authors.lastname: Simeone
authors.affiliation: From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
authors.forename: Davide
authors.initials: D
authors.lastname: Ausili
authors.affiliation: From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
authors.forename: Rosaria
authors.initials: R
authors.lastname: Alvaro
authors.affiliation: From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
authors.forename: Christopher S
authors.initials: CS
authors.lastname: Lee
authors.affiliation: From the Department of Biomedicine and Prevention, University of Rome Tor Vergata, Italy (G.P., E.V., R.A.); School of Nursing, Sapienza University, Bracciano, Rome, Italy (S. Savini); Department of Cardiology, Policlinico Federico II, Naples, Italy (S. Simeone); Department of Medicine and Surgery, University of Milano-Bicocca, Italy (D.A.); and School of Nursing, Oregon Health & Science University, Portland (C.S.L., K.S.L.).
authors.forename: Karen S
authors.initials: KS
authors.lastname: Lyons
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017028:Caregivers / Q000523:psychology; D003863:Depression / Q000503:physiopathology; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge / Q000706:statistics & numerical data; D011788:Quality of Life; D020521:Stroke / Q000503:physiopathology* / Q000523:psychology; D000071939:Stroke Rehabilitation / Q000523:psychology; D017741:Survivors
keywords: caregiver; quality of life; rehabilitation; stroke; survivor