The longitudinal and dyadic effects of mutuality on perceived stress for stroke survivors and their spousal caregivers

Abstract

Objective Functional impairment resulting from a stroke frequently requires the care of a family caregiver, often the spouse. This change in the relationship can be stressful for the couple. Thus, this study examined the longitudinal, dyadic relationship between caregivers’ and stroke survivors’ mutuality and caregivers’ and stroke survivors’ perceived stress. Method This secondary data analysis of 159 stroke survivors and their spousal caregivers utilized a cross-lagged, mixed models analysis with the Actor-Partner Interdependence Model (APIM) to examine the dyadic relationship between mutuality and perceived stress over the first year post discharge from inpatient rehabilitation. Results Caregivers’ mutuality showed an actor effect (β = −3.82, p < .0001) but not a partner effect. Thus, caregivers’ mutuality influenced one’s own perceived stress but not the stroke survivors’ perceived stress. Stroke survivors’ perceived stress showed a partner effect and affected caregivers’ perceived stress (β=.13, p=.047). Caregivers’ perceived stress did not show a partner effect and did not significantly affect stroke survivors’ perceived stress. Conclusion These findings highlight the interpersonal nature of stress in the context of caregiving for a spouse. Caregivers are especially influenced by perceived stress in the spousal relationship. Couples should be encouraged to focus on positive aspects of the caregiving relationship to mitigate stress.

Caring for caregivers after a stroke

“…For example, caregiver depression exacerbates depression in the stroke survivor (Carnwath and Johnson, 1987), similar to the close association found over time between levels of stroke survivor stress and caregiver stress (Godwin et al, 2013). Caregivers are a critical healthcare resource who save national healthcare systems vast sums each year (Arno et al, 1999;Langa et al, 2001).…”

“…Currently, stroke accounts for almost 10% of all deaths worldwide and is the second leading cause of death for those aged 60 years and over (WHF, 2014). In 2005 an estimated 16 million people worldwide suffered a first-ever stroke, with an estimated prevalence of 62 million stroke survivors (Strong et al, 2007); survivors who more often than not rely on informal family caregivers to support and care for them (Godwin et al, 2013).…”

The experience of stroke survivors three months after being discharged home: A phenomenological investigation

“…55,56 Future research should also take into consideration the lived experience of caregivers since they have an important influence on stroke survivors. 57 Implications for practice …”

Cuidado popular de familias con un adulto mayor sobreviviente del primer accidente cerebrovascular

“…Aunque el familiar no comprende los cambios emocionales del sobreviviente, usa el recurso de la paciencia para mantener una relación armoniosa con su familiar. Tanto el sobreviviente del ACV como su cuidador súbitamente son forzados a adaptarse a las limitaciones físicas o cognitivas pero esos cambios pueden ser estresantes para los dos y, más aún, si no cuentan con una preparación para enfrentar dicha situación (5,9,15).…”