ADAPTATION AFTER STROKE--PATIENT AND SUPPORT PERSON

点击翻译按钮获取中文摘要

The primary purposes of this four year multi-site longitudinal descriptive study are to: 1) describe the process of adaptation of patients with stroke and their primary support persons (PSPs), and 2) assess the relationship between selected variables and psychosocial adaptation. Specific aims are to: 1) describe the natural history of patient and PSP psychosocial adaptation to stroke, 2) describe the process of coping with stroke for patients and PSPs, 3) describe the relationship between patient outcomes and PSP outcomes, and 4) examine the relationship between background, illness-related, social-environmental and coping variables and outcomes. Two hundred and forty patients with stroke and their PSPs comprise the sample. Sixty-five patient/PSP dyads will serve as a Control Group to identify effects of study procedures on outcomes. All other dyads will comprise the Study Group and will be asked to participate in 4 interviews: prior to discharge from an acute rehabilitation program, and at 6-weeks, one year, and two years postdischarge. The Control Group will be interviewed only at Year 2. Patient and PSP will be interviewed separately and asked to complete measures of family function, perceived social support, coping, optimism, and depression. Assessments will also be made of perceived and actual burden (PSPs), and functional status and cognition (patients). Sixty of the Study Group dyads will be asked to respond to additional open-ended questions on appraisal of their situation and stressors in their life to provide indepth qualitative data on the coping adaptation process. Multivariate techniques will be used to assess the relationship of the selected variables to adaptation. Qualitative analysis of open-ended interview data will focus on a description of the subject's cognitive appraisal of the situation and identification of adaptive tasks as reported over time. This study should increase understanding of the long-term process of adapting to stroke. Such knowledge has implications for the timing and selection of future interventions.