ADAPTATION AFTER STROKE--PATIENT AND SUPPORT PERSON

这项为期四年的多中心纵向描述性研究的主要目的是 研究的目的是：1）描述患者的适应过程 中风及其主要支持者（PSP），以及2）评估 选定变量与心理社会适应之间的关系。 具体目标是：1）描述患者和PSP的自然史 对中风的心理社会适应，2）描述应对过程 脑卒中患者与PSP的关系，3）描述患者之间的关系 结果和PSP结果，以及4）检查之间的关系 背景、疾病相关、社会环境和应对变量， 结果。 240例脑卒中患者及其PSP 包括样品。 65例患者/PSP二联体将作为对照 确定研究程序对结局的影响。 所有其他二元组 将组成研究小组，并将被要求参加4 访谈：在从急性康复计划中出院之前，以及 分别在出院后6周、1年和2年时进行。 对照组将 仅在第二年接受采访。 患者和PSP将接受访谈 并被要求完成家庭功能的测量， 社会支持、应对、乐观和抑郁。 评估还将 由感知和实际负担（PSP），功能状态和 认知（患者）。 将要求研究组中的60对研究组 答复关于评估其处境的其他开放性问题 以及生活中的压力源，以提供关于 应对适应过程。 多变量技术将用于评估 所选变量与适应的关系。 定性 对开放式访谈数据的分析将侧重于描述 受试者对情境的认知评价和 随着时间的推移报告的适应性任务。 这项研究将增加 了解适应中风的长期过程。 等 知识对未来的时机和选择有影响， 干预措施。

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.