Journal of Stroke & Cerebrovascular Diseases
Volume 19, Issue 1 , Pages 10-16, January 2010

Functional and Psychosocial Outcomes 1 year after Mild Stroke

  • Theresa L. Green, RN, PhD

      Affiliations

    • Faculty of Nursing, University of Calgary, Alberta, Canada
    • Corresponding Author InformationAddress correspondence to Theresa L. Green, RN, PhD, Faculty of Nursing, University of Calgary, Professional Faculties Bldg, 2500 University Dr NW, Calgary, Alberta, Canada T2N 1N4.
    • ,
  • Kathryn M. King, RN, PhD

      Affiliations

    • Faculty of Nursing, University of Calgary, Alberta, Canada
    • Department of Community Health Sciences, University of Calgary, Alberta, Canada

Received 14 January 2009; received in revised form 6 February 2009; accepted 11 February 2009.

Background

Mild stroke survivors are generally discharged from acute care within a few days of the stroke event, often without rehabilitation follow-up. We aimed to examine the recovery trajectory for male patients and their wife-caregivers during the 12 months postdischarge.

Methods

A descriptive study was undertaken to examine functional outcomes, quality of life (QOL), depression, caregiver strain, and marital function in a prospective cohort of male survivors of mild stroke and their wife-caregivers during the 12 months postdischarge. Data from each point in time were summarized and repeated measures analyses undertaken. Logistic regression was used to determine which baseline demographic and biopsychosocial variables influenced or predicted marital functioning 1 year postdischarge.

Results

A total of 38 male patients (mean age 63.4 years) and their wife-caregivers (mean age 58.5 years) were examined. The median discharge National Institutes of Health Stroke Scale score was 1.5, modified Rankin Scale score was 1.0, Barthel Index was 100.0, and Stroke Impact Scale-16v2 score was 78.5. The patients' modified Rankin Scale (function) and QOL scores improved significantly over time (F (2) = 4.583, P = .017; and F (6) = 5.632, P < .001, respectively). However, the wife-caregiver QOL scores did not change. Multivariate analysis revealed overall worsening of depression for both the patient and wife-caregivers (F (6, 32) = 3.087, P = .017) and marital function (F (6, 32) = 3.961, P = .004), although the wife-caregivers' perceptions of caregiver strain improved (F (6, 32) = 3.923, P = .007). None of the measured variables were associated with marital functioning 1 year postdischarge.

Conclusions

Despite improvement in patients' functional status, other patient and wife-caregiver psychosocial outcomes during the 12 months postdischarge may be negatively affected. Thus, attention needs to focus on recovery beyond functional outcomes.

Key Words: Mild stroke, quality of life, caregiver burden, marital function

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 Dr. Green was supported by a Strategic Training in Health Research Fellowship from the FUTURE Program for Cardiovascular Nurse Scientists, funded by the Canadian Institutes of Health Research, the Heart and Stroke Foundation of Canada, and the Canadian Stroke Network; and a PhD Scholarship from the Alberta Heritage Foundation for Medical Research. The research was supported by the Calgary Stroke Program and the Canadian Association of Neuroscience Nurses. Dr. King is supported by a Health Scholar Award from the Alberta Heritage Foundation for Medical Research.

PII: S1052-3057(09)00036-6

doi:10.1016/j.jstrokecerebrovasdis.2009.02.005

Journal of Stroke & Cerebrovascular Diseases
Volume 19, Issue 1 , Pages 10-16, January 2010

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