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Stroke Damages Spouses' Sense of Well-Being

DALLAS, July 2001 -- The effects of a stroke are all in the family, according to a study that indicates spouses suffer psychological ill-effects immediately after their mate has a stroke, researchers report in the July issue of Stroke: Journal of the American Heart Association.

In one of the first studies to examine short-term psychological effects of a stroke on a group of patient's spouses, researchers found that spouses experience a sharp decline in their sense of well-being and a sharp rise in psychological stress within days of their mate's stroke. This can affect the spouse's ability to support the stroke survivor, which is crucial to the rehabilitation and recovery of the stroke patient.

The emotional and practical support of the caregiver is known to affect the functional and psychosocial outcome of the stroke patient, says Gunilla Forsberg-Warleby, B.S., a registered occupational therapist at the Institution of Clinical Neuroscience at Sahlgrenska University Hospital in Goteborg, Sweden. Earlier studies have shown that spouses cope better with practical issues than with emotional ones.

"Our research indicates that it is very important for health professionals to pay attention to the spouses' psychological health as well as the patient's. Giving spouses the reinforcement they need to take an active part in the care and rehabilitation of their partners will improve their outlook and sense of well-being," says Forsberg-Warleby.

Previous studies have traced the psychological impact of stroke on families over time and found that 20 percent to 50 percent of caregivers experience emotional disturbances, especially depression.

Using a questionnaire and interview, Swedish researchers measured the perceived psychological well-being of 83 spouses of stroke patients during 10 days following the stroke. The stroke patients ranged in age from 23 to 75 with an average age of 58, three-fourths were men. The average age of their spouses was 57 and the average length of their relationships was 30 years.

Researchers compared the spouses' sense of well-being to the level of impairment in the stroke patient.

Most of the spouses showed significantly lower psychological well-being compared with a normal population. The extent of disability of the stroke patients, such as motor skill impairment, correlated with the spouses' outlook of the future. There was no gender difference noted, as both husbands and wives showed virtually identical reductions in emotional well-being.

"It's easy to assume that the spouse's psychological well-being may affect the ability to give emotional and practical support," Forsberg-Warleby says. "This is an important question that needs to be investigated.

"In its first phase, a stroke is usually an unexpected event, one perceived as an existential threat that causes a breakdown in everyday life," she notes. "Being given more detailed information by health care professionals about what to expect, and how to deal with problems that arise, can help spouses overcome their negative psychological reactions, adapt better to the circumstances and develop a more positive attitude toward the future."

But merely making this information available isn't enough, the research shows. "The spouse needs to be able to integrate the information as knowledge," explains Forsberg-Warleby. "To achieve this, the information must be given in a respectful way that gives the spouse a sense of importance in the patient's recovery and is based on the spouse's own perceived needs.

"It's very important for health professionals to pay attention to the spouse's psychological health as well as the patient's," she notes.

Co-authors of the study are Anders Moller, Ph.D., and Christian Blomstrand, M.D., Ph.D.

---American Heart Association

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