Abstract
The study purposes were to assess the efficacy of a caregiver problem-solving intervention (CPSI) on stroke caregiver physical and psychosocial adaptation compared with a wait-list control (WLC) treatment, and to assess the mediation effects of coping on outcomes. A stress and coping model guided the study design. Outcomes were depression, anxiety, preparedness, life changes, and family functioning. CPSI started during acute rehabilitation and continued 3months postdischarge. Data were collected at baseline (T1), postintervention (T2), and 6 (T3) and 12months postdischarge (T4). Of 255 caregivers, 75% were depressed at baseline. Repeated measures ANOVA of study completers (n=121) indicated improved T2 depression, life change, and health (ps<.04) favoring the CPSI group. Improvements faded by 6months. Although no group differences in outcomes were found in the intention-to-treat analysis, growth curve modeling indicated a difference in depression rate of change, favoring the CPSI (p=.04). Perceived health, threat appraisal and rational problem-solving were significant mediators (ps<.05). Findings provide direction for future interventions to promote and sustain healthy caregiver adaptation.
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