Abstract 2849: Family Variables in Early Recovery Predict Stroke Survivor Quality of Life in 12 months

Abstract

Purpose : Quality of life (QOL) after stroke may be influenced by the family context in addition to the stroke survivor’s physical ability. The purpose of this study was to determine whether baseline caregiver (CG) and family characteristics (age, physical function, depressive symptoms, and family communication) predict stroke survivor (SS) QOL: physical function, memory/thinking, social activities, communication, and mood at 1 year follow-up. Methods : Data were collected on 132 SS-CG dyads. SSs were 3–9 months post stroke, 30 to 83 years old ( M = 62.2 ± 12.6), male (64%), Caucasian (74 %), and had an ischemic stroke (88%). CGs were age 25 to 85 years ( M = 56.7 ± 13.7), female (74 %), well-educated (73 %), and spouses (80 %) enrolled in a multi-site caregiving study complementary to a clinical trial testing constraint-induced movement therapy in SSs. Measures included CG physical function (SF-36), CG depressive symptoms (CES-D), family communication (McMaster Family Assessment Device), and SS QOL (Stroke Impact Scale). Pearson’s correlations and hierarchal multiple regression analyses (n = 107) controlling for SS gender, the EXCITE intervention group, and SS functional level were used for analysis. Results : Baseline CG depressive symptoms were negatively related to both SS mood ( r = -.24, p < .01) and social activities ( r = -.26, p = .01) at 1 year. Better family communication was related to higher SS memory/thinking ( r = -.24, p = .01). CG age and physical function were not associated with any SS QOL domains. In the regression models, CGs with more depressive symptoms (β = -.28, p = .007) at baseline predicted poorer SS mood ( F = 2.56, p = .02; R 2 = .13) and worse social participation (β = -.27, p = .01; F = 1.61, p = .15; R 2 = .09). Although the overall model was not significant ( F = 1.20, p = .31; R 2 = .07), worse family communication (β = -.22; p = .04) predicted poorer SS memory and thinking at 1 year. No CG or family characteristics were associated with SS physical or communication QOL domains. Conclusions : Early recognition and intervention of CG depressive symptoms may have profound effects on both CG and aspects of SS QOL in the early and chronic stroke recovery periods. Family interventions focusing on improving communication early may also improve long term stroke recovery.