Abstract 3861: The Effect of Stroke Survivor and Caregiver Family Function and Mutuality on Post Stroke Depression

Abstract

Background: Post-stroke depression is common among both stroke survivors and their caregivers. This secondary data analysis explored the effect that stroke survivor and caregiver family function and mutuality, a measure of the perceived positive aspects of the caregiving relationship, had on the depression of spousal dyads over the first 12 months post discharge from inpatient rehabilitation. Methods: Longitudinal meditational analysis was employed to examine the mediating effect of mutuality on the dyads’ perception of family function and caregiver and stroke survivor depression over time. The model was estimated in MPlus version 6.1 using bootstrap estimation with 1000 draws. The final structural model had good model fit to the data with a chi square ( df= 16; N = 132) of 17.55, p =.35, a comparative fit index (CFI) of 0.996, and root mean square error of approximation (RMSEA) of 0.027 (CI = 0-.087). Results: This study included 159 stroke survivors and their spousal caregivers who were an average (standard deviation) age of 66.4 (9.1) and 62.5 (10.5) years, respectively. The majority of stroke survivors were predominately male and non-Hispanic white, although almost 40% of the sample was represented by ethnic minorities. Mutuality was not found to mediate the relationship between caregivers’ and stroke survivors’ perception of family function at baseline and their own or their partners’ depression at 12 months as hypothesized. However, caregivers who perceived healthier family functioning at baseline and stroke survivors who had higher perceived mutuality at 12 months had lower depression at one year post discharge from inpatient rehabilitation (-.117, p=.048; -1.007, p=.034, respectively). Additionally, caregiver mutuality at 6 months, but not at baseline or 12 months, was found to be inversely related to caregiver depression at 12 months (-1.06, p=.04). Conclusions: This study highlights the importance of focusing on the relational aspects of stroke. A stroke does not only happen to the stroke survivor. It affects his or her family, and it oftentimes changes the life of both the stroke survivor and their spousal caregiver. Health professionals should encourage couples who have experienced a stroke to focus on the positive aspects of the caregiving relationship to mitigate post-stroke depression.