Changes in participation level after spouse's first stroke and relationship to burden and depressive symptoms

No comprehensive data are available on the impact of stroke on the spouse's participation level. The purpose of this study was to document changes in participation level over time and explore associations between changes in participation level, burden and depressive symptoms for spouses of people who had had a first stroke.

Participants were spouses recruited in the first 2 weeks after admission of individuals with a first stroke to acute care. Prestroke measures (T0) were collected at recruitment, simultaneously with the first measure (T1); further measures were collected 6 months after the stroke event (T2). Participation level was measured with the LIFE-H, perceived burden with the Caregiver Strain Index and depressive symptoms using the Beck Depression Inventory (BDI).

Mean age of participants (n = 54) was 69 years (SD 10.9) and the majority were female (75.9%). Changes in participation include small but significant increases at T1 for the nutrition (effect size, ES, 0.34) and responsibilities (ES 0.22) domains, and large significant persistent decreases at T2 compared to T0 were found for personal relationships (ES 0.83), employment (ES 0.63) and recreation (ES 0.93). Changes in these last three participation domains are associated with a higher Caregiver Strain Index score (p < 0.01) but not with the BDI.

Participation domains mostly affected for spouses after stroke were personal relationships, employment and recreation which could be addressed by clinicians in their provision of support.