When couples disagree on stroke recovery, one partner can suffer

by Katy Cosse

An innovative study from a University of Cincinnati (UC) social work researcher has found that when a stroke survivor and his or her caregiving spouse disagree on the survivor's rate of recovery, the caregiving spouse is more likely to experience depression and emotional distress.

Assistant Professor Michael McCarthy, PhD, working with co-author Karen Lyons at the Oregon Health and Science University, interviewed 35 couples in which one spouse had experienced a stroke within the past three years.

In separate sessions, and their discussed the survivor's recovery, including the performance of daily functions, their memory and ability to problem solve. In the first mixed-method study in the topic, both quantitative and qualitative data showed that spouses rated rehabilitation progress as significantly worse than —and that this discrepancy was associated with spouse depression.

"We found that spouses rated their partners' recovery worse than survivors rated it themselves, and that this discrepancy predicted depressive symptoms in the spouses," says McCarthy.

"So if the wife has a stroke," he continues, "and she believes, for example, that she can still drive but her husband doesn't—the difference in their perception is predictive of the husband's . We were able to quantify and capture a different kind of worry and stress that caregiving spouses can experience and connect it to their outcomes."

He adds that the magnitude of the discrepancy in perceptions between survivors and spousal caregivers is key to predicting depression in spousal caregivers—which can then cycle back onto the survivors.

McCarthy says there is some evidence that wives may be particularly susceptive to caregiver worry, as are spouses in strong, fulfilling relationships. With studies demonstrating that stroke caregivers have higher rates of depression than the general public and may be at higher risk for stroke themselves as well as premature death, caregiver mental health has profound consequences.

McCarthy hopes the study can help and other rehabilitation practitioners working with stroke survivors. Overall, he says health care needs to broaden the conversation around : from focusing solely on the patient to considering the patient-spouse couple as a unit.

"How the spouse is doing matters in the equation," he says. "They need as much care, if not more in some ways, as the patient. We need to bring partners together in the rehabilitation process, to align each person's expectations and perceptions in order to achieve the best outcomes."

His paper, "Incongruence between survivor and spouse perceptions of survivor functioning and effects on spouse emotional health," has been published online in the journal Aging & Mental Health.

More information: "Incongruence between stroke survivor and spouse perceptions of survivor functioning and effects on spouse mental health: a mixed-methods pilot study," Michael J. McCarthy & Karen S. Lyons. Aging & Mental Health 15 May 2014. DOI: 10.1080/13607863.2014.913551

add to favorites email to friend print save as pdf

Related Stories

Does chronic pain affect a spouse's sleep?

Aug 15, 2013

Research suggests that a patient's chronic pain affects a spouse's emotional well-being and marital satisfaction. In a novel study of behavioral health outcomes published in the journal Pain, researchers examined the effect ...

Recommended for you

Patient-centered medical homes reduce costs

12 hours ago

The patient-centered medical home (PCMH), introduced in 2007, is a model of health care that emphasizes personal relationships, team delivery of care, coordination across specialties and care settings, quality ...

New mums still excessively sleepy after four months

13 hours ago

(Medical Xpress)—New mums are being urged to be cautious about returning to work too quickly, after a QUT study found one in two were still excessively sleepy four months after giving birth.

It's time to address the health of men around the world

14 hours ago

All over the world, men die younger than women and do worse on a host of health indicators, yet policy makers rarely focus on this "men's health gap" or adopt programs aimed at addressing it, according to an international ...

User comments