A problem-solving early intervention for stroke caregivers: one year follow-up

Rehabil Nurs. 2012 Sep-Oct;37(5):231-43. doi: 10.1002/rnj.039. Epub 2012 Jun 29.

Abstract

Purpose: 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.

Methods: 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 3 months postdischarge. Data were collected at baseline (T1), postintervention (T2), and 6 (T3) and 12 months postdischarge (T4).

Results: 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 6 months. 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).

Conclusions: Findings provide direction for future interventions to promote and sustain healthy caregiver adaptation.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adaptation, Psychological*
  • Adult
  • Aged
  • Aged, 80 and over
  • Caregivers / psychology*
  • Family Nursing / methods
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Problem Solving
  • Rehabilitation Nursing / methods*
  • Stress, Psychological / nursing
  • Stress, Psychological / psychology
  • Stress, Psychological / rehabilitation
  • Stroke / nursing*
  • Stroke / psychology
  • Stroke Rehabilitation*
  • Young Adult