The longitudinal and dyadic effects of mutuality on perceived stress for stroke survivors and their spousal caregivers

Abstract

Objective: Functional impairment resulting from a stroke frequently requires the care of a family caregiver, often the spouse. This change in the relationship can be stressful for the couple. Thus, this study examined the longitudinal, dyadic relationship between caregivers’ and stroke survivors’ mutuality and caregivers’ and stroke survivors’ perceived stress.

Method: This secondary data analysis of 159 stroke survivors and their spousal caregivers utilized a cross-lagged, mixed models analysis with the actor–partner interdependence model to examine the dyadic relationship between mutuality and perceived stress over the first year post-discharge from inpatient rehabilitation.

Results: Caregivers’ mutuality showed an actor effect (β = −3.82, p < 0.0001) but not a partner effect. Thus, caregivers’ mutuality influenced one's own perceived stress but not the stroke survivors’ perceived stress. Stroke survivors’ perceived stress showed a partner effect and affected caregivers’ perceived stress (β = 0.13, p = 0.047). Caregivers’ perceived stress did not show a partner effect and did not significantly affect stroke survivors’ perceived stress.

Conclusion: These findings highlight the interpersonal nature of stress in the context of caregiving for a spouse. Caregivers are especially influenced by perceived stress in the spousal relationship. Couples should be encouraged to focus on positive aspects of the caregiving relationship to mitigate stress.

Keywords:

• stroke
• caregiving
• perceived stress
• mutuality
• dyadic analysis

Acknowledgments

Thanks to Sarah Felknor, DrPH and Vincent Chen, PhD for their guidance on early drafts of this manuscript. The parent grant for this study was supported by the National Institues of Health, National Institute of Nursing Research RO1 NR005316 (Sharon K. Ostwald, PI) and the Isla Carrol Turner Friendship Trust. This study was partly supported by the National Research Service Award (T32 HP10031).