Association between incongruence about survivor function and outcomes among stroke survivors and family caregivers

ABSTRACT

Background: Stroke survivors and family caregivers often have incongruent appraisals of survivor cognitive, physical, and psychosocial function. Partner incongruence contributes to poor outcomes for survivors and caregivers.

Objectives: This study explored whether partner incongruence: (1) differs by function domain; (2) increases or decreases over time, and; (3) is associated with self-rated health, distress, stress, and depressive symptoms.

Methods: Structured surveys were administered to 32 survivors and caregivers at approximately 3 (enrollment) and 7 months (follow-up) post-stroke. Paired t-tests were used to examine partners’ ratings of survivor function at enrollment and follow-up, and changes in incongruence over time. Partial correlations were used to examine the association between incongruence at enrollment and outcomes at follow-up.

Results: Survivors consistently rated their own memory and thinking as significantly better than caregivers rated their memory and thinking. At follow-up, survivors rated their own communication as significantly better than caregivers rated their communication. Incongruence about survivor memory and thinking was associated with survivor distress, as well as caregiver distress, stress, and depressive symptoms. Incongruence about survivor ADLs was associated with caregiver stress and depressive symptoms. Incongruence about survivor social participation was associated with caregiver distress.

Conclusions: Findings from this study suggest that survivors and caregivers often have incongruent appraisals of survivor function, that incongruence does not improve naturally over time, and that incongruence may be detrimental for survivor and caregiver outcomes. Further research should be directed at the mitigation of incongruence and strategies to improve outcomes for both survivors and family caregivers.

KEYWORDS:

• Survivor
• caregiver
• couples
• function
• mental health
• depression
• outcomes

Acknowledgments

Thank you to Erik Nelson and Kalyn Black for their assistance with this study. We also thank the [blinded] Nurse Navigators for their continued support, as well as the stroke survivors and caregivers who provided data. This work was supported by a grant from the [blinded for review] Interdisciplinary Research Council.

Disclosure of interest

The authors report no conflicts of interest.

Additional information

Funding

This work was supported by a grant from the University of Cincinnati Interdisciplinary Research Council.