Transition to home care after stroke: Depression, physical health, and adaptive processes in support persons

Authors

  • Rosemarie B. King,

    Corresponding author
    1. Department of Physical Medicine and Rehabilitation, Northwestern University Medical School, Chicago, IL
    2. Rehabilitation Institute of Chicago, Chicago, IL
    • Rehabilitation Institute of Chicago, 345 E. Superior Street, Room 1436, Chicago, IL 60611.
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  • Carolyn E. Carlson,

    1. Department of Nursing, Cedarville College, Cedarville, OH
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  • Yvonne Shade-Zeldow,

    1. Department of Behavioral Medicine, Chicago Institute of Neurosurgery and Neuroresearch, Chicago, IL
    2. Department of Psychiatry and Behavioral Sciences, Northwestern University Medical School, Chicago, IL
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  • Kimberly K. Bares,

    1. Mental and Behavioral Health Services, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN
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  • Elliot J. Roth,

    1. Department of Physical Medicine and Rehabilitation, Northwestern University Medical School, Chicago, IL
    2. Rehabilitation Institute of Chicago, Chicago, IL
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  • Allen W. Heinemann

    1. Department of Physical Medicine and Rehabilitation, Northwestern University Medical School, Chicago, IL
    2. Rehabilitation Institute of Chicago, Chicago, IL
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Abstract

A longitudinal design was used to examine adaptation in primary support persons (PSP) of stroke survivors during the transition from hospitalization (T1) to home care (T2). The major purposes of the study were (a) to examine changes in depression, physical health, and contextual and coping factors from hospitalization of the stroke survivor through the first 6–10 weeks of home care; and (b) to identify predictors of depression. Data (N = 136) were collected on depression, physical health, background, survivor illness, and social environmental variables; appraisal of impact; social support resources; and coping skills. Reduction in mean PSP depression was significant at T2, but the change in physical health was not significant. Significant changes occurred in survivor function, family functioning, and three of six coping skills. Hierarchical multiple regression analyses were used to predict depression. T1 variables accounted for 29% of the variance in T1 PSP depression, with gender and appraisal of impact the strongest of seven predictors. T1 depression, T2 health, family functioning, and avoidance coping were the strongest of seven predictors, explaining 50% of the variance in T2 depression. Findings highlight the importance of maintaining caregiver health and preventing depression and identify variables to target for the reduction of PSP depression. © 2001 John Wiley & Sons, Inc. Res Nurs Health 24:307–323, 2001

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