A Problem-Solving Early Intervention for Stroke Caregivers: One Year Follow-Up
Article first published online: 29 JUN 2012
© 2012 Association of Rehabilitation Nurses
Special Issue: Stroke Focused Issue
Volume 37, Issue 5, pages 231–243, September/October 2012
How to Cite
King, R. B., Hartke, R. J., Houle, T., Lee, J., Herring, G., Alexander-Peterson, B. S. and Raad, J. (2012), A Problem-Solving Early Intervention for Stroke Caregivers: One Year Follow-Up. Rehabilitation Nursing, 37: 231–243. doi: 10.1002/rnj.039
- Issue published online: 4 SEP 2012
- Article first published online: 29 JUN 2012
- National Institute of Nursing Research. Grant Number: R01NR009077
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.
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).
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).
Findings provide direction for future interventions to promote and sustain healthy caregiver adaptation.