Caregivers’ Incongruence: Emotional Strain in Caring for Persons with Stroke


  • Linda L. Pierce PhD RN CNS CRRN FAHA FAAN,

  • Teresa L. Thompson PhD RN CRRN,

  • Amy L. Govoni MSN RN BC RMT,

  • Victoria Steiner PhD



Guided by Friedemann's framework, the purpose of this study was to examine the dimensions of new family caregivers’ emotional strain in caring for persons with stroke.


Seventy-three caregivers who were new to that role participated in an interview every 2 weeks for a year as part of a NIH project. Of these caregivers, 36 participants were randomly assigned and had access to a Web-based intervention and its e-mail discussion. In this secondary data analysis, 2,148 e-mail discussion messages plus 2,455 narrative interview entries were used to examine dimensions of caregivers’ emotional strain. Rigorous content analysis was applied to these data.


The majority of these caregivers were white women with an average of 55 years who cared for spouses. Three themes emerged from these data: (1) being worried, (2) running on empty, and (3) losing self.


Caregivers worried about themselves and their care recipient, sharing feelings of being just “plain tired.” The caregivers felt that their lives were lost to giving care. They described in detail the emotional strain that they felt, as they took on new roles in caring for the person with stroke.


This study informs nurses about new family caregivers’ emotional strain, or incongruence in Friedemann's terms, from their viewpoint and provides direction for supportive education interactions.