Strengths and weaknesses of the spousal relationship following a stroke

Abstract

The purpose of this study was to investigate the strengths/weaknesses of the stroke spouse/stroke caregiver relationship in relation to the cerebral hemisphere affected by the stroke, the gender of the stroke spouse, the functional capacity of the stroke spouse, the length of time since the stroke, and the socioeconomic status of the couple.

Forty stroke spouses, who had received medical rehabilitation at four medical facilities (Woodrow Wilson Rehabilitation Center, Waynesboro Community Hospital, Chambersburg Hospital, and Blue Ridge Rehabilitation Hospital), and stroke caregivers were interviewed regarding their pre- and post-stroke marital relationship. This study specifically investigated the the spouse caregivers' perceptions of the impact stroke had upon the marriage. Scales assessing the variables of marital health/dysfunction and functional independence of stroke spouse were selected. These included: the Family Assessment Measure (FAM) - dyadic relationship version and the Barthel Index.

All scores on FAM were within the normal range of strength/weakness. Results indicated that a significant proportion of the variance in task accomplishment, role performance, communication, control, and total relationship health were associated with the gender of the stroke spouse and the level of functional independence. Spouse caregivers perceived more post— stroke than pre-stroke difficulties in these relationship areas, when the stroke spouse was male and functional disability was high. High functional disability was associated with increased difficulties in values and norms post-stroke and low SES was related to increased problems in affective expression. The cerebral location of the stroke and the length of time since the stroke were not associated with significant changes in caregivers’ perceptions of pre- and post-stroke marital health/dysfunction. Couples with male stroke spouses and/or stroke spouses with significant physical disability are at risk for marital dysfunction. Marital counseling services during medical rehabilitation may be useful to these couples.