Date Presented 4/21/2018
By better understanding the factors that affect relationship satisfaction, occupational therapy practitioners can identify areas of need for targeted interventions for stroke survivors and their care partners to improve overall satisfaction and quality of life.
Primary Author and Speaker: Meghan Berry
Additional Authors and Speakers: Whitney Hutchings, Kaitlyn Krogen, Allison Ritchie, Rachel Swan, Eliza Young, Alexandra Terrill
PURPOSE: The purpose of this study was to assess the need for support in couples coping with stroke and examine how positive and negative factors affect their relationship satisfaction. Occupational therapy practitioners address the person and context, including the social context, in treatment. Targeting relationship satisfaction and the factors that affect it after a partner experiences stroke is important in implementing a balanced intervention with this population. As role conflict arises and adjustments are made, practitioners can promote positive role balance by approaching every role and partner with an attitude of attentiveness and care. This study yields insight into how practitioners can provide more encompassing care to both the person with stroke and the care partner. Understanding and addressing relationship satisfaction in care can promote overall quality of life and life satisfaction in this population.
METHOD: For this cross-sectional, descriptive survey study, participants were recruited through university-affiliated outpatient rehabilitation clinics and an online participant database. Participants were categorized as either stroke survivor or caregiver and were in a relationship currently or before the stroke. Of the 32 participants, 68% were stroke survivors, and 71% of caregivers were female. The mean age of participants was 53.66 (range = 30–75). Time since stroke ranged from 3 mo to >25 yr.
Surveys were completed in person at university-affiliated community-based clinics, at events, or at home via a secure online survey link. Data were collected using a 5-point Likert scale survey of current relationship status and relationship satisfaction; items were change statements. Examples of positive change statements are “My partner and I have grown closer since the stroke” and “My partner and I have supported each other in changing our health habits since the stroke (exercise, eating healthier, quit smoking).” Examples of negative change statements included “My partner and I have grown further apart since the stroke,” “My partner and I don’t take as much time to enjoy each other’s company since the stroke,” and “My partner and I have difficulties with intimacy since the stroke.”
RESULTS: Of the positive and negative relationship factors assessed, growing further apart (r = –.55), not taking as much time for each other (r = .57), and growing closer (r = .59) were significantly correlated (p < .005) with current relationship satisfaction. These same factors were significantly associated with relationship satisfaction since the stroke. In addition, examining women’s and men’s responses separately, women indicated that growing further apart (r = –.73), supporting each other in changing health habits (r = .56), not taking as much time to enjoy each other’s company (r = –.76), difficulties with intimacy (r = –.54), and growing closer to their partner (r = .80) were associated with current relationship satisfaction; no factors were significantly associated with current relationship satisfaction for men.
CONCLUSION: Several areas of a person’s life can be affected after having a stroke, including social contexts. Participants who felt they had grown closer to their partner after the stroke reported higher satisfaction overall. Making positive health changes together was a key indicator of increased relationship satisfaction. These key indicators should be examined further in future research. Furthermore, women reported being affected differently than men by factors in relationship satisfaction.
IMPACT STATEMENT: This study contributes to occupational therapy by providing insight into the effect of stroke on couples and their relationship satisfaction. By better understanding the role adjustments made by couples after stroke, occupational therapy practitioners can identify areas of need for targeted interventions to address the social relationship between stroke survivors and their care partners to improve overall satisfaction and quality of life.
References
Adriaansen, J. J., Leeuwen, C. M., Visser-Meily, J. M., Bos, G. A., & Post, M. W. (2011). Course of social support and relationships between social support and life satisfaction in spouses of patients with stroke in the chronic phase. Patient Education and Counseling, 85(2), e48–e52. https://doi.org/10.1016/j.pec.2010.12.011
McCarthy, M. J., & Bauer, E. (2015). In sickness and in health: Couples coping with stroke across the life span. Health and Social Work, 40(3), e92–e100. https://doi.org/10.1093/hsw/hlv043
Visser-Meily, A., Post, M., Port, I. V., Heugten, C. V., & Bos, T. V. (2008). Psychosocial functioning of spouses in the chronic phase after stroke: Improvement or deterioration between 1 and 3 years after stroke? Patient Education and Counseling, 73, 153–158. https://doi.org/10.1016/j.pec.2008.03.011
