A Problem-Solving Early Intervention for Stroke Caregivers: One Year Follow-Up

作者:King Rosemarie B*; Hartke Robert J; Houle Timothy; Lee Jungwha; Herring Gioia; Alexander Peterson Bonita S; Raad Jason
来源:Rehabilitation Nursing, 2012, 37(5): 231-243.
DOI:10.1002/rnj.039

摘要

Purpose 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. Methods 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). Results 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 %26lt; .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 %26lt; .05). Conclusions Findings provide direction for future interventions to promote and sustain healthy caregiver adaptation.