The impact of stroke on the well-being of the patient's spouse: an exploratory study

Aims. The aim of this study was to investigate the impact of stroke on the patient's spouse, paying particular attention to psychiatric morbidity and the strain of caring, and correlating these with the degree of disability of the patient. The impact of impairment of speech was also investigated. Background. The impact of a stroke is not limited to the person who suffers it but also to the family, with the patient's spouse being particularly vulnerable. The literature suggests that the consequences for the spouse can be physical, psychological, economic and social. Methods. A quantitative approach was employed to investigate 44 couples who volunteered to participate in the study. A small battery of validated instruments was used to describe the patient's degree of disability, and psychiatric morbidity and the strain of caregiving in the spouse. Pearson's Correlation and Mann-Whitney U-test were used in data analysis. Results. The spouses were found to have a greater degree of psychiatric morbidity than a reference group and a large proportion of them found caregiving to be stressful. Psychiatric morbidity and strain in the spouses were not directly proportional to the extent of the patient's disability. Spouses whose partners' speech was affected by the stroke were more likely to experience strain than those who were unaffected in this way. Conclusions. This study contributes to our knowledge of the relationship between patients' physical disability and the level of strain and psychiatric morbidity in spouses. The relationship is a complex one, in which it is not possible to predict with confidence which spouses will be most vulnerable. Relevance to clinical practice. Caring for a patient following a stroke is very stressful, particularly in cases where the patient's speech is affected and there is also likely to be a significant effect on the psychological well-being of the spouse. This information is relevant to all nurses caring for patients with stroke and the patients' spouses.