Open AccessA Problem‐Solving Early Intervention for Stroke Caregivers: One Year Follow‐Up
Author(s) -
King Rosemarie B.,
Hartke Robert J.,
Houle Timothy,
Lee Jungwha,
Herring Gioia,
AlexanderPeterson Bonita S.,
Raad Jason
Publication year - 2012
Publication title -
rehabilitation nursing
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.355
H-Index - 36
eISSN - 2048-7940
pISSN - 0278-4807
DOI - 10.1002/rnj.039
Subject(s) - repeated measures design , psychosocial , psychological intervention , mixed design analysis of variance , anxiety , coping (psychology) , multiple baseline design , rehabilitation , depression (economics) , medicine , psychology , clinical psychology , physical therapy , analysis of variance , intervention (counseling) , psychiatry , statistics , mathematics , economics , macroeconomics
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 < .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 < .05). Conclusions Findings provide direction for future interventions to promote and sustain healthy caregiver adaptation.