Adaptation process, participation and depression over six months in first-stroke individuals and spouses.

OBJECTIVE

To describe changes in the adaptation process (appraisal and coping) in the six months after a first stroke and identify domains of the adaptation process related to participation and depressive symptoms for both affected individuals and spouses.

DESIGN

A short-longitudinal study where data of the two groups were collected at three times: in the first two weeks post stroke (T1), at three months (T2) and six months (T3) post stroke.

SUBJECTS

Individuals with a first stroke and spouses.

MAIN MEASURES

The Stress Appraisal Measure (SAM) for appraisal, Revised Ways of Coping Questionnaire (RWCQ) for coping strategies, Assessment of Life Habits (LIFE-H) for participation, and Beck Depression Inventory (BDI) for depressive symptoms.

RESULTS

Mean (SD) ages of the stroke group (n = 88) and spouse group (n = 47) were 71.8 (10.8) and 69.2 (11.2) years respectively. The Threat, Challenge and Stressfulness scales of the SAM decreased significantly (P < 0.02) from T1 to T3 in both groups whereas perceived uncontrollability of the situation increased significantly (P = 0.003) for spouses in the first six months. RWCQ Rationalisation and Giving control to others scales decreased in the stroke group (P = 0.008 and 0.002 respectively) but not in the spouse group (P = 0.07 and 0.39 respectively). Several components of adaptation at T1 could explain between 18% and 27% of the variance observed in the LIFE-H and BDI at T3.

CONCLUSION

Appraisal and coping strategies change over time. Initial adaptation could partially predict participation level and depressive symptoms six months post stroke for affected individuals as well as spouses.