Social isolation poststroke: relationship between race/ethnicity, depression, and functional independence.

Research suggests that individuals recovering from a stroke often experience social isolation, which is linked to increased depressive symptomatology and decreased ability to manage activities of daily living. Research also indicates that different racial and ethnic groups are more adversely affected than whites. This article uses poststroke narratives to explore the relationship between social isolation, depressive symptomatology, and the ability to manage activities of daily living poststroke for white, African American, and Puerto Rican veterans.

Caregiver mental health and racial/ethnic disparities in stroke: implications for culturally sensitive interventions.

Purpose/objective: The purpose of this study was to create a set of culturally sensitive mental-health-intervention recommendations for the caregivers of Latino/Puerto-Rican, Black, and White individuals with stroke. The study examined whether the mental health of stroke caregivers and functioning of individuals with stroke differed according to race/ethnicity, changed differentially over time according to race/ethnicity, and showed relationships between the two sets of constructs that differed according to race/ethnicity.

Research Method/design: Data on caregiver mental health and functioning of individuals with stroke were collected from 124 (n = 248) White, Black, and Latino/Puerto-Rican dyads at 1, 6, and 12 months post-hospital discharge.

A culturally sensitive Transition Assistance Program for stroke caregivers: examining caregiver mental health and stroke rehabilitation.

This study developed and implemented the Transition Assistance Program (TAP) for stroke caregivers. The program is composed of (1) skill development, (2) education, and (3) supportive problem solving. Sixty-one dyads (n = 122) participated: thirty-nine from Puerto Rico and twenty-two from Texas.

The VA nursing academy embedded clinical education model.

The Veterans Health System (VHS) implemented a new program, the Veterans Affairs Nursing Academy, to promote partnerships between the VHS and schools of nursing to supplement faculty resources to educate more nurses and to increase recruitment of nurses in the VHS. The partnership at the University of Florida College of Nursing and the Malcolm Randall Veterans Affairs Medical Center, Gainesville, Florida, has been successful in increasing student enrollment, improving nursing care of veterans, and increasing recruitment of new graduate nurses. The partnership implemented a new model of clinical education called the embedded faculty model.

Association between health education needs and stroke caregiver injury.

Objective: Many stroke caregivers are inadequately informed about stroke and its sequelae and have little preparation for the physical demands of moving, lifting, and handling often required. Our objectives are to examine the association between health education needs and physical injury sustained as a result of activities related to the caregiving role.

Method: A total of 276 caregivers of veterans who suffered an acute stroke event were surveyed about their information needs and injury status.

The prevalence of injury for stroke caregivers and associated risk factors.

Background: A vast body of research has shown that the emotional and physical demands of caregiving may lead to increased stress and burden. However, it is unknown whether these factors are associated with increased risk for injuries among caregivers.

Purpose: Stroke survivors and their caregivers (N = 275) were surveyed using existing measures to explore the prevalence of physical injuries among caregivers and the types of injuries and factors associated with caregiver injury.

Patterns of informal care among Puerto Rican, African American, and white stroke survivors.

Background: There has been an increase in the number of non-institutionalized stroke survivors over the past few decades leading to larger numbers of family caregivers. Less is known about the patterns of informal caregiving within racially and ethnically diverse families even though there is greater post-stroke morbidity and mortality for these groups.

Research Aims: The purpose of our research is to examine the informal caregiving networks of white, African American, and Puerto Rican caregivers.

Informal caregivers and racial/ethnic variation in health service use of stroke survivors.

We investigated the racial and ethnic variation in health service use among stroke survivors with informal caregivers in a number of Department of Veterans Affairs Medical Centers in one Veterans Integrated Service Network in the southeastern United States. We focused on the role of caregivers as an enabling factor in the use of health services. One hundred twenty-five veterans who had been hospitalized after an acute stroke, been released home, and identified an informal caregiver were enrolled in the study.

Racial/ethnic variation in recovery of motor function in stroke survivors: role of informal caregivers.

Research documents that African American and Latinos who have experienced an acute stroke recover more slowly than Caucasians in the United States. This descriptive study examines (1) the variation in Caucasian, Puerto Rican, and African American motor function after stroke; (2) the association between caregiver attributes and motor recovery after stroke; and (3) the degree to which caregiver attributes explain the variation in motor recovery between different racial/ethnic groups. One hundred and thirty-five veterans who had been hospitalized after an acute stroke, released home, and identified an informal caregiver were enrolled in the study.

Consequences of poststroke falls: activity limitation, increased dependence, and the development of fear of falling.

Objectives: We used qualitative data to explore the perceived consequences of poststroke falls during the first 6 months after discharge from the hospital.

Method: We interviewed 132 male stroke survivors 1 and 6 months after discharge to describe stroke recovery trajectories. Interviews of participants who discussed falling after stroke as one of their major concerns were analyzed to explore the consequences of poststroke falls.

Identifying at-risk, ethnically diverse stroke caregivers for counseling: a longitudinal study of mental health.

Purpose: This study examined (1) causality in the relationship between stroke caregiver mental health and care-recipient functioning, and (2) the prediction from stroke caregiver and care-recipient variables 5 months and 11 months later.

Research Method: Questionnaire, interview, and observational data were collected from 124 ethnically diverse stroke caregiver/care-recipient dyads in the homes of care recipients at 1, 6, and 12 months after discharge.

Results: The magnitudes of the causal pathways between stroke caregiver mental health and care-recipient functioning were not significantly different.

Subjective sleep, burden, depression, and general health among caregivers of veterans poststroke.

The purposes of this article are to explore and describe subjective sleep experiences of informal caregivers of stroke survivors and to explore the relationships between subjective sleep experiences, caregiver burden, depression, and health to provide a broader portrait of the role that sleep plays in the stroke caregiving experience. A total of 276 caregivers and veterans participated in the study. Results indicate a greater risk of depression (Center for Epidemiologic Studies-Depression Scale) among caregivers who sleep less, have difficulty achieving daytime enthusiasm, use sleep medications, and have poor sleep quality.

Communicating information to families of polytrauma patients: a narrative literature review.

Family caregivers of U.S. servicemembers with polytraumatic injuries (injuries to multiple body systems) need support and information to care for their family members.

Influence of sense of coherence on caregiver burden and depressive symptoms at 12 months poststroke.

Purpose: The purpose of this study was to examine the relationship of sense of coherence for informal stroke caregivers with sociodemographic variables and caregiving outcomes of depressive symptoms and burden.

Method: Using path analysis, data 1 month after the stroke (stroke survivor and caregiver characteristics) from 87 dyads (stroke survivors and their caregivers) were used to predict caregiver outcomes of burden and depressive symptoms at 12 months poststroke.

Results: Sense of coherence, although not predicted by sociodemographic variables, had a significant inverse relationship with caregiver burden and depressive symptoms, indicating that caregivers with a higher sense of coherence at 1 month experience less burden and depressive symptoms at 12 months.

The continuum of connectedness and social isolation during post stroke recovery.

During stroke recovery, individuals experience changes related to connectedness with others or becoming isolated from others. These experiences are an important part of the psychosocial dimensions of their health. A continuum of the major characteristics of connectedness and social isolation with others was developed from the data.

Stroke caregiver information needs: comparison of Mainland and Puerto Rican caregivers.

Research indicates that informal caregivers of stroke survivors often do not have the information necessary to adequately manage the recovery process at home. This article presents findings on the information sources and needs of stroke caregivers both in Puerto Rico and the Mainland United States. Data were collected from 120 caregivers (42 Puerto Rican, 78 Mainland) of veterans who had experienced a stroke.

Fear of falling: an emerging issue after stroke.

Purpose: Qualitative data regarding stroke survivors' recovery experiences were used to describe factors important in the development of fear of falling (FoF) during the first 6 months after stroke.

Method: Stroke survivors were interviewed 1 and 6 months after stroke to obtain data on their experiences related to stroke recovery trajectory. Analyses identified FoF as a naturally occurring part of stroke survivors' descriptions of their everyday lives.

Associations in sense of coherence and depression in caregivers of stroke survivors across 2 years.

The objective of this longitudinal study was to detect the relationship between the sense of coherence (SOC), which is an adaptive coping response, and depression in informal caregivers of stroke survivors across 2 years. One-hundred-fifteen veterans, who were hospitalized after experiencing an acute stroke, and their informal caregivers were enrolled prior to discharge. Data were collected via face-to-face in-home interviews at 1, 6, 12, 18, and 24 months after discharge.

Metaphor shifts in stroke recovery.

An illness event like stroke is generally believed to produce a biographical disruption in the individual, resulting in a reconstruction of one's self identity. One method of narrative reconstruction is the use of personal metaphor. Although previous research has illustrated a variety of illness metaphors, including that of war, there has been little research conducted on how these metaphors shift throughout a person's recovery period.

Transition experiences of stroke survivors following discharge home.

Background: Little is known about the transition experiences of stroke survivors after discharge home.

Purpose: The purpose of this article is to describe three domains of psychosocial experiences of stroke survivors during the first month following discharge for acute stroke.

Method: Data were collected from 125 stroke survivors interviewed at 1 month following discharge home.

Locomotor training: experiencing the changing body.

This study examined the experiences of persons with incomplete spinal cord injury who participated in loco-motor training (LT). LT is an emerging rehabilitation intervention for enhancing the recovery of walking in persons with central nervous system disorders. Multiple interviews and field observations provided data from eight participants, including four veterans.

Quality-of-life predictors for caregivers at 1 and 6 months poststroke: Results of path analyses.

In this study, weused path analyses to test a theoretical model of influences on quality of life (QOL) for stroke caregivers at 1 and 6 months poststroke. We examined data from two points in time to determine the influence of stroke survivor and caregiver characteristics on QOL for stroke caregivers. Stroke survivor and caregiver characteristics had some direct influence on QOL outcomes for stroke caregivers at both 1 and 6 months poststroke.

Recovery of cohesion in narrative discourse after left-hemisphere stroke.

Little is known about the recovery of narrative discourse after stroke. While several studies have analyzed the recovery of language in individuals with aphasia, few known studies exist on the recovery of narrative discourse in stroke survivors, particularly those who have not been diagnosed with aphasia. In this study, we evaluated the cohesiveness of narrative discourse in a cohort of individuals who had suffered a left-hemisphere stroke and had not been diagnosed with expressive language impairment.

Coping by stroke caregivers: sex similarities and differences.

Informal care provision presents many challenges. As the population ages, more people are forced to enter the role of informal caretaker. Despite the increase in the need for caregivers and the importance of providing care, there is little empirical research examining how men and women approach and cope with providing care.

Qualitative and quantitative measurement of depression in veterans recovering from stroke.

This analysis triangulates qualitative and quantitative data from interviews, Geriatric Depression Scale scores, and patient records to evaluate poststroke depression. Participants were veterans who were discharged home following a new stroke. Findings indicated underrecognition and treatment of depression.