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Ohan JL, Jackson HM, Bett R, Farmer GM, Martini A. Experiences and needs of children and adolescents affected by a parent's acquired brain injury: a systematic review and thematic synthesis. Disabil Rehabil 2024; 46:1034-1044. [PMID: 36861777 DOI: 10.1080/09638288.2023.2179673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Revised: 12/21/2022] [Accepted: 02/06/2023] [Indexed: 03/03/2023]
Abstract
PURPOSE To identify the experiences and needs of dependent children who have a parent with an acquired brain injury (ABI) using a systematic review and thematic synthesis. MATERIALS AND METHODS A systematic search of Medline, Embase, PsycINFO, CINAHL Plus, and Web of Science was conducted. The search included variants of: "children," "parents," "acquired brain injury," and "experiences" or "needs." Eligible articles reported on the experiences/needs of dependent children who have a parent with an ABI, from the child's perspective. Thematic analysis was used to identify themes. RESULTS A total of 4895 unique titles were assessed, and 9 studies met inclusion. Four themes were identified: (1) Sustained Emotional Toll (subthemes: (i) Initial Shock and Distress; (ii) Ongoing Loss and Grief; (iii) Present-Day Stress and Emotions), (2) Responsibilities Change and Children Help Out, (3) Using Coping Strategies (subtheme: Talking Can Help), and (4) Wanting Information about the Injury. CONCLUSION Themes highlighted significant disruption and challenges to children's wellbeing across development, with ongoing and considerable impacts many years after the parent's injury. The nature of the experiences shifted with time since the parent's injury. These children need ongoing support starting shortly after their parent's injury that is grounded in their particular experiences.IMPLICATIONS FOR REHABILITATIONWhen a parent has an acquired brain injury (ABI), dependent children and adolescents face emotional upheaval, significant stressors, increased responsibilities, and lack of information about their parent's injury that persist even many years after injury.The nature of these experiences and therefore their needs change based on the acute versus later stages of the parent's injury.Children often do not ask questions or tell others how they feel, which means that they need support that asks about, and listens and responds to their needs.Support for children needs to start soon after the parent's injury, be grounded in the lived experiences of this group, consider their parent's recovery stage, and be embedded as part of service provision rather than rely on children or families to make service contact.
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Affiliation(s)
- Jeneva L Ohan
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Hayley M Jackson
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Robyn Bett
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
| | - Glenda M Farmer
- School of Psychological Science, The University of Western Australia, Crawley, Western Australia
| | - Angelita Martini
- Brightwater Research Centre, Brightwater Care Group, Perth, Western Australia
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Chen CYC. Roles of physical functioning and comorbid mental illness of chronically ill parents and their spouses' health status in adolescent functioning. J Adolesc 2024; 96:381-393. [PMID: 38050767 DOI: 10.1002/jad.12282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 12/06/2023]
Abstract
INTRODUCTION Emerging research suggests that physically ill parents' psychological adjustment to illness and emotional well-being may affect adolescents' psychosocial functioning. As people with chronic medical conditions often develop mental disorders, it is important to examine the influence of comorbidity of parental physical and mental health conditions on adolescents' functioning. In addition, the physical and mental health status of the spouses/partners of chronically ill parents needs to be explored to further understand the potential impact of parental chronic illness on adolescents' psychological distress and academic performance. METHODS Cross-sectional data from 164 parent-adolescent pairs were collected through online surveys in the United States between 2018 and 2019. Parent participants (Mage = 42.69, SD = 5.96) included parents who had been diagnosed with a chronic physical illness (e.g., multiple sclerosis, diabetes, chronic pain, cancer). Adolescent participants were middle- and high-school-aged children who lived with their physically ill parents (Mage = 14.34, SD = 2.07). RESULTS Hierarchical regression analyses indicated that comorbid mental illness of parental chronic illness and spousal mental health status were associated with adolescents' distress. The level of physical functioning of chronically ill parents was related to adolescents' academic performance. CONCLUSION Parental chronic illness appears to affect adolescents' psychological and academic outcomes through distinct pathways. It is important to examine the comorbid mental health status of chronically ill parents and their spouses'/partners' mental health conditions to better understand the impact of parental chronic illness on adolescents' psychological adjustment.
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Affiliation(s)
- Cliff Yung-Chi Chen
- Educational and Community Programs, Queens College of the City University of New York, Flushing, New York, USA
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Dawes K, Carlino A, van den Berg M, Killington M. Life altering effects on children when a family member has an acquired brain injury; a qualitative exploration of child and family perceptions. Disabil Rehabil 2020; 44:282-290. [DOI: 10.1080/09638288.2020.1766582] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Kate Dawes
- South Australian Brain Injury Rehabilitation Service, SA Health, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia
| | - Ashley Carlino
- South Australian Brain Injury Rehabilitation Service, SA Health, Adelaide, Australia
| | - Maayken van den Berg
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia
| | - Maggie Killington
- South Australian Brain Injury Rehabilitation Service, SA Health, Adelaide, Australia
- College of Nursing and Health Sciences, Flinders University of South Australia, Adelaide, Australia
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Hartman L, Jenkinson C, Morley D. Young People's Response to Parental Neurological Disorder: A Structured Review. Adolesc Health Med Ther 2020; 11:39-51. [PMID: 32273785 PMCID: PMC7105371 DOI: 10.2147/ahmt.s237807] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2019] [Accepted: 02/08/2020] [Indexed: 11/23/2022] Open
Abstract
Introduction A significant paucity of literature exists relating to the impact on children of parental neurological disorder, with the exception of multiple sclerosis. The wider literature in this field (parental cancer, depression, alcoholism, HIV/AIDS) exhibits the many potential challenges young people might experience during serious parental illness. Given this, a literature review of parental neurological disorder is long overdue. Methods This review is structured around the World Health Organisation (WHO) classification of neurological disorders. The WHO identifies 10 common neurological disorders; dementia, epilepsy, headache, multiple sclerosis, neuroinfections, neurological disorders associated with malnutrition, pain associated with neurological disorders, Parkinson's disease, stroke, and traumatic brain injury. A comprehensive search of the MEDLINE database was performed using key terms for each of the 10 conditions. Results for each condition were divided in to "negative", "positive and/or neutral" and "other" child responses. Results The search yielded a total of 6247 titles, of which 184 underwent a full-text assessment. Sixty-five met all eligibility criteria and were thus included in the review. A number of negative issues emerged across parental conditions including the prevalence of child mood disorders, parent-child role reversal, children's need for information on the parental condition, the importance of family cohesion, the negative effect of parental psychopathology and differences between male and female children. A limited number of positive outcomes were evident in a minority of parental conditions. Outcomes measured and methodologies employed were highly heterogeneous. Conclusion Children generally respond negatively to parental neurological disorder. Responses varied between neurological disorders, suggesting the need for parental disease-specific guidance and clinical management where required.
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Affiliation(s)
- Lilian Hartman
- Lincoln College, University of Oxford, Oxford OX1 3DR, UK
| | - Crispin Jenkinson
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
| | - David Morley
- Nuffield Department of Population Health, University of Oxford, Oxford OX3 7LF, UK
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Chen CYC, Panebianco A. Physical and psychological conditions of parental chronic illness, parentification and adolescent psychological adjustment. Psychol Health 2019; 35:1075-1094. [DOI: 10.1080/08870446.2019.1699091] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
- Cliff Yung-Chi Chen
- Department of Educational and Community Programs, Queens College of the City University of New York (CUNY), Flushing, NY, USA
| | - Andrea Panebianco
- Department of Educational and Community Programs, Queens College of the City University of New York (CUNY), Flushing, NY, USA
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Coppock C, Ferguson S, Green A, Winter D. 'It's nothing you could ever prepare anyone for': the experiences of young people and their families following parental stroke. Brain Inj 2018; 32:474-486. [PMID: 29345501 DOI: 10.1080/02699052.2018.1426879] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
AIMS This study sought to explore the experiences of young people (aged 8-16) and their families following parental acquired brain injury (ABI), with the aim of developing an understanding of the ways in which members of a family make sense of events post-injury, and to consider the implications of different perspectives on adjustment and coping. DESIGN The study applied a qualitative approach using a thematic analysis methodology. PROCEDURE Individual semi-structured interviews were conducted with 10 individuals from three families affected by parental stroke. RESULTS Findings suggested that post-injury, families experienced a period of uncertainty in which they were required to renegotiate their roles and adjust to the loss associated with parental stroke. Additionally, the psychosocial wellbeing of young people was negatively affected, whilst protective and coping strategies were recognised. CONCLUSIONS The research offers an insight into the processes that may contribute to patterns of interpersonal relating that could negatively impact on adjustment. Provision of adequate information, psychological and practical support during recovery may therefore be crucial elements of supporting young people and their families in adjusting to the challenges posed by stroke.
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Affiliation(s)
- Clare Coppock
- a School of Life and Medical Sciences, University of Hertfordshire , Hatfield , UK
| | - Scott Ferguson
- b Bedfordshire Acquired Brain Injury Service , Dunstable , UK
| | - Anna Green
- b Bedfordshire Acquired Brain Injury Service , Dunstable , UK
| | - David Winter
- a School of Life and Medical Sciences, University of Hertfordshire , Hatfield , UK
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Järkestig Berggren U, Hanson E. Children as Next of Kin: A Scoping Review of Support Interventions for Children Who have a Parent with a Serious Physical Illness. ACTA ACUST UNITED AC 2015. [DOI: 10.1080/13575279.2015.1102125] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Tiar AMV, Dumas JE. Impact of parental acquired brain injury on children: Review of the literature and conceptual model. Brain Inj 2015; 29:1005-17. [DOI: 10.3109/02699052.2014.976272] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Kurz JM. Older Adolescents' Experiences Living with a Parent Who is a Transplant Patient. Prog Transplant 2012; 22:244-51. [DOI: 10.7182/pit2012634] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
This descriptive qualitative study using telephone interviews and surveys explored how parental transplant status affected older adolescents. A sample of 8 adolescents (62% female) between 15 and 20 years old participated. Findings revealed “a normal life.” Other themes were feeling the impact, worrying, coping, and keeping healthy. Parental transplant status had positive and negative effects. No evidence was found of signs or symptoms of depression. Transplant candidates' children worried about “something going wrong”; recipients' children worried about organ rejection. Most stated that parental transplant status did not influence career plans, jobs, or friends. Strategies and recommendations for practice and future research are discussed.
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Sieh DS, Visser-Meily JMA, Oort FJ, Meijer AM. Risk factors for problem behavior in adolescents of parents with a chronic medical condition. Eur Child Adolesc Psychiatry 2012; 21:459-71. [PMID: 22543962 PMCID: PMC3411286 DOI: 10.1007/s00787-012-0279-4] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/02/2012] [Accepted: 04/15/2012] [Indexed: 11/28/2022]
Abstract
A wide array of risk factors for problem behavior in adolescents with chronically ill parents emerges from the literature. This study aims to identify those factors with the highest impact on internalizing problem behavior (anxious, depressed and withdrawn behavior, and somatic complaints) and externalizing problem behavior (aggressive and rule-breaking behavior) as measured by the Youth Self-Report (YSR). The YSR was filled in by 160 adolescents (mean age = 15.1 years) from 100 families (102 chronically ill parents and 83 healthy spouses). Linear mixed model analyses were used, enabling separation of variance attributable to individual factors and variance attributable to family membership (i.e., family cluster effect). Predictors were child, parent, illness-related and family characteristics. The results showed that almost half of the variance in internalizing problem scores was explained by family membership, while externalizing problems were mainly explained by individual factors. Roughly 60 % of the variance in internalizing problems was predicted by illness duration, adolescents' feeling of isolation, daily hassles affecting personal life and alienation from the mother. Approximately a third of the variance in externalizing problems was predicted by adolescents' male gender, daily hassles concerning ill parents and alienation from both parents. In conclusion, the variance in adolescent problem behavior is largely accounted for by family membership, children's daily hassles and parent-child attachment. To prevent marginalization of adolescents with a chronically ill parent, it is important to be alert for signs of problem behavior and foster the peer and family support system.
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Affiliation(s)
- Dominik Sebastian Sieh
- Research Institute of Child Development and Education, University of Amsterdam, Netherlands.
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Morley D, Selai C, Schrag A, Jahanshahi M, Thompson A. Adolescent and adult children of parents with Parkinson's disease: incorporating their needs in clinical guidelines. PARKINSONS DISEASE 2011; 2011:951874. [PMID: 21766002 PMCID: PMC3135087 DOI: 10.4061/2011/951874] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/20/2011] [Accepted: 04/25/2011] [Indexed: 11/20/2022]
Abstract
Purpose. To compare the quality of life (QoL) and emotional well-being of the offspring of parents with Parkinson's disease (PD) and multiple sclerosis (MS) and to consider results in light of current UK clinical guidelines. Methods. 143 adolescent and adult children of parents with PD and MS were postally administered the Parental Illness Impact Scale and a measure of emotional well-being. Results. Minimal differences were observed between the two groups in both QoL and emotional well-being. Levels of mild to moderate depression were substantially greater than those of the general population. Conclusions. The nonsignificant differences reported indicate a similar degree of impact across the two conditions assessed. A significant body of evidence demonstrates the considerable impact of parental MS, with the needs of children being acknowledged in current clinical guidelines. There is a need to similarly acknowledge the potential impact of parental Parkinson's in UK guidelines for PD.
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Affiliation(s)
- David Morley
- Institute of Neurology, University College London, Queen Square, London WC1N 3BG, UK
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Kieffer-Kristensen R, Teasdale TW, Bilenberg N. Post-traumatic stress symptoms and psychological functioning in children of parents with acquired brain injury. Brain Inj 2011; 25:752-60. [DOI: 10.3109/02699052.2011.579933] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Sieh DS, Meijer AM, Oort FJ, Visser-Meily JMA, Van der Leij DAV. Problem behavior in children of chronically ill parents: a meta-analysis. Clin Child Fam Psychol Rev 2011; 13:384-97. [PMID: 20640510 PMCID: PMC2975921 DOI: 10.1007/s10567-010-0074-z] [Citation(s) in RCA: 98] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The aim of this meta-analysis is to examine whether children of chronically ill parents differ from norm groups in problem behavior. We report moderator effects and overall effect sizes for internalizing, externalizing and total problem behavior assessed by children and parents. In fixed effect models, we found a significant overall effect size for internalizing problem behavior (number of studies k = 19, total sample size N = 1,858, Cohen’s d = .23, p < .01) and externalizing problem behavior (k = 13, N = 1,525, d = .09, p < .01) but not for total problem behavior (k = 7; N = 896). Effects for internalizing and externalizing problem behavior were larger in non-cancer studies, in samples including younger children and younger ill parents, in samples defined by low average SES and in studies including parents with longer illness duration. In addition, effects for externalizing problem behavior were larger in studies characterized by a higher percentage of ill mothers and single parents. With exclusive self-report, effect sizes were significant for all problem behaviors. Based on these results, a family-centered approach in health care is recommended.
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Affiliation(s)
- D S Sieh
- Research Institute of Child Development and Education, Faculty of Social and Behavioral Sciences, University of Amsterdam, Nieuwe Prinsengracht 130, Amsterdam, The Netherlands.
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Cozza SJ, Guimond JM, McKibben JBA, Chun RS, Arata-Maiers TL, Schneider B, Maiers A, Fullerton CS, Ursano RJ. Combat-injured service members and their families: the relationship of child distress and spouse-perceived family distress and disruption. J Trauma Stress 2010; 23:112-5. [PMID: 20146393 DOI: 10.1002/jts.20488] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Combat injury in military service members affects both child and family functioning. This preliminary study examined the relationship of child distress postinjury to preinjury deployment-related family distress, injury severity, and family disruption postinjury. Child distress postinjury was assessed by reports from 41 spouses of combat-injured service members who had been hospitalized at two military tertiary care treatment centers. Families with high preinjury deployment-related family distress and high family disruption postinjury were more likely to report high child distress postinjury. Spouse-reported injury severity was unrelated to child distress. Findings suggest that early identification and intervention with combat-injured families experiencing distress and disruption may be warranted to support family and child health, regardless of injury severity.
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Affiliation(s)
- Stephen J Cozza
- Center for the Study of Traumatic Stress, Uniformed Services University, Bethesda, MD 20817, USA.
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Huizinga GA, Visser A, van der Graaf WTA, Hoekstra HJ, Gazendam-Donofrio SM, Hoekstra-Weebers JEHM. Stress response symptoms in adolescents during the first year after a parent’s cancer diagnosis. Support Care Cancer 2009; 18:1421-8. [DOI: 10.1007/s00520-009-0764-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2009] [Accepted: 10/12/2009] [Indexed: 10/20/2022]
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Oppenheim-Gluckman H, Chambry J, Loisel Y, Jousselme C, Weïss J, Falissard B. How physicians caring for adult patients presenting a chronic mental disturbance take account of the difficulties their patients’ children under 18: Preliminary study. Ann Phys Rehabil Med 2009; 52:623-37. [DOI: 10.1016/j.rehab.2009.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2009] [Accepted: 07/10/2009] [Indexed: 10/20/2022]
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Visser-Meily A, Post M, Schepers V, Lindeman E. Spouses’ Quality of Life 1 Year after Stroke: Prediction at the Start of Clinical Rehabilitation. Cerebrovasc Dis 2005; 20:443-8. [PMID: 16230849 DOI: 10.1159/000088983] [Citation(s) in RCA: 111] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2005] [Accepted: 07/02/2005] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND AND PURPOSE The purpose of this prospective study was to identify early predictors of spouses' quality of life at 1 year after stroke. METHODS At the start of clinical rehabilitation patient and caregiver characteristics, psychological factors, harmony in the relationship and social support were assessed. One year after stroke, caregiver burden (Caregiver Strain Index), life satisfaction (Life Satisfaction Checklist) and depressive symptoms (Goldberg Depression Scale) were assessed in 187 participants. Multiple regression analyses were performed. RESULTS About 80% of the spouses reported low quality of life on one or more of the measures; 52% reported depressive symptoms, 54% significant strain and only 50% was satisfied with life as a whole. The regression analysis identified 'passive coping strategy of the caregiver' as the most important predictor. ADL dependency was the only baseline patient characteristic significantly related to burden and life satisfaction, but explained just 0-4% of the variance. CONCLUSIONS A large proportion of caregivers perceive impaired quality of life 1 year after stroke. Caregivers at risk should be identified at the start of rehabilitation by means of coping measurement instruments or selected anamneses on coping.
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Affiliation(s)
- Anne Visser-Meily
- Rehabilitation Center De Hoogstraat and Rudolf Magnus Institute of Neuroscience, Department of Rehabilitation, University Medical Center, Utrecht, The Netherlands.
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Abstract
Background and Purpose—
The purpose of this research was to describe the clinical course of children’s functioning (depression, behavioral problems, and health status) during the first year after parental stroke and to determine which patient-, spouse-, or child-related factors at the start of inpatient rehabilitation can predict children’s functioning after parental stroke at 1-year poststroke.
Methods—
Interviews with 82 children (4 to 18 years of age) and their parents (n=55) shortly after admission to a rehabilitation center, 2 months after discharge from inpatient rehabilitation, and 1 year after stroke. Depression was assessed using the Children Depression Inventory, behavioral problems with the Child Behavior Check List, and health status with the Functional Status II. Potential predictors were gender and age (child), activities of daily living disability and communication ability (patient), and spouse’s depression and perception of the marital relationship.
Results—
At the start of the stroke patient’s rehabilitation, 54% of the children had ≥1 subclinical or clinical problems, which improved to 29% 1 year after stroke. Children’s functioning 1 year after stroke could best be predicted by their functioning at the start of rehabilitation. Spouse depression and perception of marital relationship were also significant predictors. A total of 28% to 58% of the variance in children’s functioning could be explained.
Conclusions—
Children’s functioning after parental stroke improved during the first year after stroke. Identifying children at risk for problems 1 year after stroke requires assessment of children’s functioning and the healthy spouse’s depressive symptoms and perception of the marital relationship at the start of rehabilitation. This demonstrates the need for a family-centered approach in stroke rehabilitation.
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Affiliation(s)
- Anne Visser-Meily
- Rehabilitation Center De Hoogstraat, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands.
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