An investigation into whether carers' expectations influence their psychological wellbeing following their spouses' stroke.
Doctoral thesis, UCL (University College London).
This study concerns carers and their expectations of their spouses' functional recovery and the burden of caring post stroke. Many studies have demonstrated that carers experience high levels of burden and psychological distress 12 months past stroke. However, to date carers' expectations and the potential drivers of these expectations have not been explored. Furthermore, the evidence indicates that the focus of the support provided by professionals has been on the person that has had the stroke rather than on the carer. Previous research has also not explored reasons for variation in depressed mood, although the fact that not all carers become depressed or overburdened would suggest that some carers are less susceptible to depressed mood than others. There are two main themes in this research: to establish the potential predictors of carers' expectations; and to examine whether carer expectations of their spouses' functional recovery and carer burden acted as potential drivers for level of carer's depressed mood 12 months post stroke. Analysis of the study's findings demonstrated that carers' expectations of their spouses' recovery were mainly driven by the current functional ability and quality of life of their spouses. Carer expectations of burden were also partly influenced by their spouses' current abilities but carers' dispositional optimism and depressed mood played an additional role here. The results of this study also indicated that carer's psychological wellbeing at 12 months post stroke was not in fact influenced by their expectations of their spouses recovery but rather by their expectations of burden in terms of their level of depression, anxiety and negativity. Moreover, multivariate analysis indicated that unmet expectations of burden also contributed towards carer's depressed mood and negative affect at 12 months post stroke. Interestingly, over time carers' mood was shown to improve where mean levels of depressed and anxious mood dropped. Despite these positive changes in carer's mood some carers' became less optimistic over time and support the finding of other studies that this construct is perhaps not as stable as previously thought. Further examination of carers' psychological wellbeing at 12 months post stroke demonstrated that their level of depressed mood, negative affectivity and anxiety were to some extent predicted by gender, dispositional optimism, expectation of burden and current mood status measured in the acute phase of stroke. To conclude some carers in this study were shown to have raised revels of depressed mood and anxiety levels. The findings suggest that carers' depressed and anxious mood at 12 months post stroke is predominantly influenced by baseline (i.e. acute phase of stoke) mood and dispositional optimism and also to some extent predicted by their baseline expectation of burden. There results suggest that carers who are depressed in the acute phase and who have high expectations of burden are at a higher risk of being depressed at 12 months post stroke. It could therefore be argued that it is particularly this group of carers who could benefit from early psychological intervention.
|Title:||An investigation into whether carers' expectations influence their psychological wellbeing following their spouses' stroke|
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