First Advisor

Nancy J. Chapman

Date of Publication


Document Type


Degree Name

Doctor of Philosophy (Ph.D.) in Urban Studies


Urban Studies and Planning




Cerebrovascular disease -- Patients -- Home care -- Longitudinal studies, Cerebrovascular disease -- Patients -- Family relationships -- Longitudinal studies, Long-term care of the sick -- Psychological aspects -- Longitudinal studies



Physical Description

4, viii, 210 leaves 28 cm.


This study is a Time 4 (T4) follow-up interview of ninety-three caregivers of persons who experienced a first stroke between 2 to 4 years (mean = 36 months) prior to the T4 interview. The first wave of data collection occurred within two months after the stroke. The second and third waves occurred six and twelve months, respectively, after the first interview. The caregivers were identified by the person with stroke as being the person closest to him/her who would be responsible for care after the stroke.

Data were gathered at all four interviews using reliable and valid measures for depressive symptomatology (CES-D; Radloff, 1977), psychological well-being (IPWB; Berkman, 1971), and caregiver burden (Zarit, 1980). The contribution of social support to caregiver well-being was also investigated. Additional areas of investigation at T4 included coping strategies (F-Copes; McCubbin, Larsen, and Olson, 1981), caregiver adjustment, and the respondents' perception of themselves as "caregivers".

The mean scores of depressive symptomatology, perceived burden, negative well-being, and positive well-being did not change significantly over the four points in time. However, the percentage of the sample having CES-D levels of 16 and above (indicating potential diagnosis of clinical depression) decreased by ten percent between T1 and T4. About ten percent of the respondents who were at risk for clinical depression at T4 reported high levels of depressive symptoms at all four interviews.

Respondents who specifically thought of themselves as "caregivers" (sixty-two percent) were significantly more likely to report high levels of depressive symptoms, to experience high levels of strain and caregiver burden, and to be caring for persons who were more severely impaired by the stroke than those who did not.

Caregiver characteristics contributed more to the variance in depressive symptoms and psychological well-being than did characteristics of the stroke. However, depressive symptomatology and perceived burden were significantly associated with both the functional capacity of the person with stroke and with an index of stroke severity comprised of communication impairments and negative personality/behavior changes since the stroke.

The findings from this study have implications for stroke management programs, caregiver intervention planning, and health care policy.


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