A caregiver perspective: adaptation after stroke

Three studies were designed to explore the question, "What physical, social and psychological factors contribute to adaptation in the caregiver's life following the stroke of a spouse?" Studies focused on the psychosocial, sociocultural and environmental dimensions of adaptation among the spousal caregivers of stroke survivors.

The first study in this dissertation was a critical literature review of information in the form of articles and editorials related to occupational therapy. Concepts that have evolved within occupational therapy related to informal caregiving were discussed and a comparison was made with literature available in the other fields like nursing and the social sciences. Both qualitative and quantitative studies were considered from peer reviewed journals. Articles from MEDLINE and Cumulative Index to Nursing and Allied Health Literature were selected for review for the period of 1982-2005. Keywords used were: informal caregiving, occupational therapy, environment, occupation, motivation, meaning, and spouse.

In the second study, "A Caregiver Journey: The Process of Recovery after Stroke", the participants were interviewed at five time points over a year in which the caregiving experience of spousal caregivers of stroke survivors was described. Eight participants (pseudonyms used) were selected to illustrate the adaptation process over time. For the purpose of this mixed design study interview data from caregivers were analyzed, along with scores from the Caregiver Preparedness Scale.

The third study was a qualitative design and included the same caregivers from Study 2. The third study, "Occupations Lost and Gained: A Caregiver Perspective", demonstrated the changes in the occupational lives of the caregivers. A core tenet of occupational therapy is the belief that health is reflected and maintained through participation in occupations: work, play or leisure and self care. The research from these three studies attempted to be thorough by identifying the process involved in adaptation and caregiving and by filling the gaps that currently exist in the profession on this topic. The holistic view of adaptation was a significant component of this dissertation with a focus on the dyad as a unit viewed together in treatment consideration to achieve more effective outcomes.