| 1. |
- Gosman-Hedström, Gunilla, 1947, et al.
(författare)
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Stroke hos äldre och anhörigas situation
- 2004
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Ingår i: 6:e Stroke-Team-Kongressen. Örebro 7-9 Oktober Sweden 2004. (Invited speaker).
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Konferensbidrag (refereegranskat)
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| 2. |
- Abzhandadze, Tamar, 1980, et al.
(författare)
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LIFE SATISFACTION IN SPOUSES OF STROKE SURVIVORS AND CONTROL SUBJECTS: A 7-YEAR FOLLOW-UP OF PARTICIPANTS IN THE SAHLGRENSKA ACADEMY STUDY ON ISCHAEMIC STROKE
- 2017
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977. ; 49:7, s. 550-557
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Tidskriftsartikel (refereegranskat)abstract
- Objective: To investigate life satisfaction in spouses of middle-aged stroke survivors from the long-term perspective and to identify factors that explain their life satisfaction. Subjects: Cohabitant spouses of survivors of ischaemic stroke aged < 70 years at stroke onset (n = 248) and spouses of controls (n = 246). Methods: Assessments were made 7 years after inclusion to the study. Spouses' life satisfaction was assessed with the Fugl-Meyer's Life Satisfaction Check-List (LiSAT 11). Stroke-related factors were examined with the National Institutes of Health stroke scale, Mini-Mental State Examination, Barthel Index and modified Rankin Scale. Results: Spouses of stroke survivors had significantly lower satisfaction with general life, leisure, sexual life, partner relationship, family life, and poorer somatic and psychological health than spouses of controls. Caregiving spouses had significantly lower scores on all life domains except vocation and own activities of daily living than non-caregiving spouses. Spouses' satisfaction on different life domains was explained mainly by their age, sex, support given to the partner, and the survivor's level of global disability, to which both physical and cognitive impairments contributed. Conclusion: Seven years after stroke, spouses of stroke survivors reported lower life satisfaction compared with spouses of controls. Life satisfaction in stroke survivors' spouses was associated with spouses' age, sex, giving support, and the stroke survivors' level of global disability.
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| 3. |
- Alt Murphy, Margit, 1970, et al.
(författare)
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Implementation of evidence-based assessment of upper extremity in stroke rehabilitation: From evidence to clinical practice
- 2021
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Ingår i: Journal of Rehabilitation Medicine. - : Medical Journals Sweden AB. - 1650-1977 .- 1651-2081. ; 53:1
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Tidskriftsartikel (refereegranskat)abstract
- Objective: There is an evidence-practice gap in assessment of the upper extremities during acute and subacute stroke rehabilitation. The aim of this study was to target this gap by describing and evaluating the implementation of, and adherence to, an evidence-based clinical practice guideline for occupational therapists and physiotherapists. Methods: The upper extremity assessment implementation process at Sahlgrenska University Hospital comprised 5 stages: mapping clinical practice, identifying evidence-based outcome measures, development of a guideline, implementation, and evaluation. A systematic theoretical framework was used to guide and facilitate the implementation process. A survey, answered by 44 clinicians (23 physiotherapists and 21 occupational therapists), was used for evaluation. Results: The guideline includes 6 primary standardized assessments (Shoulder Abduction, Finger Extension (SAFE), 2 items of the Actions Research Arm Test (ARAT-2), Fugl-Meyer Assessment of Upper Extremity (FMA-UE), Box and Block Test (BBT), 9-Hole Peg Test (9HPT), and grip strength (Jamar hand dynamometer)) performed at specified time-points post-stroke. More than 80% (35 to 42) clinicians reported reported being content with the guideline and the implementation process. Approximately 60-90% of the clinicians reported good adherence to specific assessments, and approximately 50% reported good adherence to the agreed time-points. Comprehensive scales were more difficult to implement compared with the shorter screening scales. High levels of work rotation among staff, and the need to prioritize other assessments during the first week after stroke, hindered to implementation. Conclusion: The robustness of evidence, adequate support and receptive context facilitated the implementation process. The guideline enables a more structured, knowledge-based and consistent assessment, and thereby supports clinical decision-making and patient involvement.
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| 4. |
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| 5. |
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| 6. |
- Carlsson, Gunnel, 1950, et al.
(författare)
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Comparison of life satisfaction within couples one year after a partner's stroke
- 2007
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Ingår i: J Rehabil Med. - : Medical Journals Sweden AB. - 1650-1977. ; 39:3, s. 219-24
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To compare life satisfaction within couples one year after a partner's stroke and with norm values and social factors. SUBJECTS AND METHODS: A total of 56 couples were consecutively included. The respondents estimated life satisfaction using the Life Satisfaction Checklist 9-item version. Patients' impairments, self-care ability and handicap were assessed. Social characteristics were registered. Non-parametrical statistical methods were used for analyses. RESULTS: Patients were physically mildly disabled by their stroke. The most common symptom was mental fatigability. Patients were, in general, less satisfied than spouses. The couples were less satisfied than norms. Satisfaction with life as a whole, leisure and sex life were most affected for both patients and spouses. Relationship with partner was the only domain in which patients were more satisfied than their spouses and almost equally satisfied compared with norms. The proportion of couples in which both partners agreed they were satisfied, for the following domains was: leisure time 20%, sex life 25%, vocation/occupation 29%, life as a whole 30%, finances 47%, social contacts 48%, relationship with partner 60%, family life 66% and ability in self-care 66%. CONCLUSION: Life satisfaction was negatively affected in both partners, although in different life domains. Support should address the different needs of patients and spouses as well as their mutual needs.
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| 7. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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Anhöriga. Livsförändring och stödbehov i anpassningsprocessen
- 2015
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Ingår i: Rehabiliteringsmedicin teori och praktik. Uppl. 1.1 Jörgen Borg, Kristian Borg, Björn Gerdle, Katharina Stibrant Sunnerhagen (red.). - Lund : Studentlitteratur. - 9789144101965 ; , s. 85-88
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 8. |
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| 9. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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"Det har skett ett paradigmskifte"
- 2009
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Ingår i: Tidskriften Arbetsterapeuten. ; 2009:5, s. 15-16
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- Det har skett ett paradigmskifte i samhället under de senaste tio, femton åren när det gäller synen på de anhörigas delaktighet, ansvar och rättigheter till stöd. Från att ha setts som samhällets ansvar att ge den enskilde det stöd som han/hon behöver i sitt vardaglig liv, har de anhöriga fått ta över allt mer av detta ansvar. Vikten av de anhörigas delaktighet i vård- omsorg och rehabilitering lyfts fram allt mer. Sedan den 1 juli har de lagstadgat rätt till att få det stöd de behöver i sin anhörigroll. Hur möter vi arbetsterapeuter detta?
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| 10. |
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| 11. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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Evidence for family support
- 2006
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Ingår i: Evidence for Stroke Rehabilitation -bridging into the future (Stroke rehab 2006). International scientific conference arranged by Journal of Rehabilitation Medicine (foundation for rehabilitation information). April 26-28 2006. Göteborg. Sverige (Invited speaker).
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Konferensbidrag (refereegranskat)
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| 12. |
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| 13. |
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| 14. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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Interventionsprogram riktade till närstående till personer med stroke - en litteraturstudie
- 2007
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Ingår i: AT-forum och Nordisk kongress. 19-20 April 2007. Stockholm. Sverige..
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Konferensbidrag (refereegranskat)abstract
- Interventionsprogram riktade till närstående till personer med stroke - en litteraturstudie När en person i familjen drabbas av stroke är ofta de närstående i behov av stöd för att hantera den nya livssituationen. Under det senaste årtiondet har olika former av strukturerat stöd utarbetats och utvärderats. Syftet med litteraturstudien var att undersöka effekten av stöd till närstående. Metod:Systematisk litteratursökning gjordes i databaserna PubMed, CINAHL. COHRANE library och PsycINFO. Sökordskombination: stroke - caregiv*/carer*/spouse* / famil* - support/education/program/intervention. Sökningen begränsades till randomiserade kontrollerade studier. Resultat: Femton studier inkluderades i analysen. Interventionerna omfattade: [1] Individuell intervention i form av att en stödperson ger information om stroke samt praktiskt stöd (sex studier), [2] Undervisning / träning i problemlösningsstrategier (fem studier) samt [3] Individuell/gruppundervisning om stroke, även med syfte att bidra till emotionellt stöd (fyra studier). Utvärdering av interventionerna visade att strukturerad undervisning bidrog till ökad kunskap om stroke. Träning i problemlösning bidrog till aktiva copingstrategier och bättre familjefunktion. Få interventioner hade betydelse för de närståendes egen aktivitet/delaktighet, belastning eller fysiska hälsa. Mindre än hälften av de studier som utvärderade effekten på de närståendes psykologiska hälsa visade på positiva resultat. Arbetsterapeuten har en viktig roll i att i stödja de närstående. Det behövs utvecklas arbetsterapeutiska interventionsprogram för att stödja de närstående i att hantera strokerelaterade problem i vardagslivet och att bibehålla sin egen aktivitet/delaktighet och därmed sin hälsa.
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| 15. |
- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Life satisfaction in spouses of patients with stroke during the first year after stroke
- 2004
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Ingår i: J Rehabil Med. - : Medical Journals Sweden AB. - 1650-1977. ; 36:1, s. 4-11
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The aims of this study were to investigate whether spouses' life satisfaction changed between their life prior to their partner's stroke, and at 4 months and 1 year after stroke, and to study the association between spouses' life satisfaction and objective characteristics of the stroke patients. SUBJECTS AND METHODS: Sixty-seven consecutively enrolled spouses to first-ever stroke patients < 75 years of age participated. Life satisfaction was measured with the Life Satisfaction Checklist (LiSat-9). RESULTS: Compared with their life before stroke, the spouses' satisfaction with life as a whole, their leisure situation, daily occupation, sexual life, partner relationship and social contacts was lower 4 months after stroke. No significant change in life satisfaction was observed between 4 months and 1 year. Spouses of patients with sensorimotor impairment and low ability in self-care were less satisfied with their leisure situation, daily occupations, own ability in self-care, sexual life and partner relationship. Spouses of patients with cognitive or astheno-emotional impairments were less satisfied with their partner relationship, family life and sexual life. The associations were stronger at 1 year than at 4 months. CONCLUSION: There is a need for support over a long time period that focuses on the social, occupational and leisure situation of spouses as well as that of patients.
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| 19. |
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| 20. |
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| 21. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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Närstående
- 2007
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Ingår i: Vårdalinstitutet: Tematiska Rum: Strokerummet. - : Vårdalinstitutet Availible from: http://www.vardalinstitutet.net/PSUser/servlet/com.ausys.ps.web.use.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 22. |
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| 23. |
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| 24. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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Närståendes situation
- 2005
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Ingår i: Socialstyrelsens riktlinjer för strokesjukvård: medicinskt och hälsoekonomiskt faktadokument. - Stockholm : Socialstyrelsen. - 9185482064
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 25. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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Olika former av stöd till anhöriga [Elektronisk]
- 2009
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Ingår i: Vårdalinstitutets Tematiska rum: Stroke - vård, omsorg och rehabilitering. - : Vårdalinstitutet.
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Bokkapitel (övrigt vetenskapligt/konstnärligt)
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| 26. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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Psychological Well-Being, Life Satisfaction and Sense of Coherence in Spouses of Persons with Stroke
- 2007
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Ingår i: Workhop: New approaches in caregiver research and interventions. Robert-Bosch-Hospital. Stuttgart, Tyskland 23 July 2007..
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- PSYCHOLOGICAL WELL-BEING, LIFE SATISFACTION AND SENSE OF COHERENCE IN SPOUSES OF PERSONS WITH STROKE. The purpose of our studies was to explore change in the psychological well-being and life satisfaction of spouses in the first year after their partner’s stroke as well as the impact of the sense of coherence on this phenomenon. We also compared the satisfaction of the spouses and their partners with important domains in life one year after a stroke. The research data consisted of data about the patients’ neurological end emotional status, questionnaires about the spouses’ self-rated well-being, life satisfaction and sense of coherence, and interview data concerning the spouses’ everyday life and need of support. Even though the spouses’ psychological well-being increased after the first chaotic months after their partner’s stroke their life satisfaction decreased, even in spouses of persons who had suffered a less severe stroke. The spouses’ sense of coherence in the first weeks after their partner’s stroke seemed to be related to their future well-being. However, change in their sense of coherence also occurred in the first year after their partner’s stroke. Need of support seemed to be different in different phases after their partner’s stroke, which has implications for the development of models of interventions to support spouses during their adaptation process. In our Stroke Research Group there are ongoing studies concerning spouses’ activities, participation, health and life satisfaction in a long-term perspective and concerning older spouses’ experience of need of support. A study concerning the effect of family-centred interventions directed to families in which a person suffers from “hidden dysfunctions” is also planned.
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| 27. |
- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Psychological well-being of spouses of stroke patients during the first year after stroke
- 2004
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Ingår i: Clin Rehabil. - : SAGE Publications. - 0269-2155. ; 18:4, s. 430-7
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To investigate whether spouses' psychological well-being changed between the first weeks after their partner's stroke and four months and one year later, and to study the relationship between spouses' psychological well-being and objective characteristics of the stroke patients. DESIGN: Prospective, longitudinal study. SETTING: Hospital care and follow-ups. SUBJECTS: Sixty-seven consecutively enrolled spouses to first-ever stroke patients < 75 years. MAIN MEASURES: The Psychological General Well-Being (PGWB) Index. Clinical examination of the stroke patients. The Barthel Index. RESULTS: The spouses' psychological well-being was significantly lower in the first weeks after their partner's stroke as compared with norms. At four months, it had increased significantly. Between four months and one year, individual changes were observed in both positive and negative directions; thus, the mean level of the group remained constant. The spouses' psychological well-being in the first weeks was significantly related to the patients' sensorimotor impairments, while it was related at four months to cognitive impairment and the patients' abilities in self-care. At one year, psychological well-being was related to remaining sensorimotor and cognitive impairments. A significant relationship was also seen between the spouses' and the stroke patients' emotional health. CONCLUSIONS: The spouses' psychological well-being increased after the first chaotic weeks. The presence of visible impairments initially seemed to affect spouses' emotional health, while cognitive and emotional impairments became more evident in everyday life. In the long term, however, the spouses' individual life situations and coping abilities seem to be of relatively increasing importance for their continued well-being.
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| 28. |
- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Relationship between sense of coherence and psychological well-being in spouses of stroke patients
- 2007
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Ingår i: 14th Nordic Meeting on Cerebrovascular Diseases.
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Konferensbidrag (övrigt vetenskapligt/konstnärligt)abstract
- RELATIONSHIP BETWEEN SENSE OF COHERENCE AND PSYCHOLOGICAL WELLBEING IN SPOUSES OF STROKE PATIENTS Background. Spouses of stroke patients often perceive stress and low well-being. To better support spouses it is important to identify predictors of well-being early on, in the first phase after their partner’s stroke. The concept of Sense of Coherence is assumed to be related to coping ability and health. The concept is composed of three closely interwined sub-components: Comprehensibility, Manageability and Meaningfulness. Aim: To explore the relationship between spouses’ SOC in the first weeks after their partner’s stroke and psychological well-being during the first year. Method: Sixty-two consecutively included spouses (18 men and 44 women, mean age 57 years) participated. Data concerning SOC (The SOC-29 Questionnaire) and psychological well-being (the Psychological General Well-Being (PGWB) Index) were gathered after ten days, four months and one year. Results: The spouses’ SOC in the first week after their partner’s stroke was increasingly significantly associated with emotional well-being during the first year. Sense of manageability in life was increasingly associated with the dimensions of spouses’ well-being (anxiety, depressed mood, positive well-being, self-control, general health and vitality) from the first week after stroke. Sense of comprehensibility in life was associated with all dimensions of well-being at four months and with four dimensions at one year. Sense of meaningfulness in life was increasingly associated with positive well-being, self-control and vitality at four months and one year. Conclusion: The spouses’ SOC in the first weeks after partner’s stroke seems to have ability to predict well-being during the first year after the stroke. Care and rehabilitation staff should focus on spouses whose rates show a low sense of comprehensibility and manageability as concerns support in understanding the consequences of stroke and finding strategies to cope with their new everyday tasks and life situation.
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| 29. |
- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Spouses of first-ever stroke patients: psychological well-being in the first phase after stroke
- 2001
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Ingår i: Stroke. - 1524-4628. ; 32:7, s. 1646-51
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: A stroke affects not only the patient but also the spouse. To better support the spouse during the acute phase of stroke, knowledge is needed about his or her experience with the situation. The aim of the present study was to study the well-being of the spouses of stroke patients during the acute state of stroke and to identify factors that may influence their well-being. METHODS: Eighty-three consecutively enrolled spouses of first-ever stroke patients <75 years old participated. Their psychological well-being, measured by the Psychological General Well-Being Index 10 days after the stroke, was compared with norm values. Multiple analyses of correlation were performed to investigate the effects on psychological well-being of (1) age and sex, (2) level of impairment of the stroke patient, and (3) intrapersonal variables such as previous life satisfaction and view of the future. RESULTS: The study group showed significantly lower psychological well-being compared with norm values except for the dimension of general health. The variables that correlated significantly with the Psychological General Well-Being total score were the sensorimotor impairment of the stroke patient and the "view of the future." This view of the future also correlated significantly with the level of functional ability of the stroke patients. CONCLUSIONS: During the acute phase of stroke, the severity of the stroke has an impact on the spouse's image of his or her future life, whereas the individual appraisal of personal consequences and of his or her own coping capacity seems to have a greater impact on the psychological well-being of the spouses than does the objective state of disability.
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| 30. |
- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Spouses of first-ever stroke patients: their view of the future during the first phase after stroke
- 2002
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Ingår i: Clin Rehabil. - 0269-2155. ; 16:5, s. 506-14
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: A partner's stroke can be perceived as a critical event by a spouse. Previous studies have focused primarily on the impact of stroke on spouses' psychosocial well-being over the long term. However, the experience of spouses in the first phase after stroke is not well known. AIM: To investigate spouses' perception of their future daily life after stroke and the association between this perception and the objective characteristics of the stroke. METHOD: Eighty-three consecutively enrolled spouses of first-ever stroke patients < 75 years admitted to Sahlgrenska University Hospital in Goteborg, Sweden participated. The mean age of the spouses was 57 years. Sixty-two of the spouses were women and 21 men. Interviews about their experiences 10 days after onset were generally made at the hospital. The interviews were analysed, categorized and combined with statistical analyses of variables such as ages and sex of the spouses, type of lesion and presence of neurological impairments in the stroke patient. RESULTS: Four different categories of the concept 'view of the future' were developed on the basis of the interviews. Of the different characteristics of the stroke, the severity of the sensorimotor impairment seemed to have the greatest impact on the spouses' view of the future. The spouses of stroke patients with pure sensorimotor impairment were more likely to have an optimistic view of the future than when the sensorimotor impairment was combined with cognitive deficits. There was a broad distribution of the different characteristics of stroke between the four categories. CONCLUSIONS: Although the perception of future daily life varied, it was possible to categorize the spouses' cognitive image of future life according to degree of optimism. While the severity of stroke was of importance, the individual perception of the disease, impact on future activities and the spouses' own coping capacity was of great significance for the perception of future daily life.
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| 31. |
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| 32. |
- Forsberg-Wärleby, Gunilla, 1953, et al.
(författare)
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Spouses of first-ever stroke victims: sense of coherence in the first phase after stroke
- 2002
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Ingår i: J Rehabil Med. - 1650-1977. ; 34:3, s. 128-33
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Tidskriftsartikel (refereegranskat)abstract
- According to Antonovsky, the individual's sense of coherence is assumed to be crucial in coping with stressful life events. The purpose of this study was to investigate the associations between the sense of coherence of the spouses of stroke victims, the objective severity of the stroke and the spouses' perception of life satisfaction, psychological well-being and cognitive image of life in the future in the first phase after stroke. Eighty-three consecutively enrolled spouses to first-ever stroke victims < 75 years participated. Multiple correlations were done to study the association between Antonovsky's 29-item Sense of Coherence scale and the objective impairments of the stroke victim, the Life Satisfaction Checklist, the "view of the future" and the Psychological General Well-being Index. The sense of coherence was significantly associated with satisfaction with life as a whole before stroke (p < 0.001), partnership (p = 0.002), sexual life (p = 0.005), family life (p < 0.001) and financial situation (p = 0.001). The severity of the impairments of the stroke victims was not significantly associated with the spouses' sense of coherence. However, the sense of coherence was significantly associated with the perception of the future life situation (p = 0.006). The sense of coherence was also significantly associated with the perception of positive well-being (p = 0.007), self-control (p = 0.009), general health (p = 0.009) and vitality (p = 0.002) at the present, whereas the association with anxiety and depressed mood were not statistical significant. In the experience of a stressful life event such as stroke, satisfaction with general life, close relationships and the socio-economic situation were significantly associated with the spouse's sense of coherence. Spouses with a low sense of coherence were more likely to have low psychological well-being and a more pessimistic view of their life in the future.
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| 33. |
- Forsberg-Wärleby, Gunilla, 1953
(författare)
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Spouses of Stroke Patients: Psychological Well-Being and Life Satisfaction
- 2002
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Aim: The aim of this study was to investigate longitudinal changes in spouses' psychological well-being and life satisfaction between the first weeks, four months and one year after their partners' stroke and to study the associations between spouses' psychological well-being and life satisfaction and characteristics of the spouses and stroke patients at these three points in time.Method: Eighty-three consecutively recruited spouses of first-ever stroke patients < 75 years participated. The spouses' self-rated psychological general well-being, life satisfaction and sense of coherence were measured in the first week, four months and one year after stroke in a semi-structured interview also including open questions about experiences of their ongoing life situation. The stroke patients' physical and cognitive impairments and level of self-care were documented in the first week and one year after stroke. Depression and astheno-emotional syndrome were documented at one year. The interview data were analysed with qualitative analysis methods. The quantitative data were analysed with non-parametric statistical methods.Results: In the first weeks, the spouses' psychological well-being was significantly lowered as compared with norm values. Four different categories of the concept of "view of the future" were developed on the basis of the interviews. The spouses' view of the future was strongly associated with their psychological well-being. Their sense of coherence was associated with satisfaction with social relationships and financial situation prior to stroke and with psychological well-being in the present. Four months after the stroke, the spouses' psychological well-being had increased. However, as compared with life prior to stroke, their life satisfaction was lower. There were no statistically significant changes in psychological well-being or life satisfaction between four months and one year. The spouses' sense of anxiety, depressed mood and vitality as well as satisfaction with their daily activities and leisure situation were significantly associated with the stroke patients' physical impairments and ability in self-care. Their sense of positive well-being and their satisfaction with the partner relationship and family life were significantly associated with the presence of cognitive impairments and astheno-emotional syndrome in the stroke patients. The spouses' and stroke patients' emotional health was related. The associations between the spouses' psychological well-being and the stroke patients' impairments were most marked at four months, except for sensorimotor impairment, while the associations between spouses' life satisfaction and the stroke patients' impairments were most marked at one year.Conclusion: The spouses' individual appraisal of the consequences for their personal lives seems to have a greater impact on their well-being than the patients' objective impairments in the first period after stroke. The visible physical impairments had a great impact on spouses' well-being in the firs phase, while the impact of cognitive and emotional impairments became more evident in everyday life. Some months after the initial crisis reaction, the psychological well-being of the spouses increased, while satisfaction with valuable domains of life decreased. Between four months and one year, individual changes were observed in both positive and negative directions. Spouses of stroke patients with persisting dependency often perceived a decline in life satisfaction.
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| 34. |
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| 35. |
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| 36. |
- Persson, Josefine, 1981, et al.
(författare)
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Long- term cost of spouses’ informal support for dependent midlife stroke survivors
- 2017
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Ingår i: Brain and Behavior. - : Wiley. - 2162-3279. ; 7:6
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Stroke is a major global disease that requires extensive care and support from society and relatives. The aim of this study was to identify and quantify the long- term informal support and to estimate the annual cost of informal support provided by spouses to their stroke surviving partner. Method: Data were based on the 7- year follow- up of the Sahlgrenska Academy Study on Ischemic Stroke. One- third of the spouses stated that they provided support to their stroke surviving partner. The magnitude of the support was assessed with a study- specific time- diary and was estimated for independent and dependent stroke survivors based on the scores of the modified Rankin Scale. To deal with skewed data, a two- part econometric model was used to estimate the annual cost of informal support. Result: Cohabitant dyads of 221 stroke survivors aged <70 at stroke onset were in- cluded in the study. Spouses of independent stroke survivors ( n = 188) provided on average 0.15 hr/day of practical support and 0.48 hr/day of being available. Corresponding figures for spouses of dependent stroke survivors ( n = 33) were 5.00 regarding practical support and 9.51 regarding being available. The mean annual cost of informal support provided for independent stroke survivors was estimated at €991 and €25,127 for dependent stroke survivor. Conclusion: The opportunity cost of informal support provided to dependent midlife stroke survivors is of a major magnitude many years after stroke onset and should be considered in economic evaluations of health care.
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| 37. |
- Persson, Josefine, 1981, et al.
(författare)
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Long-term QALY-weights among spouses of dependent and independent midlife stroke survivors.
- 2017
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Ingår i: Quality of Life Research. - : Springer Science and Business Media LLC. - 0962-9343 .- 1573-2649. ; 26:11, s. 3059-3068
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Tidskriftsartikel (refereegranskat)abstract
- PURPOSE: The aim of this study was to investigate whether the dependency of midlife stroke survivors had any long-term impact on their spouses' QALY-weights. METHOD: Data on stroke survivors, controls, and spouses were collected from the 7-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke. Health-related quality of life was assessed by the SF-36, and the preference-based health state values were assessed with the SF-6D. Spouses of dependent and independent stroke survivors were categorized according to their scores on the modified Rankin Scale. An ordinary least squares regression analysis was used to evaluate whether the dependency of the stroke survivors had any impact on the spouses' QALY-weights. RESULT: Cohabitant dyads of 247 stroke survivors aged <70 at stroke onset and 245 dyads of controls were included in the study. Spouses of dependent stroke survivors (n = 50) reported a significant lower mean QALY-weight of 0.69 in comparison to spouses of independent stroke survivors (n = 197) and spouses of controls, (n = 245) who both reported a mean QALY-weight of 0.77. The results from the regression analysis showed that higher age of the spouse and dependency of the stroke survivor had a negative association with the spouses' QALY-weights. CONCLUSION: The QALY-weights for spouses of dependent midlife stroke survivors were significantly reduced compared to spouses of independent midlife stroke survivors. This indicates that the inclusion of spouses' QALYs in evaluations of early treatment and rehabilitation efforts to reduce stroke patients' dependency would capture more of the total effect in dyads of stroke survivors.
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| 38. |
- Persson, Josefine, 1981, et al.
(författare)
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Makar till personer med stroke upplever långsiktigt nedsatt hälsorelaterad livskvalitet
- 2015
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Ingår i: Neurologi i Sverige. - 2000-8538. ; :4, s. 22-27
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Tidskriftsartikel (övrigt vetenskapligt/konstnärligt)abstract
- En avsevärd andel av makar och sambor till personer som haft stroke upplever lägre hälsorelaterad livskvalitet än makar till friska kontrollpersoner sju år efter partnerns insjuknande. Störst risk att påverkas har de som ger ett omfattande stöd till partnern och som saknar eget socialt stöd. Den hälsorelaterade livskvaliteten var även relaterad till strokepatientens grad av funktionshinder, kognitiva svårigheter och depression. Detta visar en ny studie, som här presenteras av Josefine Persson, Christian Blomstrand och Gunilla Forsberg-Wärleby, samtliga verksamma vid Institutionen för neurovetenskap och fysiologi, Sahlgrenska akademin, Göteborgs universitet.
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| 39. |
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| 40. |
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| 41. |
- Persson, Josefine, 1981, et al.
(författare)
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Stroke survivors’ long-term QALY-weights in relation to their spouses’ QALY-weights and informal support: a cross-sectional study
- 2017
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Ingår i: Health and Quality of Life Outcomes. - : Springer Science and Business Media LLC. - 1477-7525. ; 15
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Tidskriftsartikel (refereegranskat)abstract
- Background: Healthcare interventions that have positive effects on the stroke survivors’ health-related quality of Life (HRQoL) and quality-adjusted life-years (QALYs) might also have positive effects for their spouses in terms of improved HRQoL and/or reduced spousal informal support. However, knowle dge about stroke survivors ’ HRQoL and QALY and the consequences for their spouses’ HRQoL and QALY is limited. Therefore, the aim of this study was to describe the HRQoL and QALY-weights in dyads of stroke survivors in comparison with dyads of healthy controls, and to study the relationship between the stroke survivors’ QALY-weights and consequences for spouses in terms of QALY-weight and annual cost of informal support, using a long-term perspective. Methods: Data on stroke survivors, controls, and spouses were collected from the seven-year follow-up of the Sahlgrenska Academy Study on Ischemic Stroke (SAHLSIS). HRQoL was assessed by the SF-36, and the preference-based health state values were assessed with the SF-6D. The magnitude of the support was assessed with a study specific time-diary. An ordinary least squares (OLS) regression was used to estimate the association between stroke survivors’ and spouses’ QALY-weights. A two-part econometri c model was used to estimate the association between stroke survivors’ QALY-weights and the time spent and cost of spouses’ informal support. Results: Cohabitant dyads of 248 stroke survivors’ aged <70 at stroke onset and 245 controls were included in the study. Stroke survivors had lower HRQoL in the SF-36 domains physical functioning, physical role, general health, vitality (P <0.001), and social functioning (P = 0.005) in comparison with their cohabitant spouses. There was no significant difference in HRQoL for the dyads of controls. The results from the regression analyses showed that lo wer QALY-weights of the stroke survivors were associated with lower QALY-weights of their spouses and increased annual cost of spousal informal support. Conclusion: Our results show that the QALY-weight s for stroke surv ivors had consequences for their spouses in terms of annual cost of spousal informal support and QALY-weights. Hence, economic evalu ation of interventions that improve the HRQoL of the stroke survivors but ignore the consequences for their spouses may underestimate the value of the intervention.
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| 42. |
- Visser-Meily, Anne, et al.
(författare)
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Psychosocial functioning of spouses of patients with stroke from initial inpatient rehabilitation to 3 years poststroke: course and relations with coping strategies.
- 2009
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Ingår i: Stroke; a journal of cerebral circulation. - 1524-4628. ; 40:4, s. 1399-404
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: Few studies have focused on long-term changes in the caregiving experience after stroke. This study assessed changes in the psychosocial functioning of spouses (burden, depressive symptoms, harmony in the relationship between patient and spouse, and social relations) during the first 3 years after stroke and identified predictors of the course of spouses' psychosocial functioning based on the characteristics of patients and spouses with special emphasis on coping style. METHODS: We examined 211 couples shortly after the patient's admission to a rehabilitation center, 197 2 months after discharge, 187 1 year poststroke, and 121 3 years poststroke. Burden was assessed using the Caregiver Strain Index, depressive symptoms with the Goldberg Depression Scale, harmony in the relationship with the Interactional Problem Solving Inventory, and social relations with the Social Support List. Multilevel regression analyses were performed. RESULTS: A significant effect of time (P<0.01) was found for all 4 aspects of spouses' psychosocial functioning. Although burden decreased, harmony in the relationship and social relations also decreased. The depression score showed a nonlinear pattern with an initial decrease but a long-term increase. All outcomes were significantly related to caregiver coping strategies. A total of 15% to 27% of the variance in psychosocial functioning could be explained. CONCLUSIONS: Follow-up of spouses of patients with stroke requires not only assessment of burden, but also other aspects of psychosocial functioning like harmony in the relationship, depression, and social relations, because our results show negative long-term consequences of stroke for these aspects of caregiver quality of life.
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