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First-stroke recovery process: The role of family social support,☆☆,

https://doi.org/10.1053/apmr.2000.4435Get rights and content

Abstract

Tsouna-Hadjis E, Vemmos KN, Zakopoulos N, Stamatelopoulos S. First-stroke recovery process: the role of family social support. Arch Phys Med Rehabil 2000;81:881-7. Objective: To determine the role of family social support in three stroke rehabilitation variables (functional status, depression, social status) during a 6-month recovery period. Design: Assessment of first-stroke patients' functional status, depression, and social status before discharge and at 1, 3, and 6 months after stroke onset, in comparison with the amount of family social support received. The family social support scale—compliance, instrumental, and emotional support—was employed in the first month. Setting: A university hospital and patients' residences. Patients: A consecutive sample of 43 first-stroke patients meeting the inclusion criteria. Main Outcome Measures: Changes of patients' rehabilitation variables over the 6-month period were tested by use of repeated multivariate analysis of variance measures. Results: Observers of functional, depression, and social status changes were blind to patient grouping according to levels of family support. These three variables were significantly affected by higher levels of support (p =.001, p =.001, p =.020, respectively), but a significant interaction was found only with regard to functional status adjusted for initial stroke severity (p =.019). Patients with moderate/severe stroke and high levels of social support attained a significantly better and progressively improving functional status than those with less support. Conclusions: High levels of family support—instrumental and emotional—are associated with progressive improvement of functional status, mainly in severely impaired patients, while the psychosocial status is also affected. © 2000 by the American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation

Section snippets

Subjects

The sample of the study is part of a prospective stroke databank developed in the Department of Clinical Therapeutics of Athens University over a period of 5 years (1042 patients).26 All study subjects, suffering from an acute first stroke, were admitted to the hospital and were classified according to aetiopathogenic mechanisms of stroke. A brain computed tomography scan was obtained on admission and standard investigations were performed during hospitalization according to the study protocol.

Patient characteristics

Twenty-four (56%) patients were men. This percentage is not statistically different compared with 613 (59%) men of our 5-year stroke registry. The mean age of patients was 70.7 years. The etiology of stroke in our sample was atherosclerosis in 10 patients, cardioembolism in 16, lacunar stroke in 9, infarction of undetermined cause in 11, and intracerebral hemorrhage in 4.

Patients' demographic and clinical characteristics in total and according to level of social support are presented in table 1.

Discussion

The longitudinal method applied in this study revealed that the quantity of family social support received by the 43 first-stroke patients was found to significantly predict changes in their functional status as well as in their social and depression status within the first 6 months after the stroke. Among more severely impaired patients, a high level of support was found to be predictive of a great amount of progressive functional improvement. Functional recovery in these patients showed the

Acknowledgements

We thank Dr. Lia Tselika-Garfe, Department of Health Science, Athens, for helpful feedback and suggestions, and Ms. Sofia Argyropoulou, Ms. Kallioppi Vakrakou, and Ms. Despina Savvidou, for contacting the patients and carrying out the interviews.

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    No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the authors or upon any organization with which the author are associated.

    ☆☆

    Reprint requests to Evie Tsouna-Hadjis, PhD, Acute Stroke Unit, Department of Clinical Therapeutics, University of Athens School of Medicine, Alexandra Hospital, 80 V. Sofias & Lourou St, 11528, Athens, Greece.

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