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Marriage after the transition to stroke: a systematic review

  • SHARON ANDERSON (a1) and NORAH KEATING (a2)
Abstract
ABSTRACT

In health and chronic illness, satisfying marriages promote wellbeing and life satisfaction, yet stroke research has focused on either the stroke survivor as the patient or the spouse as a care-giver. Using Pope, Mays and Popay's framework for synthesising qualitative and quantitative methods, we conducted a systematic review and synthesis of 39 peer-reviewed studies to determine what happens to marital relationships after one partner has suffered a stroke. All the articles examined the impact of stroke. Three overarching themes characterise the evolution of marriage after stroke: chaos in the marriage, work to re-establish the marriage and evolution of the marriages. While both the stroke condition itself and the survivors’ need for care undermined the emotional qualities of the relationship for some couples, about two-thirds were able to retain or regain the relationship closeness. As in other chronic illnesses, the relationship closeness and a couple's ability to collaborate contributed to the survivor's recovery and to the satisfaction with life of the stroke survivor and the spouse. Our results underscore the need to consider the quality of, and the qualities of, the relationship between stroke survivors and their spouses. Future research could include a greater focus on qualitative or mixed-methods approaches to explore the interactions between stroke survivors and spouses that impact the wellbeing of both partners.

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Corresponding author
Address for correspondence: Sharon Anderson, Department of Human Ecology, University of Alberta, 302 Human Ecology Building, Edmonton, AB Canada T6 G 2N1 E-mail: sdanders@ualberta.ca
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*† D. Achten , J. M. A. Visser-Meily , M. W. M. Post and V. P. M. Schepers 2012. Life satisfaction of couples 3 years after stroke. Disability and Rehabilitation, 34, 17, 1468–72.

A. A. Aizer , M. H. Chen , E. P. McCarthy , M. L. Mendu , S. Koo , T. J. Wilhite , P. L. Graham , T. K. Choueiri , K. E. Hoffman , N. E. Martin , J. C. Hu and P. L. Nguyen 2013. Marital status and survival in patients with cancer. Journal of Clinical Oncology, 31, 31, 3869–76.

* B. Backstrom , K. Asplund and K. Sundin 2010. The meaning of middle-aged female spouses’ lived experience of the relationship with a partner who has suffered a stroke, during the first year postdischarge. Nursing Inquiry, 17, 3, 257–68.

H. Badr and P. Krebs 2013. A systematic review and meta-analysis of psychosocial interventions for couples coping with cancer. Psycho-Oncology, 22, 8, 1688–704.

T. Bakas , P. C. Clark , M. Kelly-Hayes , R. B. King , B. J. Lutz and E. L. Miller 2014. Evidence for stroke family caregiver and dyad interventions: a statement for healthcare professionals from the American Heart Association and American Stroke Association. Stroke, 45, 9, 2836–52.

* P. Banks and C. Pearson 2004. Parallel lives: younger stroke survivors and their partners coping with crisis. Sexual and Relationship Therapy, 19, 4, 413–29.

R. L. Beard , S. Sakhtah , V. Imse and J. E. Galvin 2012. Negotiating the joint career: couples adapting to Alzheimer's and aging in place. Journal of Aging Research, 2012, 797023, 112.

C. A. Berg and R. Upchurch 2007. A developmental–contextual model of couples coping with chronic illness across the adult life span. Psychological Bulletin, 133, 6, 920–54.

* M. Brann , K. L. Himes , M. R. Dillow and K. Weber 2010. Dialectical tensions in stroke survivor relationships. Health Communication, 25, 4, 323–32.

* K. Buschenfeld , R. Morris and S. Lockwood 2009. The experience of partners of young stroke survivors. Disability and Rehabilitation, 31, 20, 1643–51.

J. I. Cameron , G. Naglie , M. A. M. Gignac , M. Bayley , G. Warner , T. Green , A. Czerwonka , M. Huijbregts , F. L. Silver , S. J. Phillips and A. M. Cheung 2014. Randomized clinical trial of the Timing it Right stroke family support program: research protocol. BMC Health Services Research, 14, 18.

*† G. E. Carlsson , G. Forsberg-Warleby , A. Moller and C. Blomstrand 2007. Comparison of life satisfaction within couples one year after a partner's stroke. Journal of Rehabilitation Medicine, 39, 3, 219–24.

E. Clark-Polner and M. S. Clark 2014. Understanding and accounting for relational context is critical for social neuroscience. Frontiers in Human Neuroscience, 8, 127.

* U. E. Coombs 2007. Spousal caregiving for stroke survivors. Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses, 39, 2, 112–9.

T. Dalteg , E. Benzein , B. Fridlund and D. Malm 2011. Cardiac disease and its consequences on the partner relationship: a systematic review. European Journal of Cardiovascular Nursing, 10, 3, 140–9.

B. Demiray and S. Bluck 2014. Time since birth and time left to live: opposing forces in constructing psychological wellbeing. Ageing & Society, 34, 7, 1193–218.

M. Dixon-Woods , A. Sutton , R. Shaw , T. Miller , J. Smith , B. Young , S. Bonas , A. Booth and D. Jones 2007. Appraising qualitative research for inclusion in systematic reviews: a quantitative and qualitative comparison of three methods. Journal of Health Services Research and Policy, 12, 1, 42–7.

* T. M. Enterlante and J. M. Kern 1995. Wives’ reported role changes following a husband's stroke: a pilot study. Rehabilitation Nursing: The Official Journal of the Association of Rehabilitation Nurses, 20, 3, 155–60.

* A. Erikson , M. Park and K. Tham 2010. Belonging: a qualitative, longitudinal study of what matters for persons after stroke during one year of rehabilitation. Journal of Rehabilitation Medicine, 42, 9, 831–8.

V. L. Feigin , M. H. Forouszanfarm , R. Krishnamurthi , G. A. Mensha , M. Connors , D. A. Bennet , A. E. Moran , R. L. Sacco , L. Anderson , T. Truelsen , M. O'Donnell , N. Venketasubramanian , S. Barker-Collo , C. M. M. Lawes , W. Wang , T. Shinohara , E. Witt , M. Ezzati , M. Naghavi and C. Murray 2014. Global and regional burden of stroke during 1990–2010: findings from the global burden of disease study 2010. The Lancet, 383, 9913, 245–55.

*† G. Forsberg-Warleby , A. Moller and C. Blomstrand 2004. Life satisfaction in spouses of patients with stroke during the first year after stroke. Journal of Rehabilitation Medicine, 36, 1, 411.

J. E. Gaugler 2010. The longitudinal ramifications of stroke caregiving: a systematic review. Rehabilitation Psychology, 55, 2, 108–25.

* S. Giaquinto , S. Buzzelli , L. Di Francesco and G. Nolfe 2003. Evaluation of sexual changes after stroke. Journal of Clinical Psychiatry, 64, 3, 302–7.

A. S. Go , D. Mozaffarian , V. L. Roger , E. J. Benjamin , J. D. Berry , M. J. Blaha , S. F. Dai , E. S. Ford , C. S. Fox , S. Franco , H. J. Fullerton , C. Gillespie , S. M. Hailpern , J. A. Heit , V. J. Howard , M. D. Huffman , S. E. Judd , B. M. Kissela , S. J. Kittner , D. T. Lackland , J. H. Lichtman , L. D. Lisabeth , R. H. Mackey , D. J. Magid , G. M. Marcus , A. Marelli , D. B. Matchar , D. K. McGuire , E. R. Mohler , C. S. Moy , M. E. Mussolino , R. W. Neumar , G. Nichol , D. K. Pandey , N. P. Paynter , M. J. Reeves , P. D. Sorlie , J. Stein , A. Towfighi , T. N. Turan , S. S. Virani , N. D. Wong , D. Woo , M. B. Turner , American Heart Association Statistics Committee and Stroke Statistics Subcommittee. 2014. Heart disease and stroke statistics – 2014 update: a report from the American Heart Association. Circulation, 129, 3, E28292.

*† K. M. Godwin , S. K. Ostwald , S. G. Cron and J. Wasserman 2013 a. Long-term health-related quality of life of stroke survivors and their spousal caregivers. Journal of Neuroscience Nursing, 45, 3, 147–54.

*† K. M. Godwin , P. R. Swank , P. Vaeth and S. K. Ostwald 2013 b. The longitudinal and dyadic effects of mutuality on perceived stress for stroke survivors and their spousal caregivers. Aging & Mental Health, 17, 4, 423–31.

D. P. Goldman , D. Cutler , J. W. Rowe , P. C. Michaud , J. Sullivan , D. Peneva and S. J. Olshansky 2013. Substantial health and economic returns from delayed aging may warrant a new focus for medical research. Health Affairs, 32, 10, 1698–705.

D. S. Goodin and A. T. Reder 2012. Evidence-based medicine: promise and pitfalls. Multiple Sclerosis Journal, 18, 7, 947–8.

*† T. L. Green and K. M. King 2009. Experiences of male patients and wife-caregivers in the first year post-discharge following minor stroke: a descriptive qualitative study. International Journal of Nursing Studies, 46, 9, 1194–200.

*† T. L. Green and K. M. King 2010. Functional and psychosocial outcomes 1 year after mild stroke. Journal of Stroke & Cerebrovascular Diseases, 19, 1, 1016.

T. Greenhalgh and R. Peacock 2005. Effectiveness and efficiency of search methods in systematic reviews of complex evidence: audit of primary sources. British Medical Journal, 331, 7524, 1064–65.

M. L. Hackett , N. Glozier , S. Jan and R. Lindley 2012. Returning to paid employment after stroke: the Psychosocial Outcomes in Stroke (POISE) cohort study. PLOS ONE, 7, 7.

M. L. Hackett and K. Pickles 2014. Part I: frequency of depression after stroke: an updated systematic review and meta-analysis of observational studies. International Journal of Stroke, 9, 8, 1017–25.

W. E. Haley , D. L. Roth , M. Hovater and O. J. Clay 2015. Long-term impact of stroke on family caregiver well-being: a population-based case-control study. Neurology, 84, 13, 1323–29.

J. Holt-Lunstad , T. B. Smith and J. B. Layton 2010. Social relationships and mortality risk: a meta-analytic review. PLOS Medicine, 7, 7.

L. Huang , K. A. Cronin , K. A. Johnson , A. B. Mariotto and E. J. Feuer 2008. Improved survival time: what can survival cure models tell us about population-based survival improvements in late-stage colorectal, ovarian, and testicular cancer? Cancer, 112, 10, 2289–300.

S. Jacobs , C. Xie , S. Reilly , J. Hughes and D. Challis 2009. Modernising social care services for older people: scoping the United Kingdom evidence base. Ageing & Society, 29, 4, 497538.

A. Karraker and K. Latham 2015. In sickness and in health? Physical illness as a risk factor for marital dissolution in later life. Journal of Health and Social Behavior, 56, 3, 420–35.

K. B. King and H. T. Reis 2012. Marriage and long-term survival after coronary artery bypass grafting. Health Psychology, 31, 1, 5562.

*† G. Kitzmuller , K. Asplund and T. Haggstrom 2012. The long-term experience of family life after stroke. Journal of Neuroscience Nursing, 44, 1, E113.

*† G. Kitzmuller and B. Ervik 2015. Female spouses’ perceptions of the sexual relationship with stroke-affected partners. Sexuality and Disability 33, 4 , 499512.

*† G. Kitzmüller , T. Häggström , K. Asplund and F. Gilje 2012. The existential meaning of couples’ long-term experience of living with stroke. Illness, Crisis and Loss, 20, 4, 339–62.

* J. T. Korpelainen , P. Nieminen and V. V. Myllyla 1999. Sexual functioning among stroke patients and their spouses. Stroke: A Journal of Cerebral Circulation, 30, 4, 715–9.

H. Kravdal and A. Syse 2011. Changes over time on the effect of marital status on cancer survival. BMC Public Health, 11, 804.

H. Krueger , J. Koot , R. E. Hall , C. O'Callaghan , M. Bayley and D. Corbett 2015. Prevalence of individuals experiencing the effects of stroke in Canada: trends and projections. Stroke: A Journal of Cerebral Circulation, 46, 8, 2226–31.

* L. Lemieux , R. Cohen-Schneider and S. Holzapfel 2002. Aphasia and sexuality. Sexuality and Disability, 19, 4, 253–65.

B. J. Lutz and M. E. Young 2010. Rethinking intervention strategies in stroke family caregiving. Rehabilitation Nursing, 35, 4, 152–60.

A. D. Mancini and G. A. Bonanno 2006. Marital closeness, functional disability, and adjustment in late life. Psychology and Aging, 21, 3, 600–10.

S. C. Martin 2016. Relational issues within couples coping with Parkinson's disease: implications and ideas for family-focused care. Journal of Family Nursing, 22, 2, 224–51.

N. E. Mayo , S. Wood-Dauphinee , R. Carlton , L. Durcan and J. Carlton 2002. Activity, participation, and quality of life 6 months poststroke. Archives of Physical Medicine and Rehabilitation, 83, 8, 1035–42.

*† M. J. McCarthy and E. Bauer 2015. In sickness and in health: couples coping with stroke across the life span. Health & Social Work, 40, 3, E92100.

M. J. McCarthy , K. S. Lyons and L. E. Powers 2011. Expanding poststroke depression research: movement toward a dyadic perspective. Topics in Stroke Rehabilitation, 18, 5, 450–60.

*† M. J. McCarthy , K. S. Lyons and L. E. Powers 2012. Relational factors associated with depressive symptoms among stroke survivor–spouse dyads. Journal of Family Social Work, 15, 4, 303–20.

J. McGovern 2011. Couple meaning-making and dementia: challenges to the deficit model. Journal of Gerontological Social Work, 54, 7, 678–90.

*† C. J. McPherson , K. G. Wilson , L. Chyurlia and C. Leclerc 2010. The balance of give and take in caregiver–partner relationships: an examination of self-perceived burden, relationship equity, and quality of life from the perspective of care recipients following stroke. Rehabilitation Psychology, 55, 2, 194203.

*† C. J. McPherson , K. G. Wilson , L. Chyurlia and C. Leclerc 2011. The caregiving relationship and quality of life among partners of stroke survivors: a cross-sectional study. Health and Quality of Life Outcomes, 9, 29.

D. Mortimer and L. Segal 2008. Is the value of a life or life-year saved context specific? Further evidence from a discrete choice experiment. Cost Effectiveness and Resource Allocation, 6, 8.

S. K. Ostwald 2008. Predictors of life satisfaction among stroke survivors and spousal caregivers: a narrative review. Aging Health, 4, 3, 241–52.

*† S. K. Ostwald , M. P. Bernal , S. G. Cron and K. M. Godwin 2009. Stress experienced by stroke survivors and spousal caregivers during the first year after discharge from inpatient rehabilitation. Topics in Stroke Rehabilitation, 16, 2, 93104.

*† S. K. Ostwald , K. M. Godwin and S. G. Cron 2009. Predictors of life satisfaction in stroke survivors and spousal caregivers after inpatient rehabilitation … with commentary by Bays CL. Rehabilitation Nursing, 34, 4, 160–74.

S. Palmer and T. A. Glass 2003. Family function and stroke recovery: a review. Rehabilitation Psychology, 48, 4, 255–65.

A. Pearson , H. White , F. Bath-Hextall , S. Salmond , J. Apostolo and P. Kirkpatrick 2015. A mixed-methods approach to systematic reviews. International Journal of Evidence-based Healthcare, 13, 3, 121–31.

P. R. Pietromonaco , B. Uchino and C. D. Schetter 2013. Close relationship processes and health: implications of attachment theory for health and disease. Health Psychology, 32, 5, 499–13.

P. Pluye 2013. Critical appraisal tools for assessing the methodological quality of qualitative, quantitative and mixed methods studies included in systematic mixed studies reviews. Journal of Evaluation in Clinical Practice, 19, 4, 722.

P. Pluye and Q. N. Hong 2014. Combining the power of stories and the power of numbers: mixed methods research and mixed studies reviews. Annual Review of Public Health, 35, 2945.

K. Quinn , C. Murray and C. Malone 2014 a. Spousal experiences of coping with and adapting to caregiving for a partner who has a stroke: a meta-synthesis of qualitative research. Disability and Rehabilitation, 36, 3, 185–98.

*† K. Quinn , C. D. Murray and C. Malone 2014 b. The experience of couples when one partner has a stroke at a young age: an interpretative phenomenological analysis. Disability and Rehabilitation, 36, 20, 1670–8.

*† E. Radcliffe , K. Lowton and M. Morgan 2013. Co-construction of chronic illness narratives by older stroke survivors and their spouses. Sociology of Health and Illness, 35, 7, 9931007.

*† G. Robinson-Smith and C. Mahoney 1995. Coping and marital equilibrium after stroke. Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses, 27, 2, 83–9.

T. F. Robles , R. B. Slatcher , J. M. Trombello and M. M. McGinn 2014. Marital quality and health: a meta-analytic review. Psychological Bulletin, 140, 1, 140–87.

M. J. Rohrbaugh , V. Shoham , A. A. Cleary , J. S. Berman and G. A. Ewy 2009. Health consequences of partner distress in couples coping with heart failure. Heart and Lung: Journal of Acute and Critical Care, 38, 4, 298305.

K. Salter , C. Hellings , N. Foley and R. Teasell 2008. The experience of living with stroke: a qualitative meta-synthesis. Journal of Rehabilitation Medicine, 40, 8, 595602.

K. Salter , L. Zettler , N. Foley and R. Teasell 2010. Impact of caring for individuals with stroke on perceived physical health of informal caregivers. Disability and Rehabilitation, 32, 4, 273–81.

T. Satink , E. H. Cup , I. Ilott , J. Prins , B. J. De Swart and M. W. Nijhuis-Van Der Sanden 2013. Patients’ views on the impact of stroke on their roles and self: a thematic synthesis of qualitative studies. Archives of Physical Medicine and Rehabilitation, 94, 6, 1171–83.

* M. A. Schmitz and M. Finkelstein 2010. Grand rounds. Perspectives on poststroke sexual issues and rehabilitation needs. Topics in Stroke Rehabilitation, 17, 3, 204–13.

C. Spittlehouse , M. Acton and K. Enock 2000. Introducing critical appraisal skills training in UK social services: another link between health and social care? Journal of Interprofessional Care, 14, 4, 397404.

H. Tanji , K. E. Anderson , A. L. Gruber-Baldini , P. S. Fishman , S. G. Reich , W. J. Weiner and L. M. Shulman 2008. Mutuality of the marital relationship in Parkinson's disease. Movement Disorders, 23, 13, 1843–9.

R. Teasell , N. Hussein , A. McClure and M. Meyer 2014. Stroke: more than a ‘brain attack’. International Journal of Stroke, 9, 2, 188–90.

* M. Tellier , A. Rochette and H. Lefebvre 2011. Impact of mild stroke on the quality of life of spouses. International Journal of Rehabilitation Research, 34, 3, 209–14.

* H. S. Thompson and A. Ryan 2009. The impact of stroke consequences on spousal relationships from the perspective of the person with stroke. Journal of Clinical Nursing, 18, 12, 1803–11.

M. J. Traa , J. De Vries , G. Bodenmann and B. L. Den Oudsten 2015. Dyadic coping and relationship functioning in couples coping with cancer: a systematic review. British Journal of Health Psychology, 20, 1, 85114.

* S. Trygged , E. Hedlund and I. Kåreholt 2011. Education and poststroke separation among couples with mutual children. Journal of Divorce and Remarriage, 52, 6, 401–14.

* F. Van Nes , V. Runge and H. Jonsson 2009. One body, three hands and two minds: a case study of the intertwined occupations of an older couple after a stroke. Journal of Occupational Science, 16, 3, 194202.

*† A. Visser-Meily , M. Post , I. van de Port , C. Maas , G. Forstberg-Warleby and E. Lindeman 2009. Psychosocial functioning of spouses of patients with stroke from initial inpatient rehabilitation to 3 years poststroke: course and relations with coping strategies. Stroke: A Journal of Cerebral Circulation, 40, 4, 1399–404.

* S. D. Yilmaz , H. Gumus and H. Yilmaz 2015. Sexual life of poststroke women with mild or no disability: a qualitative study. Journal of Sex & Marital Therapy, 41, 2, 145–54.

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