Life satisfaction in spouses of patients with stroke during the first year after stroke.

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.     

Life satisfaction of couples 3 years after stroke

Purpose: To compare the life satisfaction of stroke patients to that of their spouses, and to examine spouses’ variables as determinants of the patients’ life satisfaction. Method: Patients with a first-ever stroke who were admitted to an inpatient rehabilitation centre and their spouses were included (n?=?78 couples). Measurements took place 3 years after the stroke. Life satisfaction was measured using the Life Satisfaction Questionnaire (LiSat-9). Results: More spouses (50%) than patients (28%) were dissatisfied with their life as a whole. Spouses were also more likely to be dissatisfied with all other domains of life satisfaction than patients. The associations between the life satisfaction of patients and of spouses were weak (Cramer’s V 0.00–0.43). In the backward linear regression analysis both patients’ participation in social activities and spouses’ life satisfaction were significantly related to patients’ life satisfaction. A total of 17.8% of the variance of patients’ life satisfaction could be explained by the model. Conclusions: Both spouse and patient in a couple experience decreased life satisfaction in the chronic phase after stroke, spouses even more so than patients. The life satisfaction of stroke patients was significantly related to spouses’ life satisfaction. Family-centred care should be an important part of the rehabilitation process.

Implications for Rehabilitation

• Both spouse and patient in a couple experience decreased life satisfaction in the chronic phase after stroke.

• The life satisfaction of stroke patients was significantly related to spouses’ life satisfaction.

• Family-centred care, in which the spouse is closely involved, should be an important part of the rehabilitation process.

     

The Medical Marriage: A National Survey of the Spouses/Partners of US Physicians

ObjectiveTo evaluate physician relationships from the perspective of their spouses/partners.MethodsNearly all data on satisfaction with physician relationships come from the perspective of the physician rather than their spouse/partner. We conducted a national study of the spouses/partners of US physicians from August 17, 2011, through September 12, 2011. Responding spouses/partners provided information on demographic characteristics, their own work life, and the work life of their physician partners. Spouses/partners also rated relationship satisfaction and the effect of the work life of their physician partner on the relationship.ResultsOf the 1644 spouses/partners of physicians surveyed, 891 (54.2%) responded. Most spouses/partners (86.8%) reported that they were satisfied with their relationship with their physician partner. Satisfaction strongly related to the amount of time spent awake with their physician partners each day. Despite their overall satisfaction, spouses/partners reported their physician partners frequently came home irritable, too tired to engage in home activities, or preoccupied with work. On multivariate analysis, minutes spent awake with their physician partners each day was the strongest predictor of relationship satisfaction, exhibiting a dose-response effect. No professional characteristic of the physician partners (eg, hours worked per week, specialty area, and practice setting) other than the number of nights on call per week correlated with relationship satisfaction on adjusted analysis.ConclusionThe spouses/partners of US physicians report generally high satisfaction with their relationships. The mean time spent with their physician partners each day appears to be a dominant factor associated with relationship satisfaction and overshadows any specific professional characteristic of the physicians' practice, including specialty area, practice setting, and work hours.     

Activities,participation and satisfaction one-year post stroke

Purpose. To evaluate the chronic consequences of stroke in terms of activity limitations, restricted participation and dissatisfaction from life, and the relationship between these variables, in stroke survivors living in the community one-year post onset.

Method. A total of 56 stroke patients (mean age: 57.7) who completed an in-patient rehabilitation programme, were evaluated one-year post onset in their homes, using the following instruments: Functional Independence Measure (FIM), Instrumental Activities of Daily Living Questionnaire (IADLq), Activity Card Sort (ACS), a work questionnaire, Life-Satisfaction Questionnaire (Li-Sat 9) and the Geriatric Depression Scale (GDS).

Results. One year post stroke onset the mean FIM motor score was 75.88 (max score: 91), yet more than 50% of the sample still required assistance (usually mild to moderate) in dressing, bathing and use of stairs. The majority of the sample required full assistance in some IADL domains, notably meal preparation (77%), housekeeping (70%) and laundry (82%). Only one subject returned to paid employment and the mean activity level (ACS), representing the percentage of leisure and IADL activities retained from before stroke, was 42.8%. Satisfaction ratings were generally low but varied between domains. Only 39% were satisfied from ‘life as a whole’. The lowest satisfaction rates were noted for ‘vocational situation’ (14%), ‘leisure situation’ (34%) and ‘ability in self-care’ (43%), whereas the satisfaction rate from family life was high (84%). Significant correlations were found between overall life satisfaction scores and the overall FIM motor, IADLq, and ACS scores (Pearson r values: 0.32, 0.48 and 0.57, respectively). Activity level was found to be a significant predictor of satisfaction (p = 0.007) beyond that accounted for by demographic variables and depression.

Conclusions. Stroke survivors dwelling in the community demonstrate long-standing dissatisfaction one-year post onset, correlating with activity limitation and restricted participation. The findings present a compelling need for rehabilitation services with a focus on participation in IADL and leisure activities, in order to improve the satisfaction of this population.     

Spouses' satisfaction with caregiver support in stroke rehabilitation

OBJECTIVE: To examine the satisfaction of spouses of stroke patients with the support given to them during clinical rehabilitation and to explore the relationships between satisfaction and characteristics of the support received. METHODS: Spouses of patients with a first-ever supratentorial stroke were included (n = 194). Satisfaction was measured on a 0-10 scale. Bivariate and multivariate relationships were studied between overall satisfaction score and characteristics of the support provided (number of full days of attendance, participation in caregiver group, discipline providing most support), the spouses (age, gender, family situation, education and employment) and the patients (activity of daily living (ADL) dependency (Functional Independence Measure), length of stay). RESULTS: The median satisfaction score was 7, and 44% of all spouses scored >or=8 (very satisfied) but 23% were dissatisfied. Spouses' and patients' characteristics and satisfaction scores were not associated. Of the support characteristics the number of full days of attendance (p = 0.02), participation in a caregiver group (p = 0.006) and support received from a team member (p = 0.000) were related to satisfaction. No differences in spouses' satisfaction scores were found between the participating rehabilitation centres. Only 39% of the spouses participated in a caregiver group. The most important reason for not participating in such a group was not being aware of the opportunity to take part in a group (49%). Spouses participating in a group showed more depressive symptoms and had a more severely disabled partner. Caregiver support was primarily given by the nurse and the social worker. One in five spouses indicated not to have been supported at all by the rehabilitation team. CONCLUSION: A large proportion of the caregivers were satisfied with the care they had received, although one in four was dissatisfied. Satisfaction was related to support characteristics.     

Factors associated with life satisfaction in Japanese stroke outpatients

PURPOSE: To measure life satisfaction in Japanese stroke outpatients and randomly-sampled community residents and to investigate variables influencing their life satisfaction. METHOD: Data on the demographic and clinical profiles, Satisfaction in Daily Life (SDL), other measurements, were obtained from 869 stroke outpatients (552 males, 317 females) and 748 community-dwelling elderly (360 males, 388 females), aged 55 years and older. Differences in categorical variables and continuous variables were tested by chi-square test and ANCOVA with age as the covariate, respectively. RESULTS: The 11 SDL items were subjected to a factor analysis, which extracted two factors. Factor 1 (F1), labeled as 'satisfaction with one's own abilities', included satisfaction with housework, self-care, gait, physical health, hobby and leisure, social intercourse and mental health. Factor 2 (F2), 'satisfaction with external factors', included satisfaction with partner/ family relationship, economic state and social security, and house facilities. Both F1 and F2 scores were significantly lower for stroke outpatients (M = 19.7 and 10.9, respectively) than for community-dwelling elderly (M = 28.2 and 12.0, respectively) (p < 0.001). Living conditions were significantly associated with F2, but not with F1. Males living alone scored lowest on F2 than the others for both groups. Among stroke outpatients, both F1 and F2 scores differed significantly by the type of hemiparesis and the severity of aphasia. CONCLUSIONS: SDL of stroke outpatients, which was lower than community-dwelling elderly, differed by the type of hemiparesis, the severity of aphasia, and living conditions. The effects of living conditions might vary with gender.     

Factors associated with life satisfaction in Japanese stroke outpatients

Purpose. To measure life satisfaction in Japanese stroke outpatients and randomly-sampled community residents and to investigate variables influencing their life satisfaction.

Method. Data on the demographic and clinical profiles, Satisfaction in Daily Life (SDL), other measurements, were obtained from 869 stroke outpatients (552 males, 317 females) and 748 community-dwelling elderly (360 males, 388 females), aged 55 years and older. Differences in categorical variables and continuous variables were tested by chi-square test and ANCOVA with age as the covariate, respectively.

Results. The 11 SDL items were subjected to a factor analysis, which extracted two factors. Factor 1 (F1), labeled as ‘satisfaction with one's own abilities’, included satisfaction with housework, self-care, gait, physical health, hobby and leisure, social intercourse and mental health. Factor 2 (F2), ‘satisfaction with external factors’, included satisfaction with partner/family relationship, economic state and social security, and house facilities. Both F1 and F2 scores were significantly lower for stroke outpatients (M = 19.7 and 10.9, respectively) than for community-dwelling elderly (M = 28.2 and 12.0, respectively) (p < 0.001). Living conditions were significantly associated with F2, but not with F1. Males living alone scored lowest on F2 than the others for both groups. Among stroke outpatients, both F1 and F2 scores differed significantly by the type of hemiparesis and the severity of aphasia.

Conclusions. SDL of stroke outpatients, which was lower than community-dwelling elderly, differed by the type of hemiparesis, the severity of aphasia, and living conditions. The effects of living conditions might vary with gender.     

Activities, participation and satisfaction one-year post stroke

Purpose. To evaluate the chronic consequences of stroke in terms of activity limitations, restricted participation and dissatisfaction from life, and the relationship between these variables, in stroke survivors living in the community one-year post onset.

Method. A total of 56 stroke patients (mean age: 57.7) who completed an in-patient rehabilitation programme, were evaluated one-year post onset in their homes, using the following instruments: Functional Independence Measure (FIM), Instrumental Activities of Daily Living Questionnaire (IADLq), Activity Card Sort (ACS), a work questionnaire, Life-Satisfaction Questionnaire (Li-Sat 9) and the Geriatric Depression Scale (GDS).

Results. One year post stroke onset the mean FIM motor score was 75.88 (max score: 91), yet more than 50% of the sample still required assistance (usually mild to moderate) in dressing, bathing and use of stairs. The majority of the sample required full assistance in some IADL domains, notably meal preparation (77%), housekeeping (70%) and laundry (82%). Only one subject returned to paid employment and the mean activity level (ACS), representing the percentage of leisure and IADL activities retained from before stroke, was 42.8%. Satisfaction ratings were generally low but varied between domains. Only 39% were satisfied from 'life as a whole'. The lowest satisfaction rates were noted for 'vocational situation' (14%), 'leisure situation' (34%) and 'ability in self-care' (43%), whereas the satisfaction rate from family life was high (84%). Significant correlations were found between overall life satisfaction scores and the overall FIM motor, IADLq, and ACS scores (Pearson r values: 0.32, 0.48 and 0.57, respectively). Activity level was found to be a significant predictor of satisfaction (p = 0.007) beyond that accounted for by demographic variables and depression.

Conclusions. Stroke survivors dwelling in the community demonstrate long-standing dissatisfaction one-year post onset, correlating with activity limitation and restricted participation. The findings present a compelling need for rehabilitation services with a focus on participation in IADL and leisure activities, in order to improve the satisfaction of this population.     

Life satisfaction and self-reported impairments in persons with late effects of polio

ObjectiveDecades after an acute poliomyelitis infection many persons experience new symptoms or impairments which may affect their life satisfaction. The objective of this study was to investigate the association between life satisfaction and self-reported impairments in persons with late effects of polio.Material and methodsOne hundred and sixty-nine persons (104 women and 65 men) with prior polio responded on admission to rehabilitation to the Life Satisfaction Questionnaire (LiSat-11) assessing satisfaction with life as a whole and 10 domains of life satisfaction and to a 13-item questionnaire assessing self-reported impairments related to late effects of polio.ResultsA majority was to some degree satisfied with life as a whole and with all 10 domains of life satisfaction in LiSat-11, but less than 20% was very satisfied or satisfied with their somatic health. Muscle fatigue, muscle weakness, general fatigue, muscle and/or joint pain during physical activity and cold intolerance were the most frequently reported impairments. Overall, those who rated themselves as not satisfied (according to LiSat-11) reported significantly higher degrees of impairment than those who were satisfied. The relationships between the items of life satisfaction in LiSat-11 and the items in the self-report questionnaire varied from ?0.01 to ?0.64.ConclusionSatisfaction with life as a whole, and different domains of life satisfaction are low to moderately associated with self-reported impairments. This implies that rehabilitation interventions must address not only self-reported impairments but also activity limitations and participation restrictions in order to enhance life satisfaction in people with late effects of polio.     

Daily occupations and well-being in women with limited cutaneous systemic sclerosis.

OBJECTIVE: This study investigated occupational performance, well-being (operationalized as general life satisfaction, domain-specific life satisfaction, and self-rated health), and perceived symptoms in women with limited scleroderma and healthy controls. METHODS: Interview-based and self-administered questionnaires were used with 36 women with limited scleroderma and 40 healthy women. RESULTS: In the scleroderma group, most of occupation problems were perceived in work and household chores. The women with scleroderma were mainly satisfied with self-care and least satisfied with household chores. Regarding domain-specific life satisfaction, the women were least satisfied with physical health and leisure. General life satisfaction showed the strongest relations to performance of self-defined occupations and satisfaction with leisure, whereas the strongest association with self-rated health was found for satisfaction with work. Fatigue was perceived as a dominant problem and was significantly associated with well-being. Furthermore, the women with scleroderma felt lower satisfaction with daily occupations and well-being than the healthy women. CONCLUSION: Loss of occupations, low satisfaction with leisure, perceived fatigue, shortness of breath, and pain indicated poorer well-being in women with scleroderma and need to be focused on in occupational therapy interventions.     

Predictors of Life Satisfaction in Stroke Survivors and Spousal Caregivers After Inpatient Rehabilitation

A global measure of life satisfaction has become increasingly important as an adjunctive outcome of healthcare interventions for people with disabilities, including those caused by stroke. Life satisfaction of stroke survivors may affect caregiving spouses, as well. The purpose of this study was to identify, among many physical and psychosocial variables, specific variables that were associated with life satisfaction at 12 months after discharge from inpatient rehabilitation, and variables that were predictive of life satisfaction 1 year later (at 24 months). Between 12 and 24 months, life satisfaction decreased for stroke survivors, while it increased for caregiving spouses. The relationship between the couple (mutuality) was the only variable that was a significant predictor of life satisfaction for both stroke survivors and their spouses.     

Partner influences on smoking cessation: A longitudinal study of couple relationships

Introduction: Despite declines in population tobacco use, smoking remains unacceptably high. Smoking cessation may be particularly difficult in couple relationships when partners continue to smoke, and when relationship satisfaction is low. This study examined the longitudinal influence of partner tobacco use and relationship satisfaction on the likelihood of smoking cessation. Methods: Data were obtained from 238 tobacco-using couples aged between 18 and 45 over three assessments from a nationally representative sample of Australian households. Results: There was high concordance between partner smoking six years after the initial assessment, with a little more than three-quarters (76.1%) of non-smokers residing with partners who had also ceased smoking. Step-wise logistic regression models indicated that females were more likely to cease smoking if their partners had previously quit. Males were more likely to quit smoking when they perceived their relationship as highly satisfying and their partner had stopped smoking. Female partners were also more likely to quit smoking when they were highly satisfied with their relationships. Conclusions: Both partner’s smoking status and relationship satisfaction are important considerations in smoking-related cessation. For entrenched smokers in couple relationships, involvement of partners in interventions may be useful.     

Satisfaction with quality of life poststroke: effect of sex differences in pain response

OBJECTIVE: To study the relationship between sex differences among men and women in the response to pain and the effect on satisfaction with quality of life (QOL) in poststroke patients approximately 90 days after discharge from inpatient medical rehabilitation. DESIGN: Cross-sectional design. SETTING: Community based. PARTICIPANTS: The sample included 1724 patients (877 men, 847 women) aged 40 years and older with a history of stroke, according to information obtained from the IT HealthTrack database. The average age was 68.7 years; 79.3% were non-Hispanic white. INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURE: Satisfaction with QOL. RESULTS: Pain ratings for both the men and the women were significant and inversely associated with satisfaction with QOL after adjustments for possible confounding factors. However, among men with stroke, each 1-point increase in pain rating was associated with an 18% decreased odds of being satisfied with QOL (odds ratio [OR], .81; 95% confidence interval [CI], .77-.86). Conversely, among women with stroke, each 1-point increase in pain rating was associated with an 11% decreased odds of being satisfied with QOL (OR=.89; 95% CI, .84-.95). CONCLUSIONS: Our data indicate that pain after stroke is significantly associated with reduced satisfaction with QOL, particularly among men. Increased awareness and treatment of pain may improve satisfaction with QOL. Our findings suggest that sex differences and pain response are clinically important factors in examining satisfaction with QOL in the poststroke population.     

Long-term outcome in children of patients after stroke.

OBJECTIVE: To investigate the long-term effects on children of parental stroke, with respect to care-giving tasks, children's behavioural problems and stress, and to study the relationship between stress and child, patient and partner characteristics. SUBJECTS: A total of 44 children (age range 10-21 years) were assessed 3 years after parental stroke. MAIN MEASURES: Behavioural problems were assessed with the Child Behaviour Check List and the Youth Self-Report. Stress was measured using the Dutch Stress Questionnaire for Children. RESULTS: Most children (66%) assisted their parent in self-care or mobility. Some of the children (31%) experienced behavioural problems. The results showed that 37.5% of younger children show externalizing problems on the Child Behaviour Check List. Stress was significantly related to female gender of the child, and to depression, limitations in extended activities of daily living and life satisfaction of the patient. CONCLUSION: Most children do well 3 years after parental stroke. However, some children of patients after stroke have behavioural problems and need attention in clinical practice.     

Participation in People Living With Spinal Cord Injury in Switzerland: Degree and Associated Factors

ObjectiveTo describe different domains of participation such as productive, leisure and social activities and describe sociodemographic and spinal cord injury (SCI)-related characteristics that are associated with participation in these domains in a large sample of community-dwelling individuals with SCI in Switzerland.DesignCross-sectional population-based survey within the Swiss Spinal Cord Injury Cohort Study. Participation in major life domains was measured by the Utrecht Scale for Evaluation of Rehabilitation-Participation (USER-Participation). Univariable unconditional analysis and unbiased recursive partitioning were used to identify the predominant associations of sociodemographic and SCI-related characteristics with multiple dimensions of participation.SettingCommunity.ParticipantsSwiss residents aged 16 years or older and living with traumatic or nontraumatic SCI (N=1549).InterventionsNot applicable.Main Outcome MeasureThe USER-Participation, a 32-item self-report questionnaire with 3 scales (Frequency, Restrictions, and Satisfaction) to assess key domains of participation (productive, leisure, social).ResultsFrequency (median 34.5 out of 100) in productive, outdoor leisure, and social activities was reduced with distinctive perceived restrictions in work and education, sports, and partner relationships. Domestic leisure activities (65.4%) and maintaining social relationships (76.1%) were those activities most often performed and with least perceived restrictions. Participants were generally satisfied with their current daily life activities. Lower scores across all participation scales were associated with more severe SCI, higher age, being female, not having a partner, and lower level of education.ConclusionsThis study provides a thorough analysis of participation in major life domains of individuals with SCI in Switzerland. Different risk groups for reduced levels in participation in productive, leisure, and social activities were identified. This population-based evidence is instrumental to the better targeting of rehabilitation and policy interventions that aim to improve community participation.     

Satisfacción vital y factores sociodemográficos en mujeres de mediana edad

ObjectiveTo assess life satisfaction and related factors in middle-aged Spanish women.MethodThis was a cross-sectional study including 235 women aged 40 to 65, living in Granada (Spain), healthy companions of patients visiting the obstetrics and gynecology clinics. They completed the Diener Satisfaction with Life Scale, the Menopause Rating Scale, the Perceived Stress Scale, the Insomnia Severity Index and a sociodemographic questionnaire containing personal and partner data. Internal consistency of each tool was also calculated.ResultsAlmost two-thirds (61.3%) of the women were postmenopausal, and 43.8% had abdominal obesity, 36.6% had insomnia, 18.7% had poor menopause-related quality of life, 31.9% performed regular exercise, and 5.1% had severe financial problems. Life satisfaction showed significant positive correlations (Spearman's test) with female and male age, and inverse correlations with menopause-related quality of life, perceived stress and insomnia. In the multiple linear regression analysis, high life satisfaction is positively correlated with having a partner who performed exercise, and inversely with having work problems, perceived stress and the suspicion of partner infidelity. These factors explained 40% of the variance of the multiple regression analysis for life satisfaction in middle-aged women.ConclusionLife satisfaction is a construct related to perceived stress, work problems, and having a partner, while aspects of menopause and general health had no significant influence.     

Relationship between occupation and life satisfaction in people with multiple sclerosis

Activity is essential for all human beings, and provides a means through which human beings develop, gain recognition, and fulfil life's goals. The focus for this study was on activities performed by people with a chronic disease and their effects on experienced life satisfaction. Thirty subjects with multiple sclerosis (MS) were interviewed with regard to activities of daily living (ADL), and checklists were used for activity preferences and levels of satisfaction with life as a whole and with nine domain-specific forms of life satisfaction. The results of the study reveal 14 of the subjects to be satisfied and 16 to be dissatisfied. The main differences between the two groups were that the satisfied were less tired, and that they were more independent in self-care. Those in the satisfied group reported being more satisfied with leisure situation (57%, cf. 25% in the dissatisfied group) and housekeeping ability (36%, cf. 6% in the dissatisfied group). Leisure and housekeeping appear to have an impact on subjects' experienced satisfaction, and are factors to be taken into consideration by occupational therapists when treating MS patients.     

Life satisfaction, illness behaviour, and rehabilitation outcome: results of a one year follow-up study with cardiac patients

One year after an inpatient cardiac rehabilitation programme, 83 out of 105 male cardiac patients were subjected to a follow-up study. Data collection comprised the Life Satisfaction Questionnaire, the Freiburg Personality Inventory, the Freiburg Somatic Complaint List, an adjective list for current mood, and a follow-up questionnaire assessing life habits, health and work status. One year after discharge, reported life satisfaction is lower than at the end of the treatment, with the exception of the areas health and leisure time. Physical complaints and emotional liability increased as well. On the other hand, patients' ratings of the success of the rehabilitation programme remain unchanged, with positive evaluations on completion of treatment as well as at follow-up one year later. At the start of rehabilitation, patients were divided into two groups with high or low life satisfaction according to their questionnaire scores. Various medical variables showed no differences between these groups. However, at follow-up, 90% of the patients with high life satisfaction and only 66% of those with low satisfaction were back at work. Resumption of work, although depending on the physician's rating, is influenced to a high degree by non-medical factors. These diverse factors are discussed in connection with patients' illness behaviour.