Adaptation process, participation and depression over six months in first-stroke individuals and spouses

Objective: To describe changes in the adaptation process (appraisal and coping) in the six months after a first stroke and identify domains of the adaptation process related to participation and depressive symptoms for both affected individuals and spouses. Design: A short-longitudinal study where data of the two groups were collected at three times: in the first two weeks post stroke (T1), at three months (T2) and six months F3) post stroke. Subjects: Individuals with a first stroke and spouses. Main measures: The Stress Appraisal Measure (SAM) for appraisal, Revised Ways of Coping Questionnaire (RWCQ) for coping strategies, Assessment of Life Habits (LIFE-H) for participation, and Beck Depression Inventory (BDI) for depressive symptoms. Results: Mean (SD) ages of the stroke group (n = 88) and spouse group (n = 47) were 71.8 (10.8) and 69.2 (11.2) years respectively. The Threat, Challenge and Stressfulness scales of the SAM decreased significantly (P < 0.02) from T1 to T3 in both groups whereas perceived uncontrollability of the situation increased significantly (P = 0.003) for spouses in the first six months. RWCQ Rationalisation and Giving control to others scales decreased in the stroke group (P = 0.008 and 0.002 respectively) but not in the spouse group (P = 0.07 and 0.39 respectively). Several components of adaptation at T1 could explain between 18% and 27% of the variance observed in the LIFE-H and BDI at T3. Conclusion: Appraisal and coping strategies change over time. Initial adaptation could partially predict participation level and depressive symptoms six months post stroke for affected individuals as well as spouses.