The longitudinal ramifications of stroke caregiving: a systematic review.

Family members assume considerable care responsibilities for relatives suffering from stroke. Although a number of quantitative and qualitative studies examine the emotional and psychological ramifications of stroke caregiving, no recent review has considered the longitudinal implications of family stroke care. The goal of this systematic review was to determine whether duration of family care is a significant predictor of stroke caregiving outcomes and if stroke caregiving outcomes change over time. PsycINFO (1950 to 2009), MEDLINE (1966 to 2009), and CINAHL (1982 to 2009) databases were searched to identify relevant research articles. Reference lists of selected articles were also hand searched. Of 1,188 studies identified, 117 were selected for review based on eligibility criteria. Synthesized results found that duration of care did not emerge as a significant predictor of stroke caregiving outcomes in most cross-sectional quantitative studies. Caregiver stress, depression, and subjective health measures did not tend to demonstrate significant change in longitudinal quantitative studies (although some studies did indicate increases and/or decreases in well-being over time). Qualitative studies describe a more dynamic stroke caregiving process. The results of this review emphasize the need to apply more rigorous research approaches, appropriate theories, and mixed-method designs to advance the state-of-the-art. Such improvements will provide practitioners with stronger evidence to guide the development, targeting, and timing of clinical interventions.