Psychosocial adjustment following a stroke.

A stroke can be a serious and debilitating health problem. The present study examined the effect of the severity of the stroke, patients' cognitive adaptation to their situation, the relationship with the caregiver and caregivers' adaptation on patient depression and motivation in outpatient therapy. Forty poststroke patients and their primary caregivers (usually a spouse) were interviewed an average of 9 months poststroke. Three independent predictors of depression were identified: a lack of meaningfulness in life, overprotection by the caregiver, and a less recent stroke. Motivation was independently related to less overprotection and lower perceptions of control over recovery. It was found that psychosocial factors predicted depression and motivation even when the effects of severity and site of the stroke were controlled for. The implications of cognitive adaptation and social support ideas for coping with a stroke are discussed.