Improving Engagement and Fostering Resilience in Couples

Post-Stroke: A Qualitative Analysis

Miranda Anderson, BS1, Artemis Sefandonakis, BS2, Anna Houston, BS1, Vanessa Russell, BS1, Jackie Einerson, MOT, OTR/L1, Alexandra L. Terrill, PhD1
1Department of Occupational & Recreational Therapies, University of Utah, Salt Lake City; 2College of Applied Sciences, University of Illinois, Chicago

Introduction Design
Figure 1. Resilience Model
• Stroke is the leading cause of long-term disability in Cross-sectional, descriptive mixed-methods data were
the U.S. and greatly impacts the survivor and their collected on couples coping with stroke as part of a behavioral
partner’s ability to participate in desired occupations. intervention pilot study. See Table 1 for demographic
• To enhance participation and promote resilience for information.
couples coping with stroke, we created a dyadic
Methods
intervention using positive psychology activities
including expressing gratitude, practicing acts of • Intervention: Couples were trained in positive psychology
kindness, fostering relationships, focusing on the activities, which they implemented at home for 8-weeks
positive, savoring, working toward a goal, and individually and as a couple.
spirituality.
• We developed a model that incorporates the • Measures: In addition to quantitative measures, qualitative
International Classification of Functioning, Disability, data were collected through semi-structured post-
and Health that examines the dynamics between the intervention feedback interviews. The interviews were
factors shown in Figure 1. transcribed and coded to determine how factors from our
resilience model interacted with the couple’s overall quality
Objective of life and well-being.
• To examine interview data from couples who
participated in the intervention for co-occurring factors Survivor Carepartner
Table 1. Participant Characteristics
represented in our resilience model. (n=32) (n=32)
Women (n, %) 12 (38) 20 (62)
Age, mean years (SD) 53.6 (16.3) 53.1 (14.6)
Interpersonal, Disability, Well-being, Resilience (Terrill, MacKenzie, Einerson, & Reblin, 2019)
Relationship length, mean years (range) 25 (3-65)
"We’ve had conversations over the last couple of months that we’ve
never had before. And I think [partner’s] stroke was really challenging Disability
Stroke Characteristics
for us and kind of scary and we actually talked a lot about that “Right after the stroke, I don’t Time since stroke, mean years (range) 2.6 (0.3–8)
experience too, which we hadn’t talked about in the past... we didn’t know whether everybody will feel
have as deep conversations, so that was really important in my life. this, but you feel worthless. You Results
And I don’t think it would have happened without this, so that was don’t do anything that contributes Intrapersonal
The transcribed interviews included examples of all factors
really great." to anybody and you’re more of a "...Caring is really a big thing
from the model, and frequently contained descriptions of
drag or a drag down for everybody, to me. People think that to
engaging in intervention activities. Common patterns of co-
than anything else." care you have to do this
occurring factors were identified and aligned within the model;
monumental task. Actually,
Well-being, Resilience, Social for example, the process of resilience (e.g., becoming more
all that you have to do is
"...we’re not taking things quite as seriously mindful about an activity) often co-occurred with an
show that you cared
that don’t need to be taken quite as seriously outcome/quality of life (e.g., feeling calmer).
whether the person is okay,
as we have in the past... it’s made a big
[or] not okay."
difference in both how we move through both
our days. Me at work and [partner] at home." Conclusion
Well-being The qualitative data largely supported our model. Disability,
"It helped me try to be nice to other due to stroke, does not need to have a negative impact on
people, practice acts of kindness. That one’s quality of life or the activities they participate in. By
was easier than what I thought it increasing resilience, couples may be able to maintain positive
Stroke
Carepartner would be." outlooks, find meaning in activities, and build supportive
survivor relationships. These factors can enhance quality of life and
promote occupational engagement.
Acknowledgement of financial support: NIH NCMRR #1R03HD091432-01 Utah StrokeNet Research Training & Career Development
Program (NIH NINDS #5U10NS086606-03) & University of Utah Consortium for Families & Health Research (C-FAHR)
Contact email: alex.terrill@hsc.utah.edu Phone: (801) 581-5951