Exploring discrepant views of the quality of life of stroke survivors: a means of investigating adjustment to stroke
Objectives: Reviews have suggested that stroke patients and family members frequently hold different impressions of the patient’s quality of life. Understanding such differences may be particularly useful for clinicians who wish to help clients adjust to the effects of a stroke. The aim of this study was to investigate how the responses of stroke survivors and their family members differ when indicating the stroke survivors’ quality of life, and whether such differences are associated with greater time elapsed since the stroke onset. Design and Method: A related-subject design and a correlational design were utilised in this study. People who had suffered a stroke within five years were compared with nominated members of their family. All participants indicated the perceived quality of life of the stroke survivor using the WHOQOL-BREF. The time elapsed since their stroke was recorded and the participants’ mood was assessed. Results: No significant differences were found between the stroke survivors and the family members’ views of the stroke survivors’ quality of life. However, agreement between these groups was found to be low in the Social domain of the WHOQOLBREF. Greater time since the stroke onset was found to correlate with greater discrepancy between groups in the Social domain, but not in the other domains. Conclusions: The results suggest that families’ adjustment to stroke does not conclude when improvement in function slows. Instead, a stroke continues to affect families years after the initial stroke. These findings may be interpreted within the context of quality of life response shift, where changes in the stroke survivors’ evaluation of their social lives may not be identified by their families. This may reflect a common trajectory following stroke. The methodological limitations of this study and suggestions for future research are discussed.