Dyadic analysis of illness perceptions among individuals with stroke and their caregivers: effects on activity engagement in community living.

ABSTRACT

PURPOSE: To explore the relationship between activity engagement and dyadic illness perceptions of community-dwelling individuals with stroke and their caregivers. METHODS: We performed a secondary analysis on a cross-sectional study encompassing eight rehabilitation settings. Participants were recruited from June to December 2019 via the distribution of flyers, use of admission databases, and direct onsite interactions. Activity engagement of individuals with stroke was measured by the Assessment of Life Habits. Dyadic illness perceptions were measured using the Stroke-Specific Illness Perceptions Questionnaire-Revised. RESULTS: Data from 202 dyads of individuals with stroke (mean age 61.3 ± 8.3 years; 76.7% male; stroke duration 314.3 ± 170.5 days), and caregivers (mean age 52.6 ± 11.6 years; 73.3% female) were analyzed. Results show that individuals with stroke who shared similar optimistic illness perceptions with their caregivers concerning the consequences of stroke had a higher level of activity engagement (ΔR2 = .020, F(2,193) = 5.42, p = .005). Gender differences were found in the dyadic illness perception components concerning acute/chronic and cyclical timeline (ΔR2 = .017, F(2,191) = 4.72, p = .01; ΔR2 = .02, F(2,190) = 3.45, p = .034) and illness coherence (ΔR2 = .012, F(2,191) = 3.42, p = .035). CONCLUSIONS: Illness perceptions and post-stroke activity engagement with gender differences should be considered at a dyadic level, as the individuals with stroke and their caregivers influence each other's beliefs.

Implications for rehabilitationActivity engagement in individuals with stroke is related to how their individual­caregiver dyads perceive their health condition.Clinicians should provide opportunities for individuals with stroke and caregivers to better understand the nature of stroke, and to develop positive outlooks for the future. This information includes, but is not limited to, the relevant sequelae, stroke development and prognosis, treatment and rehabilitation protocols, and the potential impact on daily living.Depending on their genders, individuals with stroke may require different approaches to facilitate community-dwelling activity engagement. Future research is needed to determine the effect of dyadic illness perceptions on post-stroke activity engagement among individuals of different genders.