Factors Related to the Quality and Stability of Partner Relationships After Stroke: A Systematic Literature Review.

OBJECTIVE: To provide an overview of the current state of knowledge on factors related to relationship quality and relationship stability after stroke. DATA SOURCES: Cumulative Index to Nursing and Allied Health (CINAHL), Embase, MEDLINE, Psychology and Behavioral Sciences Collection, APA PsycINFO, and PubMed were searched on November 15, 2022, for literature on factors associated with (1) relation quality and (2) relation stability after stroke. STUDY SELECTION: English quantitative and qualitative studies investigating factors associated with relation quality and/or stability after stroke were included. Three reviewers independently assessed eligibility. Consensus meetings were held in case of divergent opinions. A total of 44 studies were included. DATA EXTRACTION: Information regarding study objectives and characteristics, participant demographics, independent and dependent variables, and main findings was extracted. Study quality was rated using the Joanna Briggs Institute Checklist for Analytical Cross-Sectional Studies and/or the Critical Appraisal Skills Programme Checklist for Qualitative Research. Both were administered by the lead reviewer and checked by the second reviewer. Identified factors are described and presented according to the domains of the International Classification of Functioning, Disability, and Health model. DATA SYNTHESIS: Thirty-seven factors related to relationship quality after stroke were identified, covering the domains of body functions and structures (eg, cognitive problems), activities (eg, decrease in physical intimacy), participation (eg, being socially active), environment (eg, medication side effects), and personal factors (eg, hypervigilance). Eight factors related to relationship stability were identified, covering the domains of participation (agreement on reciprocal roles) and personal factors (eg, quality of prestroke relation). CONCLUSIONS: Relationship quality and stability after stroke are related to a multitude of factors. Future research should confirm the relevance of factors found in a few studies of suboptimal quality; explore possible associations between relationship stability and factors falling in the domains of body functions and structure, activity, and environmental factors; and explicitly explore potential positive effects of stroke on relationships.

Factors Related to the Quality and Stability of Partner Relationships After Traumatic Brain Injury: A Systematic Literature Review.

OBJECTIVE: The latest literature review on partner relationships after traumatic brain injury (TBI), conducted a decade ago, discussed solely quantitative work and noted significant knowledge gaps. The current review updates and expands on this work by providing an overview of the current state of knowledge on factors related to relationship quality and stability after TBI. DATA SOURCES: Cumulative Index to Nursing and Allied Health, Embase, MEDLINE, Psychology and Behavioral Sciences Collection, APA PsycINFO, and PubMed were searched on April 23, 2020, for literature on factors associated with (1) relationship quality; and (2) relationship stability after TBI. STUDY SELECTION: English quantitative and qualitative studies investigating factors associated with relationship quality and/or stability after TBI were included. Two reviewers independently assessed eligibility. If consensus was not reached, a third reviewer's conclusion was decisive. Forty-three studies were included. DATA EXTRACTION: Information regarding study objectives and characteristics, participant demographics, independent and dependent variables, and main findings was extracted. Study quality was rated using the JBI Checklist for Analytical Cross-Sectional Studies and/or the CASP Checklist for Qualitative Research. Both were performed by the lead reviewer and checked by the second reviewer. DATA SYNTHESIS: Thirty-eight factors related to relationship quality and/or stability were identified, covering injury characteristics (eg, severity), body functions (eg, personality changes), activities (eg, communication), participation (eg, social dependence), environment (eg, children), and personal factors (eg, coping strategies). CONCLUSIONS: Relationship quality and stability after TBI are related to a multitude of factors, including newly identified factors such as personality changes and dependence. Future research may wish to quantitatively investigate factors thus far only identified in qualitative research, explore possible positive effects of TBI on relationships, study the experiences of same-sex couples, and include the perspectives of both partners with and without the injury.

Exploring Perceived Interactions Between Consequences of Traumatic Brain Injury.

OBJECTIVE: To explore the perceived interactions between consequences of traumatic brain injury (TBI). PARTICIPANTS: Fifteen clinicians experienced in working with patients with TBI. METHODS: Participating clinicians completed an online questionnaire in which they estimated the degree to which consequences of TBI (taken from the Brief ICF Core Set for Traumatic Brain Injury) causally relate to each other. Based on these perceived interactions, a visual network was constructed and centrality measures for this network were computed. RESULTS: The resulting network demonstrates various strong perceived causal relations between the consequences of TBI. Impairments in consciousness were perceived to most strongly cause other TBI consequences in the network. Difficulties with acquiring, keeping, and terminating a job were perceived to be most strongly caused by other TBI consequences. Difficulties in partaking in complex interpersonal interactions were also perceived to play a central role in the network. CONCLUSION: In the perception of clinicians, consequences of TBI interact with each other and are thus not solely a direct result of the injury. While more research is needed to map the interactions between consequences of TBI, our results could have important implications for the way we understand and treat the problems patients are faced with after TBI.

Exploring social cognition in individuals with neuropsychiatric symptoms following acquired brain injury.

In this study, we explored the social cognitive skills of individuals with neuropsychiatric symptoms following acquired brain injury (ABI). To this end, a retrospective chart review was carried out. We examined scores on social cognition tests that were administered as part of routine neuropsychological assessment at a Dutch specialized care facility for patients with neuropsychiatric symptoms following ABI. In addition, correlations with time post injury were explored. Aspects of social cognition (emotion recognition, Theory of Mind (ToM) and empathy) were measured using the Emotion Recognition Task (n = 40), the Ekman 60-Faces Test of the Facial Expression of Emotion: Stimuli and Tests (n = 11) and the Faux Pas Test (n = 36). 72.5% to 81.8% of participants scored very low or low on emotion recognition. Participants' scores for ToM and empathy were lower than those reported recently for samples of Dutch stroke and traumatic brain injury patients. Correlations between social cognition scores and time since injury were non-significant or negative. While further research is necessary, our results indicate that social cognitive problems are prevalent and persistent in individuals who display neuropsychiatric symptoms after ABI. Future studies should employ a prospective approach in order to confirm our exploratory findings.

Comment on Laratta et al. Marital Stability and Quality of Couple Relationships after Acquired Brain Injury: A Two-Year Follow-Up Clinical Study. Healthcare 2021, 9, 283.

We read with great interest the recent article by Laratta et al. [...].