Hope, health work and quality of life in families of stroke survivors

Abstract

Aim: This paper reports a study to examine the relationships among hope, family health promotion, and quality of life after stroke, by testing hypotheses derived from the Developmental Model of Health and Nursing.

Background: Little attention has been given to the influences of family strengths on health promotion behaviours and quality of life after stroke. The majority of studies have focused on stroke survivors, not their spouses.

Method: A descriptive, correlational study was carried out with 40 families of stroke survivors with moderate to severe functional impairments and their spouses. Both partners completed the Herth Hope Index (measure of hope), the Health Options Scale (measure of health work), the Reintegration to Normal Living Index (measure of quality of life) and a demographic questionnaire.

Results: For both partners, moderate, positive relationships were found between hope and health work (r = 0.52, r = 0.39, P < 0.01) and between hope and quality of life (r = 0.59, r = 0.32, P < 0.05). Family health work was positively associated with quality of life of stroke survivors (r = 0.50, P </= 0.001), but not their spouses. Spouses' employment status, number of supports and functional independence at discharge predicted 40.6% and 46.3% of the variance in quality of life for stroke survivors and spouses, respectively, with the combination of hope and health work contributing an additional 17.8% in predicting stroke survivors' quality of life but no additional variance to the prediction of spouses' quality of life.

Conclusion: Theoretical relationships of the Developmental Model of Health and Nursing were supported for stroke survivors, but the model was less useful in explaining spouses' experiences of hope, health work and quality of life. Findings provide direction for identifying 'at risk' families and raise awareness of the contribution of caregiver burden to quality of life in families of stroke survivors.