Psychosocial readjustment in the families of stroke patients.

The study set out to investigate readjustment to disability on the part of spouses of stroke patients, and to elicit the particular problems faced by the spouse of an aphasic patient. Seventy-nine stroke patients and their spouses were selected, from rehabilitation records for assessment. They were classified firstly according to the patient's disability: Aphasia without hemiplegia; Aphasia with hemiplegia; Hemiplegia without aphasia. The groups were found to be closely comparable on demographic variables such as age, sex and social class. Subsequently they were reclassified by laterality of lesion. The assessments of the spouse included ratings of their personality, social adjustment, psychiatric health attitude towards, the patient and the disability, and help and coimatmication patterns. Spouses of aphasic patients showed evidence of significantly poorer overall social adjustment than spouses of non-aphasic patients. The areas that were particularly impaired were social and leisure activities, and marital relationships. Although the areas of work, parental-relationship, and relationship with the extended family were relatively less impaired, they were also frequently, problematic. In the marital area, aphasia appeared to be particularly disruptive, but marriages of all stroke patients were characterised by poor comnunication, diminished sexual satisfaction and loss of partnership. Social isolation also affected all spouses, but more especially the spouses of aphasic patients. There was a raised incidence of apparent neurotic disturbance in all spouses and again this was more pronounced amongst the spouses of aphasic patients. Overprotective and unrealistic attitudes were a more common response than rejection or retributive guilt feelings. It is suggested that the emotional reactions of the patient to his disability differentially affect the interpersonal relations and adjustment of the spouse: the laterality of the lesion presenting differing emotional reactions to disability