Exploring Spousal Relationships Post-Stroke and the Association Between Relationship Congruence and Dysphagia-Related Caregiver Burden

Abstract

Stroke survivors often receive spousal support for post-stroke impairments. The quality of spousal caregiving and couples’ wellbeing can suffer from post-stroke relationship changes and caregiver burden. Because swallowing impairment (dysphagia) is common post-stroke and spouses providing dysphagia care may experience burden, it is also important to explore whether relationship changes post-stroke are associated with dysphagia outcomes. The purpose of this study was to describe stroke survivor-spouse relationships post-stroke and explore whether relationship congruence is associated with dysphagia-related caregiver burden or swallowing-related quality of life (SWAL-QoL). Twenty-nine survivor-spouse couples completed a relationship questionnaire with 13 Likert scale questions (15 for spouses), analyzed for frequency of agreement and disagreement, and 2 open-ended questions regarding relationship strengths and possible improvements, analyzed thematically. Correlations were analyzed between relationship congruence (the absolute magnitude of difference between total scores of corresponding couples) and dysphagia-related caregiver burden score and SWAL-QoL using Spearman’s correlations. The majority (≥70%) of survivors and spouses responded positively to questions regarding closeness, care/affection, and communication in their relationship. Similarly, affection (41% survivors, 31% spouses) and communication (14% survivors, 17% spouses) were the first and second most described relationship strengths; spouses also identified honesty as the third most common strength (14%). Many participants were unsure of how the relationship could be improved (34% survivors, 31% spouses). Relationship congruence was not significantly correlated with dysphagia-related caregiver burden (rs = -0.273, p = 0.076) or SWAL-QoL (rs = -0.133, p = 0.246). Future research should assess how dysphagia affects relationships. This could provide further nuance regarding the association between spousal relationships and dysphagia outcomes and potentially inform future interventions.