The interplay of disability, depression, social support, and quality of life in middle-aged and young couples affected by stroke : a dyadic path analysis using the actor-partner interdependence mediation model

Abstract

Objective: The purpose of this study was to explore the impact of disability on dyadic quality of life (QoL) among stroke survivors and to examine the mediating role of social support in this process. Methods: Outcome measures were collected at four time points: baseline, 1 month, 3 months, and 6 months post-discharge. The Actor–Partner Interdependence Mediation Model was used to analyze the dyadic data. Results: A significant association was observed between a higher degree of disability and more severe depressive symptoms in stroke survivors (β = 0.626) and their spouses (β = 0.426). Survivors’ disability had a negative impact on their own physical health (β = −3.731) and indirectly affected the physical health of the spouse caregiver through the spouse caregiver’s depression (β = −0.198). In addition, disability affects the survivor’s own mental health through depression and social support (β = −0.231) and indirectly through the spouse caregiver’s depression and their own social support (β = −0.156). Conclusions: Survivor disability has a major impact on depression and QoL in couples with stroke. It is recommended that healthcare providers should identify disability early in stroke survivors and then target interventions to improve the QoL of couples affected by stroke who are at high risk of negative emotions.