Role of Family and social support in stroke recovery process

Being the third leading cause of death in the United States, stroke is a significant source of disability. Therefore, stroke prevention, treatment as well as rehabilitation of stroke patients are critical public health concerns. Family involvement becomes even more important when the patient is cared for at home after dismissal from the acute facility. Family members should provide encouragement, show confidence in improvement and permit the recovering person to do as much as he or she can and to be as independent and vigorous as possible. It is indeed very important that the patient not become overly discouraged by failures. Patients need to be reassured that they are wanted and needed and that they are still important to the family and part of the social picture. Social support is an extremely important aspect of general well being, to illness course and rehabilitation. And in case of stroke patients, social support is believed to directly affect the quality of illness outcome in relation to physical and psychosocial deterioration and major depression.

It is evident that family members in a supportive family play important role in providing with social support, emotional encouragement as well as compliance with treatment protocol, which is indeed very important and has a positive impact on the course of illness in stroke patients.

Despite the evidence of positive role of social support in stroke recovery process three major drawbacks remain evident in this context. First the outcome measures refer to functional condition only, secondly no study has provided with an answer to which of the behavioral patterns of the

family members plays important role in the rehabilitation process. And finally, the initial severity of the stroke and the functional condition during the time of discharge have so far been rarely investigated against the factor of family social support.

In July 2000, Hadjis et al, examined the impact of family social support on the rehabilitation process in terms of functional status, depression as well as social status changes of a sample of first stroke survivors. The study involved 1042 patients suffering from first stroke over a 5 year period who were initially admitted to the hospital and classified according to cause and mechanism of stroke. Under the study,, stroke severity was assessed by a Physician on admission,, functional capacity was measured, depression and social status were assessed. Patient's rehabilitation variables were assessed in the hospital before discharge and also at 1,3 and 6 months from stroke onset at patients households.

Despite some study limitations, such as small sample size, selection of all patients by the same facility, the study concludes that the amount of family social support can considerably predict the well being of stroke patients , though further research should be carried on this.

In conclusion, it is highly recommended that stroke rehabilitation programs should involve intense family support through education and other forms of assistance.

Ref : Evie Tsouna-Hadiis,, PhD, Kostas N. Vemmos, MD, Nikolaos Zakapoulus, MD Stamatis Stamatelopoulus, MD; First Stroke recovery process: the role of family social support : Arch Phys Med Rehabil 2000;81:881-7.

Syed Rahman , M.D. House Staff Physician
Coma Recovery Unit / TBI Jamaica Hospital Medical Center.