Disagreement in patient and career assessment of functional abilities after stroke

Background and Purpose-The aims of this study were to describe differences between functional ability assessments made by stroke patients and their informal carers and to investigate the psychological associates of the difference in assessments. Methods-A prospective design was used, with repeated assessments of function, mood, and carer strain. Thirty hospital stroke patients and their main carer were interviewed 3 times: within 1 month of stroke, 1 month after discharge, and 6 months after discharge. Results-There were significant differences between patient and carer assessments at all 3 time points, with patient self-assessment less disabled than carer assessment (at least P<0.02). The disagreement in assessment was unrelated to patient or carer mood (P>0.05) but greater disagreement was associated with greater carer strain (P<0.05). The source of the disagreement in functional ability assessment remains unclear. Conclusions-The method of assessment affects the rating of functional abilities after stroke. Carer strain is potentially increased when the patient or carer makes an unrealistic assessment of the patient's level of independence.