Informal stroke caregivers' self-appraised problem-solving abilities as a predictor of well-being and perceived social support

Aim. To describe the relationship between self-appraised problem-solving abilities and psychological distress, burden and perceived social support in informal, family stroke caregivers. Background. Previous research suggests that self-appraised problem-solving abilities play a significant role in the well-being of family caregivers of patients with chronic illness. However, little is known about its role in caregivers of stroke survivors. Design. Prospective correlational study. Methods. One week before discharge, 103 family caregivers of survivors of a first stroke were assessed for their perceived problem-solving abilities, social support, anxiety, depression and physical well-being. At three months postdischarge, 85 of these caregivers (83% retention) were reassessed on the same measures. In addition, their levels of burden and perceived difficulties were also measured. Results. Using multiple regression, overall self-appraised problem-solving abilities and its subscale ` confidence in problemsolving' at one week before discharge were significant predictors of caregiver perceived social support (R 2 = 29%) and perceived physical well-being (R 2 = 42%) at three months postdischarge. Other relationships were non-significant. Conclusions. Caregivers' perceived social support and physical well-being were significantly predicted by confidence in problem- solving. Relevance to clinical practice. This study is timely given the challenges facing health systems in Hong Kong to effectively manage chronic illness through family-centred care. The significant relationships between caregiver self-appraised problemsolving, perceived social support and well-being suggest that interventions maximising caregiver confidence in problem-solving might be valuable in supporting family caregivers of stroke survivors. Nurses working with families caring for stroke survivors both close to discharge and in the early transition stages back at home may be in an ideal position to offer this support.