Changes in depression and self-esteem of spouses of stroke patients with aphasia as a result of group counseling Public Deposited

http://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/tx31qk785

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  • The primary purpose of this research was to compare posttest scores for changes in depression and self-esteem in spouses of stroke patients with aphasia who received group counseling with those who did not receive group counseling. Depression was measured by the Depressive Adjective Checklist (A-D) and self-esteem by the Tennessee Self-Concept Scale (P-score) (Clinical Research Form). Eleven spouses of aphasics (8 female and 3 male) were recruited from the Olympia and Tacoma area in the State of Washington. They ranged in age from 46 to 73 years and their aphasic spouse had suffered a CVA within the last two years (1977-1979). A pre and posttest control group design was used that allowed the eleven spouses to volunteer for a treatment or control group. Six spouses (4 female and 2 male) volunteered for the treatment group and five spouses (4 female and 1 male) volunteered for the control group. Both groups were found to be similar in the following characteristics: age; sex; number of children at home; degree of aphasic language difficulty as perceived by the spouse; years of education; months post CVA for aphasics; mobility of aphasic spouse; depression as measured by the DACL (A-D) and self-esteem as measured by the TSCS P-score. A developmental and personal mastery approach to group counseling reinforced an eclectic nine week treatment program that met 1 1/2 - 2 hours once a week. The program was designed to: facilitate self-exploration; promote improved self-understanding; develop a mutual support system; encourage the setting of personal and meaningful goals and action plans; help the spouse become aware of their own physical and psychological needs; and encourage independence in the spouse as well as in the aphasic. When comparing the treatment and control groups by pretest data for similarity in levels of depression, an analysis of variance revealed, at the .05 level of confidence, a significant difference in depression between forms A, B, C, and D of the DACL (F=3.764). This indicates that possibly forms A, B, C, and D did not equally assess depression in the two groups. Non significant F-values were found between the total means of the treatment and control groups (F=2.046); and for interaction between the four forms and the two groups (F=1.269). No significant difference was revealed in the pretest comparison of P-scores in measuring self-esteem within the treatment and control groups (F=.6l4). The posttest means were adjusted for the DACL (A-D) for the treatment and control groups and no significant difference was found in depression between the six spouses who received group counseling when compared to the five who did not receive group counseling. The analysis of covariance revealed non significant F-values in comparing the treatment and control groups (F=.014); between forms A, B, C and D of the DACL (F=2.876); and for interaction between groups and forms (F=.804). However all posttest group mean scores for the four forms decreased for the treatment group when compared to the pretest scores, with changes being the largest for forms A and B. An analysis of covariance gave no significant changes in posttest TSCS P-scores for the six spouses of aphasics who received group counseling when compared to the changes in the group of five who did not receive group counseling (F=.167). The pretest was a significant covariate on posttest scores of the TSCS P-scores (F=12.816) but not for the DACL (A-D) posttest scores (F=.203). Although neither null hypothesis was rejected, it was felt that an eclectic treatment program that stresses the developmental and personal mastery approach to group work has strong potential. This is supported by feedback at the end of the treatment program and by individual changes between pre and posttest scores. This evidence suggests, though not empirically verified by group analyses, that spouses of stroke patients with aphasia can benefit from such a program.
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