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What Happens to Marriage after Stroke? Open Access


Other title
grounded theory
life course
symbolic interaction
Type of item
Degree grantor
University of Alberta
Author or creator
Anderson, Sharon D
Supervisor and department
Johnson, Matthew (Human Ecology)
Wilson, Donna (Nursing)
Keating, Norah (Human Ecology)
Examining committee member and department
Roberto, Karen A. (Health Sciences, Virginia Tech)
Low, Gail (Nursing)
Department of Human Ecology

Date accepted
Graduation date
2017-06:Spring 2017
Doctor of Philosophy
Degree level
Abstract Background: Family transitions such as the birth of children and retirement often necessitate a redefinition of the marriage relationship, as other roles are added or changed. Stroke is a common, and also a particularly difficult, transition for a married couple. In a third of marriages that have experienced stroke, both survivors and their spouses report they are dissatisfied with their lives. Marital relationships, however, seem to be a strength for many such couples. Purpose: This dissertation responds to the need to understand how stroke survivors and spouses regard their marital relationships in the context of impairments from stroke and the survivors’ need for care. Methods: The dissertation consists of: (1) a systematic literature review that answers the research question “What is the current state of knowledge about what happens to a couple’s marital relationship after one partner has suffered a stroke?” and (2) a grounded theory qualitative study of interviews with 18 couples that answers the questions “What happens to marriage in the context of care after stroke?” and “What are the key elements related to marriage stability or breakdown after stroke?” Findings: Three research gaps were apparent in the literature review: how survivors and spouses characterize their post-stroke roles and marriages, the ways in which couples reorganize their marriages after stroke, and the impact of marriage, particularly a satisfying marriage, on the caregiver burden and the survivor’s functional recovery after stroke. My empirical study revealed that at homecoming after stroke, the initial work involved role management for caregivers and care receivers. The work of realigning the husband and wife role-identities to fit the caregiving and care receiving contexts was a second post-stroke transition. To make this transition, couples had to rethink the meaning of their relationship in the new context of care and disability. Three distinct types of marriages evolved from these processes: the couple’s relationship was reconfirmed around the pre-stroke marriage relationship; the couple’s relationship was recalibrated around care; the couple existed in a parallel relationship. I identified three themes related to the reconstruction or breakdown of the marital identity: feeling overwhelmed, resolving conflict, and perceiving value in the marriage. Conclusion: Marriage relationships are not peripheral to survivors’ and spouses’ outcomes after stroke; rather, marriage is fundamental to the management of impairments and to the wellbeing of the couple.
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