The double ABCX model of family crisis as a representation of family functioning after rehabilitation from stroke

There is evidence that stroke may impair family functioning. This study assessed the extent to which the double ABCX model of family crisis can accommodate family functioning after rehabilitation from stroke. Participants were 60 12-month stroke survivors who had undergone an inpatient rehabilitation programme at Repatriation General Hospital, in Adelaide, South Australia. The components of the double ABCX model were operationalized using functional, psychological and social indicators comprising the McMaster Family Assessment Device, Australian ADL Index, Frenchay Activities Index, Stroke Care Information Test, Zung Self-Rating Depression Scale and Illness Behaviour Questionnaire. Patient expectations of rehabilitation, satisfaction with progress and medical staff attitudes to patient outcome were assessed by interview. There were five assessments from acute care to 12 months after discharge. Path analysis supported the proposed model, and showed that family adaptation at 12 months was the product of family stresses and demands. family resources and family perceptions. In particular, family functioning was poorer when the patient developed psychological morbidity, when the patient was less satisfied with the recovery, and when the health burden of the stroke was great. The results suggest that family disturbance after stroke may be limited by anticipating and dealing with potential problems during the rehabilitation programme.