Paddling to the dyadic rhythm in post-stroke recovery: coping mechanisms among survivor-caregiver dyads in Singapore

Abstract

Background: Despite stroke’s substantial impact on both stroke survivors and their family caregivers, the coping responses of these members of dyadic units remained underexplored, particularly in the Asian context where caregiving relationships were often shaped by cultural values such as familism and filial piety. Thus, this study sought to examine how individual coping strategies of survivors and caregivers in the Singapore context interact to promote dyadic coping during post-stroke recovery.

Methods: The present qualitative research adopted the social constructivist paradigm and a phenomenological approach. Meaning-oriented interviews were conducted at two time points, [T1] as baseline and [T2] three-month follow-up. Lived experiences of four non-spousal Singaporean survivor-caregiver dyads (three parent-child and one sibling relationship) were analysed using thematic framework analysis informed by the Theory of Dyadic Illness Management.

Findings: The analysis generated three conceptual themes and ten subthemes which formed the Family-Oriented Reciprocal Stroke Care Among Singaporeans (FORSCAS) Model. This model illuminated the coping strategies adopted by caregivers (Theme 1: Caregiving Adaptation) and survivors (Theme 2: Enhancing Wellness) in managing the impact of stroke, resulting in changes to their coping strategies and impacting the overall dyadic unit’s management of stroke (Theme 3: Dyadic Functioning).

Discussion: The reciprocal effect of coping strategies and changes in dyadic functioning were heavily nuanced by familism and filial piety. Overall, these findings reinforced the importance of dyadic stroke management, highlighting the need for a contextualised approach to stroke care that takes into account the role of the family and their caregiving relationships with one another.