Marital Satisfaction in Spouses of Patients with Chronic Aphasia: A Mixed Methods Study

Abstract

Despite the prevalence of aphasia in the United States, there remains a dearth of research focusing specifically on the impact of chronic aphasia on marriage and marital satisfaction. This study used a sequential explanatory mixed methods design to explore marital satisfaction in spouses of patients with chronic aphasia. Results from the quantitative phase, involving 21 couples in which one spouse had aphasia resulting from stroke for more than one year, demonstrated a significant decrease in marital satisfaction in the non-aphasic spouse when comparing post-aphasia and retrospective recall of pre-aphasia marital satisfaction as measured using the Dyadic Adjustment Scale (p<.001). More severe aphasia was found to have a statistically significant correlation with lower post-aphasia marital satisfaction (r=.433, p=.05). Lower physical function scores in the non-aphasic spouse were also significantly correlated with lower post-aphasia marital satisfaction (r=.474, p=.03). The aim of a subsequent qualitative analysis of data obtained from 11 non-aphasia spouses from the original quantitative sample was to explain these findings. Two major concepts emerged from the qualitative data: living with loss and creating a new normal. Placed within the context of the ABCX crisis theory, incorporation of the quantitative and qualitative findings suggests that aphasia onset places a stress on the marriage. That stress is defined, in part, as a loss by the non-aphasic spouse. Findings suggest that many aspects of that loss are magnified in situations where the aphasia is more severe as the deficit in communication impacts intrapersonal and interpersonal elements of the marriage. The subcategories derived from the concept of creating a new normal describe the process of adaptation by non-aphasic spouse. The non-aphasic spouses' abilities to adapt, and their subsequent marital satisfaction, appeared related to their various definitions of the situation and availability of resources. Recognizing the complex relationship between chronic aphasia and marital satisfaction in the non-aphasic spouse may help speech-language pathologists and other health care providers provide more effective intervention strategies and better support for patients with aphasia and their spouses.