A psychosocial intervention for stroke survivors and carers: 12–month outcomes of a randomized controlled trial

Abstract

Background and Purpose: Stroke can have a devastating impact on the mental and physical health of stroke survivors and their carers. We aimed to evaluate the effectiveness of a novel psychosocial intervention designed to improve health outcomes in both groups. Methods:We conducted a randomized controlled trial of a personalized psychosocial intervention (8 one hour weekly sessions plus 1 booster) compared to usual care for adult stroke survivors and carers. Participants recruited from hospital services and community referrals completed questionnaires at baseline, 3, 6 and 12 months. Primary outcomes were quality of life and self-efficacy; secondary outcomes were depressive and anxiety symptoms, coping, illness perception, work and social adjustment, carer strain and carer satisfaction.Mixed-effect model repeated measures analysis between groups and across time was conducted.Results: Of the 173 participants recruited (89 stroke survivors; 84 carers), a total of 137 participants -73 stroke survivors (intervention n=42; usual care n=31) and 64 carers (intervention n=35; usual care n=29) -underwent analysis up to 12 months. No statistically significant differences were found in the primary outcomes between groups over time, though a significant improvement in carer satisfaction was found at 6 months in the intervention group compared to the usual care group. Conclusion:A personalized psychosocial intervention resulted in a significant improvement in carer satisfaction at 6 months but in no other outcomes. A lack of available services and barriers to social engagement may have impeded the effectiveness of this intervention.

Effect of Self-Management Support for Elderly People Post-Stroke: A Systematic Review

“…Full text was obtained for 43 studies, 32 of which were subsequently excluded. Reasons for exclusion were not being able to obtain full text on three occasions [24][25][26], two studies turning out to be protocols [27,28], ten studies having a population with a mean age under 65 years [29][30][31][32][33][34][35][36][37][38], three study interventions being based on body functions [39][40][41], three studies only including outcome measures at body level [42][43][44], two studies not including the target population or including other chronic diseases [45,46], three studies focusing on education or exercise only [47][48][49], two studies providing peer or caregiver support [50,51], three studies involving a workbook or diary as the only content in the intervention [52][53][54], and one study being based on art [55]. This resulted in eleven studies eligible for inclusion in this review [56][57][58][59][60][61][62][63][64][65][66].…”

Coping Strategies, Quality of Life, and Neurological Outcome in Patients Treated with Mechanical Thrombectomy after an Acute Ischemic Stroke

“…Thus, encouraging patients to adopt coping strategies is a complex process because it involves the patient adopting self-management behaviors, exercising self-control of their processes and results, and actively participating in their health education, although there is limited evidence of the effect of psychosocial interventions in stroke patients that can improve the results in terms of their quality of life [ 35 , 36 , 37 ]. Therefore, effective coping should be based on using a set of coping strategies that enable stress management in the context of the illness and switching to new adaptive strategies as the situation evolves [ 30 ].…”

“…Our findings suggest that these factors should be taken into account to promote better interventions with regard to the secondary prevention for these patients and improve their HRQoL, leaving an open door for future investigations. While the technology associated with interventional strategies is improving and technical outcomes are also improving, longer-term outcomes may not be [ 36 , 37 ].…”

A Narrative Review on the Non-Pharmacologic Interventions in Post-Stroke Depression

“…Psychosocial interventions prove to be an essential component for the management of PSD. As patients and their caregivers have a marked reduction in social participation and functioning after a stroke, approaches that involve motivational interviewing, transitional care, social support, and psychoeducation should be integral in stroke rehabilitation 37 On an individual patient level, exploration of their respective needs, assessment of the potential barriers and supporting the skills and networks needed to achieve this has been suggested as an essential framework for recovery. 38 These strategies should eventually aim to achieve self-efficacy, a factor which has been shown to be negatively associated with PSD.…”