Five-year follow-up of a cluster-randomized controlled trial of a client-centred activities of daily living intervention for people with stroke

Abstract

Objective:To compare five-year outcomes and changes over time of a client-centred activities of daily living (ADL) intervention versus usual ADL interventions for people with stroke and their significant others.Design:Five-year follow-up of a cluster-randomized controlled trial where a client-centred ADL intervention (n = 129) or usual ADL interventions (n = 151) were delivered to people with stroke.Setting:Multicentre study including 16 inpatient or home-based rehabilitation units.Participants:People with stroke and significant others.Intervention:The client-centred ADL intervention aimed at enabling agency in daily activities and participation in everyday life and at reducing caregiver burden.Main measures:For people with stroke, perceived participation (Stroke Impact Scale), independence in ADL, life satisfaction, and use of formal/informal care were measured. For significant others, caregiver burden, life satisfaction, and mood (Hospital Anxiety and Depression Scale) were assessed.Results:Five years post-intervention, data were collected from 145 people with stroke (intervention group: n = 71/control group: n = 74) and 75 significant others (intervention group: n = 36/control group: n = 39). For those with stroke, the Participation domain of the Stroke Impact Scale showed no group differences at year five (68.9 vs 75.4, P = 0.062) or in changes over time. At year five, the control group had better outcomes regarding Other help/supervision. Significant others in the control group were more likely to show signs of depression at year five (odds ratio = 22.3; P < 0.001).Conclusion:The client-centred ADL intervention appears to render similar long-term effects as usual ADL interventions for people with stroke, but for significant others signs of depression might be reduced.

Optimizing patients' functional status during daily nursing care interventions: A systematic review

“…See Table S1. Thirteen studies had a total quality score between 60% and 86% (Galik et al, 2008; Guidetti & Ytterberg, 2011; Hafsteinsdóttir, Algra, Kappelle, & Grypdonck, 2005; Hedman, Eriksson, von Koch, & Guidetti, 2019; Henskens, Nauta, Drost, & Scherder, 2018; Henskens, Nauta, Scherder, Oosterveld, & Vrijkotte, 2017; Henskens, Nauta, van Eekeren, & Scherder, 2018; Kerse et al, 2008; Parsons, Sheridan, Rouse, Robinson, & Connolly, 2013; Peri et al, 2008; Resnick et al, 2006; Resnick, Galik, Gruber‐Baldini, & Zimmerman, 2009; Tuntland, Aaslund, Espehaug, Førland, & Kjeken, 2015), and seven studies had a quality score between 40% and 59% (Bertilsson et al, 2014; Galik, Resnick, Hammersla, & Brightwater, 2013; Galik, Resnick, Lerner, Hammersla, & Gruber‐Baldini, 2015; Resnick, Gruber‐Baldini, et al, 2009; Resnick, Galik, Gruber‐Baldini, & Zimmerman, 2011; Sidani, Streiner, & LeClerc, 2012; Tinetti et al, 2002). Four studies fulfilled less than 40% of the quality criteria and were excluded from the review (Engelman, Mathews, & Altus, 2002; Johnson et al, 2004; Lim, 2003; Padula, Hughes, & Baumhover, 2009).…”

“…Twelve studies did not show positive effects on patient outcomes (Bertilsson et al, 2014; Galik et al, 2008, 2015; Guidetti & Ytterberg, 2011; Hafsteinsdóttir et al, 2005; Hedman et al, 2019; Henskens et al, 2017; Henskens, Nauta, Drost, et al, 2018; Kerse et al, 2008; Resnick et al, 2006, 2011; Sidani et al, 2012). In six of these studies, a cluster randomized controlled trial was used (Bertilsson et al, 2014; Galik et al, 2015; Guidetti & Ytterberg, 2011; Henskens, Nauta, Drost, et al, 2018; Kerse et al, 2008; Resnick et al, 2011).…”

Activities in Daily Living: The development of a new client-centred ADL intervention for persons with stroke

“…before 2009). We therefore found it important to report on how we developed the theoretical base and modelled the content of the new and complex ADL intervention, before the effectiveness of the intervention was evaluated in an RCT [5][6][7][8][9]. Nevertheless, developing and evaluating a new and complex client-centred intervention has been a long process involving multiple phases.…”

“…The effects of the CADL have been evaluated in a randomized controlled trial (RCT) (ClinicalTrials.gov NCT01417585) and the CONSORT Statement [2] has been used to report the trial. The findings from the RCT were presented in both qualitative [3,4] and quantitative studies [5][6][7][8][9]. However, the development, rationale and content of the intervention have been requested but have not yet been presented in detail.…”

The everyday life situation of caregivers to family members who have had a stroke and received the rehabilitation intervention F@ce in Uganda

“…This is considered to be a valid scale reduction [ 25 ]. LiSat-11 and has been used in a number of studies with a sample of caregivers to people with stroke [ 11 , 12 , 26 , 27 ].…”