The Stroke and Carer Optimal Health Program (SCOHP) to enhance psychosocial health: study protocol for a randomized controlled trial

Brasier, Catherine; Ski, Chantal F.; Thompson, David R.; Cameron, Jan; O'Brien, Casey L; Lautenschlager, Nicola T.; Gonzales, Graeme; Hsueh, Y; Moore, Gaye; Knowles, Sandra R.; Rossell, Susan L.; Haselden, Rachel

doi:10.1186/s13063-016-1559-y

Cited by 10 publications

(20 citation statements)

References 40 publications

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“…Literature reviews and research protocols were conserved up to this stage so that author tracing and examination of reference lists could also be undertaken. The same five databases were used to trace the authors of two study protocols (Brasier et al, 2016;Terrill et al, 2016) but did not uncover additional studies; nor did an examination of reference lists of one literature review, and these articles were then dropped.…”

Section: Study Selectionmentioning

confidence: 99%

Spirituality and resilience among family caregivers of survivors of stroke: A scoping review

Gibbs

Anderson

Simpson

et al. 2020

NRE

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BACKGROUND: Stroke is the leading cause of disability in Australia and the third-leading cause of disability worldwide and a significant burden on caregivers. OBJECTIVE: To map the extent, range and nature of the literature investigating spirituality and resilience among family caregivers of survivors of stroke. METHOD: A scoping review. RESULTS: Six studies were identified, conducted in the United States, United Kingdom, China and Turkey. These included two quantitative, one experimental and three qualitative designs. No studies linked spirituality to resilience. For the qualitative studies, spirituality was the primary focus of one, and the secondary focus of two others. Qualitative data reflected the lived experience of caregivers drawing upon spirituality to help cope with the burden of caregiving. For the two quantitative studies, spirituality was measured as a secondary focus and showed no significant links between spirituality or adjustment in caregivers. The one experimental study comprised a psycho-educational intervention focused on building resilience, finding a significant increase in social support not reflected in a matched control group. Clinical implications suggested the need for strength-based interventions, including spiritual needs and religious beliefs of the family caregiver. CONCLUSIONS: Spirituality and resilience following stroke are essential factors in caregiver adjustment following stroke. Further research with a focus on causality and the link between spirituality, resilience and adjustment in this population is needed.

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Section: Study Selectionmentioning

confidence: 99%

Spirituality and resilience among family caregivers of survivors of stroke: A scoping review

Gibbs

Anderson

Simpson

et al. 2020

NRE

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“…To our knowledge, this the first full economic evaluations of self-management intervention for post stroke patients. Although the importance was recognised [9,35] and ongoing studies are identified [36][37][38][39], no economic evaluation relating to this topic was published yet. The USER-Participation scores were significant different between the two groups, this does not account for UPCC, Utilities and QALYs.…”

Section: Discussionmentioning

confidence: 99%

A trial-based economic evaluation of the Restore4Stroke self-management intervention compared to an education-based intervention for stroke patients and their partners

Mastrigt

Eeden

Heugten

et al. 2020

BMC Health Serv Res

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Background: Since stroke survivors are increasingly responsible for managing stroke-related changes in their own health and lifestyle, self-management skills are required. In a recent randomised controlled trial a self-management intervention based on proactive coping action planning (SMI) in comparison with an education-based intervention (EDU) in stroke patients was investigated. However, no relevant treatment effects on the Utrecht Proactive Coping Competence scale (UPCC) and the Utrecht Scale for Evaluation of Rehabilitation Participation (USER-Participation) were found. The current study is a trial-based economic evaluation from a societal perspective comparing the same interventions (SMI versus EDU). Methods: UPCC, USER-Participation and EuroQol (EQ-5D-3 L) and costs were measured at baseline, three, six and twelve months after treatment. For the cost-effectiveness analyses, incremental cost effectiveness ratios (ICERs) were calculated for UPCC and USER-Participation. For the cost-utility analyses the incremental cost utility ratio (ICUR) was expressed in cost per Quality Adjusted Life Years (QALYs). Outcomes were tested by means of AN(C)OVA analyses and costs differences by means of bootstrapping. Bootstrapping, sensitivity analyses and a subgroup analysis were performed to test the robustness of the findings.(Continued on next page) Results: One hundred thirteen stroke patients were included in this study. The mean differences in USER-Participation scores (95%CI:-13.08,-1.61, p-value = .013) were significant different between the two groups, this does not account for UPCC scores (95%CI:-.267, .113, p-value = not significant) and QALYs (p-value = not significant) at 12 months. The average total societal costs were not significantly different (95%CI:€-3380,€7099) for SMI (€17,333) in comparison with EDU (€15,520). Costeffectiveness analyses showed a mean ICER of 26,514 for the UPCC and 346 for the USER-Participation. Cost-utility analysis resulted in an ICUR of €44,688 per QALY. Assuming a willingness to pay (WTP) threshold of €50,000 per QALY, the probability that SMI will be cost-effective is 52%. Sensitivity analyses and subgroup analysis showed the robustness of the results. Conclusions: SMI is probably not a cost-effective alternative in comparison with EDU. Based on the current results, the value of implementing SMI for a stroke population is debatable. We recommend further exploration of the potential costeffectiveness of stroke-specific self-management interventions focusing on different underlying mechanisms and using different control treatments.

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“…Written informed consent from each participant was obtained. The study protocol is reported elsewhere; 33 there were no significant deviations from this.…”

Section: Methodsmentioning

confidence: 99%

“…In addition to usual stroke care, 33 the intervention group received a program of personalized psychosocial support -Stroke Care Optimal Health Program (SCOHP) -delivered over 8 onehour weekly sessions, followed by a 'booster' session at three months (Table 1). Participants received a structured workbook and professional facilitator (psychologist) who worked with them on an individualized basis and offered flexible delivery times (weekend, afterhours) and modes (face-to-face, telephone, Skype).…”

Section: Interventionmentioning

confidence: 99%

“…4 Meta-analysis (11 trials; n=1280) of depressive symptoms found that in seven trials psychosocial interventions reduced depressive symptoms in stroke survivors (SMD: -0.36, 95% CI -0.73 to 0.00; p =0.05) and in six trials reduced depressive symptoms in carers (SMD: -0.20, 95% CI -.40 to 0.00; p = 0.05). These psychosocial interventions for stroke survivors, 22,28--30 carers 33,40 and survivor-carer dyads 46,47,49 utilized motivational interviewing, 29 transitional care, 30 problem solving and psychoeducation 22 and anti-depressant medication with behavioural support. 28 Psychosocial interventions using social support, psychoeducation and problem-solving improved coping in carers 35,37,38,50 and survivor-carer dyads 46,47 to varying levels.…”

Section: Introductionmentioning

confidence: 99%

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

Minshall

Castle

Thompson

et al. 2020

Topics in Stroke Rehabilitation

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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.

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The Stroke and Carer Optimal Health Program (SCOHP) to enhance psychosocial health: study protocol for a randomized controlled trial

Cited by 10 publications

References 40 publications

Spirituality and resilience among family caregivers of survivors of stroke: A scoping review

Spirituality and resilience among family caregivers of survivors of stroke: A scoping review

A trial-based economic evaluation of the Restore4Stroke self-management intervention compared to an education-based intervention for stroke patients and their partners

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

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