Category: Stroke; Clinical Practice (assessment, diagnosis, treatment, knowledge translation/EBP, implementation science, program development); Geriatric Rehabilitation
Objective : Sustaining well-being in stroke patients and caregiving partners is important for optimal outcomes. However, support for couples post-stroke is largely lacking or inaccessible. We aimed to pilot test a self-administered positive psychology-based intervention for these couples. Hypothesis: Participants demonstrate improvement across outcome measures from pre- to post-intervention and maintain improvement at 3-month follow-up.
This is a mixed methods pre-post pilot trial with a 3-month follow-up.
Setting : Community-based.
Participants (or Animals, Specimens, Cadavers) : Participants included 28 community-dwelling cohabitating couples that were at least 3 months post-stroke. One or both partners needed to report changes in mood or anhedonia since the stroke. Participants were predominantly white, well-educated, and approximately 50% of survivors and care-partners were women. Mean participant age was 54 years (SD=5.6). Various stroke types, locations, and sequelae were represented.
Interventions : The 8-week behavioral intervention is self-administered and consists of brief positive psychology-based activities (e.g. expressing gratitude, practicing acts of kindness) completed individually and as a couple.
Main Outcome Measure(s) :
PROMIS-Positive Affect and Wellbeing, PROMIS-Depression, PROMIS-Fatigue, and Connor-Davidson Resilience Scale. Semi-structured interviews were conducted post-intervention to supplement quantitative data.
Results : All assessments are self-report measures completed by participants. Interviews were conducted separately with partners to encourage unbiased responding. Results showed significant improvement in well-being (p=.04) and a trend for reducing fatigue (p=.08) across the sample. When examining survivor and care-partner outcomes separately, there is significant improvement in well-being (p=.005) and resilience for survivors (p=.04), and a trend for decreased fatigue in care-partners (p=.10). Interview feedback similarly reflects themes of gratitude, increased engagement, and mindfulness. There were no significant findings or trends for depression.
Preliminary results suggest the intervention may be effective for improving well-being in couples coping with stroke, but findings should be interpreted with caution. Though more research is needed, this represents a promising first step in a novel dyadic intervention for this population with exciting potential clinical implications.
Alexandra Terrill– Assistant Professor, University of Utah, Salt Lake City, Utah
Jackie Einerson– Occupational Therapist, PhD Student, University of Utah, Salt Lake City, Utah
Justin MacKenzie– Psychologist, University of Utah, Saint George, Utah
Maija Reblin– Assistant Member, Moffitt Cancer Center, Tampa, Florida
Beth Cardell– Associate Professor, Lecturer, University of Utah, Salt Lake City, Utah
Jennifer Majersik– Associate Professor, Neurology, University of Utah, Salt Lake City, Utah
Lorie Richards– Chair and Associate Professor, University of Utah, Salt Lake City, Utah