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Early Occupational Therapy Intervention Programme and Coping Strategies and Burden in Caregivers of People with Sub-Acute Stroke: A Randomised Controlled Trial.

ABSTRACT: Caregivers of people who have suffered a stroke experience a great burden and may use disengagement coping strategies. We studied the influence of an early occupational therapy intervention programme in the process of hospital-to-home discharge after stroke (EOTIPS) in a Spanish cohort that improved patients' quality of life and caregivers' burden and coping strategies. EOTIPS was delivered by a single occupational therapist. We conducted a prospective randomised controlled trial that included 60 adults who suffered a stroke, of which 91.6% had a caregiver who agreed to be involved in their care (n = 55). Evaluations assessed the caregivers' burden and coping strategies within two weeks post-stroke and after a three-month follow-up. Statistical analyses included intent-to-treat analysis (considering dropouts as failures) and efficacy analysis, considering only end-of-treatment participants. The caregivers in the intervention group showed a significantly better evolution in the main outcome measure of burden (p = 0.019), as well as in the coping strategies of social support (p = 0.037) and social withdrawal (p ≤ 0.001), compared with the control group. EOTIPS was effective in improving the caregivers' burden and two coping strategies, and it could be considered as an applicable tool that can minimise the risk of suffering burden.

SUBMITTER: Garcia-Perez P

PROVIDER: S-EPMC11355327 | biostudies-literature | 2024 Aug

REPOSITORIES: biostudies-literature

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Early Occupational Therapy Intervention Programme and Coping Strategies and Burden in Caregivers of People with Sub-Acute Stroke: A Randomised Controlled Trial.

García-Pérez Patricia P Rodríguez-Martínez María Carmen MC Gallardo-Tur Alejandro A Blanco-Reina Encarnación E de la Cruz-Cosme Carlos C Lara José Pablo JP

Journal of personalized medicine 20240801 8

Caregivers of people who have suffered a stroke experience a great burden and may use disengagement coping strategies. We studied the influence of an early occupational therapy intervention programme in the process of hospital-to-home discharge after stroke (EOTIPS) in a Spanish cohort that improved patients' quality of life and caregivers' burden and coping strategies. EOTIPS was delivered by a single occupational therapist. We conducted a prospective randomised controlled trial that included 6 ...[more]

PMID: 39202012

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Project description:ObjectivesTo evaluate the effectiveness of a tailored multidimensional intervention in reducing the care burden of family caregivers of stroke survivors. This intervention considered caregivers' perceived needs and incorporated three evidence-based dimensions (psychoeducation, skill-building and peer support).DesignA prospective randomised control trial.SettingA community-based study conducted in Egypt.ParticipantsA total of 110 caregivers aged ≥18 years who cared for a survivor within 6 months of stroke, with modified Rankin Scale scores of 3-5, and without other physical disabilities or terminal illnesses were recruited between December 2019 and May 2020. Participants were assigned to the intervention group (IG; n=55) and control group (CG; n=55) through open-label, parallel 1:1 randomisation.InterventionThe IG was provided with tailored multidimensional interventions for 6 months until November 2020, including three home visits, six home-based telephone calls and one peer-support session. The CG received simple educational instructions at a single visit.OutcomeThe participants completed the Zarit Burden Interview (primary outcome) and the WHO Quality of Life-BREF (secondary outcome) before the intervention (T0), at 3 months (T1) and at 6 months (T2).ResultsNo differences were observed between the characteristics of the groups at baseline (T0). The independent t-test showed no significant differences in the care burden and Quality of Life (QoL) at T1 and T2 between the groups. The intervention had no significant effect on the outcomes between or within groups over time, as shown by the repeated-measures analysis of variance. However, the group and time interaction had significant main effects on caregivers' QoL (psychological and social domains).ConclusionThe main results showed that participants in the IG did not experience an improvement in the main outcomes. Nevertheless, the improvement in the psychological and social domains may have been attributed to our intervention.Trial registration numberNCT04211662.

Project description:BackgroundPeople with disabilities and without natural speech often rely on care provided by informal caregivers. The caregiving situation of these informal caregivers has been poorly researched. The objectives of the study are 1) to identify stressors, resources, and coping strategies among informal caregivers of people without natural speech and 2) to examine whether a complex intervention in augmentative and alternative communication (AAC) that is not primarily tailored to the needs of informal caregivers can reduce care-related burden.MethodsThe main components of the AAC intervention were (1) initial counselling session, (2) 4 AAC training sessions, (3) 20 AAC therapy sessions and (4) accompanying case management. The control group received only the initial counselling session. Within a quasi-experimental intervention study, survey data on self-perceived burden (Burden Scale for Family Caregivers, BSFC-s) from n = 154 informal caregivers of people without natural speech were collected at three time points between June 2018 and April 2021 from a postal survey. Qualitative interviews with n = 16 informal caregivers were conducted.ResultsCaregivers reported various stressors such as limited communication with the cared-for person and concerns about the living situation in adulthood. Diverse resources and effective coping strategies, which the caregivers refer to when dealing with stressors, could also be identified. Burden was significantly reduced in the intervention group compared to the control group. According to the results of the qualitative study, AAC use led to better communication skills and a reduction in behavioural problems and thus a decreased burden.ConclusionsThe AAC intervention seems to have a positive impact on self-perceived burden. Linkages between intervention components and burden reduction as well as stressors and coping strategies could be identified and provide an evidence-based foundation for developing future holistic interventions for families with individuals without natural speech.Trial registrationGerman Clinical Trials Register (DRKS); ID: DRKS00013628 (registered on 05/02/2018).

Project description:IntroductionCaring for stroke survivors creates high levels of care burden among family caregivers. Previous initiatives at alleviating the care burden have been unsuccessful. The proposed study aims to evaluate the effect of a tailored multidimensional intervention on the care burden among family caregivers of stroke survivors. Based on the perceived needs of family caregivers, this intervention takes into account scientific recommendations to combine three different approaches: skill-building, psychoeducation and peer support.Methods and analysisUsing a prospective, randomised, open-label, parallel-group design, 110 family caregivers will be enrolled from Dakahlia Governorate, Egypt between December 2019 and May 2020, and randomly assigned to either the intervention group or the control group. The tailored multidimensional intervention will be administered for 6 months, including three home visits, six home-based telephone calls and one peer support session. The primary outcome is the care burden as measured using the Zarit Burden Interview. Secondary outcomes include changes in the family caregivers' perceived needs (Family Needs Questionnaire-Revised), coping strategies (Brief-Coping Orientation to Problems Experienced) and quality of life (WHO Quality of Life-BREF). Outcomes evaluation will be conducted at baseline (T0), month 3 (T1) and month 6 (T2). Independent t-test will be performed to compare the mean values of study variables between the two groups at both T1 and T2. After adjusting for confounding variables, analysis of covariance will be used to assess the effect of the intervention. In addition, repeated measures analysis of variance will be conducted to assess changes in effect over time.Ethics and disseminationThis study was approved by the Research Ethics Committee of the Faculty of Nursing, Mansoura University, Mansoura, Egypt (P.0195). The results will be published in a scientific peer-reviewed journal, and findings will be disseminated at the local and international levels.Trial registration numberNCT04211662.

Dataset Information

Early Occupational Therapy Intervention Programme and Coping Strategies and Burden in Caregivers of People with Sub-Acute Stroke: A Randomised Controlled Trial.

Publications

Early Occupational Therapy Intervention Programme and Coping Strategies and Burden in Caregivers of People with Sub-Acute Stroke: A Randomised Controlled Trial.

Similar Datasets

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