Jill I Cameron1, Gary Naglie2, Theresa L Green3, Monique A M Gignac4, Mark Bayley5, Maria Huijbregts6, Frank L Silver7, Anna Czerwonka8. 1. Department of Occupational Science and Occupational Therapy, University of Toronto, Canada Department of Medicine, UHN-Toronto Rehabilitation Institute, Canada jill.cameron@utoronto.ca. 2. Department of Medicine and Rotman Research Institute, Baycrest Health Sciences; Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto, Canada. 3. Faculty of Nursing, University of Calgary, Canada Hotchkiss Brain Institute, Calgary, Alberta, Canada. 4. Institute for Work and Health; Toronto Western Research Institute; Dalla Lana School of Public Health, University of Toronto, Canada. 5. Department of Medicine, UHN-Toronto Rehabilitation Institute, Canada. 6. Family Service Toronto, Department of Physical Therapy, University of Toronto, Canada. 7. Department of Neurology, UHN-Toronto Western Hospital, Canada. 8. Department of Occupational Science and Occupational Therapy, University of Toronto, Canada.
Abstract
OBJECTIVE: Examine feasibility of conducting a randomized controlled trial of the Timing it Right Stroke Family Support Program (TIRSFSP) and collect pilot data. DESIGN: Multi-site mixed method randomized controlled trial. SETTING: Acute and community care in three Canadian cities. SUBJECTS:Caregivers were family members or friends providing care to individuals who experienced their first stroke. INTERVENTION: The TIRSFSP offered in two formats, self-directed by the caregiver or stroke support person-directed over time, were compared to standard care. MAIN MEASURES: Caregivers completed baseline and follow-up measures 1, 3 and 6 months post-stroke including Centre for Epidemiological Studies Depression, Positive Affect, Social Support, and Mastery Scales. We completed in-depth qualitative interviews with caregivers and maintained intervention records describing support provided to each caregiver. RESULTS: Thirty-one caregivers received standard care (n=10), self-directed (n=10), or stroke support person-directed (n=11) interventions. We retained 77% of the sample through 6-months. Key areas of support derived from intervention records (n=11) related to caregiver wellbeing, caregiving strategies, patient wellbeing, community re-integration, and service delivery. Compared to standard care, caregivers receiving the stroke support person-directed intervention reported improvements in perceived support (estimate 3.1, P=.04) and mastery (estimate .35, P=.06). Qualitative caregiver interviews (n=19) reflected the complex interaction between caregiver needs, preferences and available options when reporting on level of satisfaction. CONCLUSIONS: Preliminary findings suggest the research design is feasible, caregivers' needs are complex, and the support intervention may enhance caregivers' perceived support and mastery. The intervention will be tested further in a large scale trial.
RCT Entities:
OBJECTIVE: Examine feasibility of conducting a randomized controlled trial of the Timing it Right Stroke Family Support Program (TIRSFSP) and collect pilot data. DESIGN: Multi-site mixed method randomized controlled trial. SETTING: Acute and community care in three Canadian cities. SUBJECTS: Caregivers were family members or friends providing care to individuals who experienced their first stroke. INTERVENTION: The TIRSFSP offered in two formats, self-directed by the caregiver or stroke support person-directed over time, were compared to standard care. MAIN MEASURES: Caregivers completed baseline and follow-up measures 1, 3 and 6 months post-stroke including Centre for Epidemiological Studies Depression, Positive Affect, Social Support, and Mastery Scales. We completed in-depth qualitative interviews with caregivers and maintained intervention records describing support provided to each caregiver. RESULTS: Thirty-one caregivers received standard care (n=10), self-directed (n=10), or stroke support person-directed (n=11) interventions. We retained 77% of the sample through 6-months. Key areas of support derived from intervention records (n=11) related to caregiver wellbeing, caregiving strategies, patient wellbeing, community re-integration, and service delivery. Compared to standard care, caregivers receiving the stroke support person-directed intervention reported improvements in perceived support (estimate 3.1, P=.04) and mastery (estimate .35, P=.06). Qualitative caregiver interviews (n=19) reflected the complex interaction between caregiver needs, preferences and available options when reporting on level of satisfaction. CONCLUSIONS: Preliminary findings suggest the research design is feasible, caregivers' needs are complex, and the support intervention may enhance caregivers' perceived support and mastery. The intervention will be tested further in a large scale trial.
Authors: Judith Dm Vloothuis; Marijn Mulder; Janne M Veerbeek; Manin Konijnenbelt; Johanna Ma Visser-Meily; Johannes Cf Ket; Gert Kwakkel; Erwin Eh van Wegen Journal: Cochrane Database Syst Rev Date: 2016-12-21
Authors: Inken Padberg; Petra Knispel; Susanne Zöllner; Meike Sieveking; Alice Schneider; Jens Steinbrink; Peter U Heuschmann; Ian Wellwood; Andreas Meisel Journal: BMC Neurol Date: 2016-07-20 Impact factor: 2.474