Abstract 11395: Randomized Feasibility Study of Problem-Solving Therapy Compared to Stroke Education for Depressive Symptoms and Quality of Life in Stroke Survivor-Care Partner Dyads

Abstract

Introduction: Stroke survivors often face multiple physical and/or cognitive disabilities requiring ongoing assistance with activities of daily living. Family members often step in to provide this care. Both stroke survivors and care partners commonly report depressive symptoms impacting health and QOL. Poststroke depression is well-studied in survivors, but care partner depression is less understood. Symptoms shared by stroke survivors and their care partners present opportunities for dyad-focused interventions. Problem-Solving Therapy (PST) is a psychosocial intervention that has been effective for managing depression. We adapted this therapy in a novel way for use with stroke survivor-care partner dyads for reduction of depressive symptoms and improvement in QOL. Our primary aim was to address the feasibility and acceptability of PST with secondary aims measuring changes in PHQ-9 and EQ-5D pre/post intervention. Methods: A convenience sample of 14 adult stroke survivor-care partner dyads were randomized 1:1 to either 6 weekly sessions of PST or 6 matched weekly sessions of stroke-related health education as an attention control group. Participants completed PHQ-9 and EQ-5D at baseline, mid-point, and post-intervention. Survivor functional status and caregiver burden were also assessed at these points. Results: The PST intervention was well-received by dyads with 100% of post-intervention ratings indicating satisfaction or great satisfaction with the experience. Participants reported being challenged to think differently (55.6%), improved dyad communication (44.4%) and feeling a sense of accomplishment (33.3%). Analysis focused on feasibility measures, identifying recruitment challenges and design considerations for subsequent studies. No significant changes in outcome measures were noted in this small sample. Conclusion: A dyad approach to behavioral interventions may promote a sense of well-being by providing an opportunity to address challenges that are faced by both individuals. Feasibility and acceptability were established in this small sample; future studies should focus on a larger, diverse sample. Participant feedback suggests booster sessions may also be helpful in sustaining the impact of this novel approach.