Acceptability of mindfulness from the perspective of stroke survivors and caregivers: a qualitative study

Bhautesh Dinesh Jani,Maggie Lawrence,Robert Simpson,Sharon Simpson,Stewart W Mercer

doi:10.1186/s40814-018-0244-1

Bhautesh Dinesh Jani, Maggie Lawrence + Show 3 more

Open Access

https://doi.org/10.1186/s40814-018-0244-1

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Abstract

BackgroundDepression is very common among stroke survivors with estimated prevalence rates of approximately 33% among stroke survivors, but treatment options are limited. Mindfulness-Based Stress Reduction (MBSR) is an effective treatment for depression generally, but benefits in stroke patients are unclear. The aim of this study was to determine the feasibility of delivering MBSR to stroke survivors and their caregivers in the community. We conducted a study to gain views of MBSR as a potential treatment option among stroke survivors and their caregivers in the community.MethodsParticipants were recruited from an urban community in Scotland (UK) using newspaper adverts, social media and support groups run by health charities. A 2-h MBSR taster session was delivered by two experienced mindfulness instructors, followed by focus group sessions with all participants on their user experience and suggestions for MBSR modifications for stroke survivors. The focus group sessions were audio recorded and transcribed verbatim. Transcript data were analysed thematically using the framework approach.ResultsThe study sample consisted of 28 participants (16 females); there were 21 stroke survivors (11 females) and 7 caregivers (5 females). The median age for participants was 60 years.Most participants described the MBSR taster session as a positive experience. The main challenge reported was trying to maintain focus and concentration throughout the MBSR session. Some participants expressed reservations about the duration of standard mindfulness course sessions, suggesting a preference for shorter sessions. The potential for achieving better control over negative thoughts and emotions was viewed as a potential facilitator for future MBSR participation. Participants suggested having an orientation session prior to starting an 8-week course as a means of developing familiarity with the MBSR instructor and other participants.ConclusionIt was feasible to recruit 21 stroke survivors and 7 caregivers for MBSR taster sessions in the community. A shorter MBSR session and an orientation session prior to the full course are suggestions for potential MBSR modifications for stroke survivors, which needs further research and evaluation.

Highlights

Depression is very common among stroke survivors with estimated prevalence rates of approximately 33% among stroke survivors, but treatment options are limited
Mindfulness-Based Stress Reduction (MBSR) taster sessions were well received by most participants, with the majority expressing willingness to take part in a future full course
Potential for therapeutic gains was the perceived facilitator for future MBSR participation, while stroke-related impairment and travel involved were perceived as potential barriers

Summary

Introduction

Depression is very common among stroke survivors with estimated prevalence rates of approximately 33% among stroke survivors, but treatment options are limited. A review published in 2010 reported an overall prevalence rate of 21.7% (range 6 to 40%) for post-stroke major depressive disorder (MDD) and 19.5% (range 8 to 44%) for post-stroke minor depression—DSMIV classification [8]. A multi-national study of 220 patients observed that the prevalence of depression remained as high as 33% for up to 5 years post stroke [9]. A review assessing post-stroke mortality reported increased odds of mortality for a period of 2 to 5 years among patients with depressive symptoms based on findings from 13 studies including 59,598 patients with stroke [10]. There is evidence that stroke survivors and their carers mutually influenced each other’s emotional state [14, 15]

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