Pilot testing a positive psychology intervention to promote well-being in couples coping with stroke

Abstract

Depressive symptoms post-stroke occur in 30–50% of survivors and partner caregivers, and can have negative consequences for recovery, function, and quality of life. Further, emotional well-being is interdependent in couples; depression in one partner increases risk of depression in the other. Sustaining well-being in both partners is important for rehabilitation engagement and community re-integration. However, support for couples post-stroke is lacking or inaccessible. We aimed to pilot test a self-administered positive psychology-based intervention (PPI) for these couples. Eighteen couples consisting of one partner who had a stroke > 6 months ago and a cohabiting caregiver were enrolled. One or both partner(s) reported depressive symptoms. The sample was primarily white, well-educated, consisted of 50% female survivors and male caregivers, and had a mean age of 55 years (range: 27–84). A variety of stroke types and locations were represented. After a brief training, participants engaged in the PPI at home, completing two activities alone and two together each week. Activity booklets, tracking calendars, and weekly check-in calls were provided. Pre-, post-intervention, and 3-month-follow-up measures included the PROMIS-Depression, PROMIS-Fatigue, PROMIS-Positive Affect and Well-being, and Stroke Impact Scale 3.0 (SIS). Due to the exploratory nature of the study, significance was set at P = 0.10. Fourteen of 18 couples completed the program. Analyses show a trend for decreased depressive symptoms across time points. Fatigue and well-being significantly improved. Caregivers demonstrated greater improvement in fatigue and depressive symptoms. Participants with stroke reported significant improvement in the SIS cognition, communication, and participation in meaningful activities domains. Preliminary results suggest the PPI may be effective for improving mood, fatigue, and well-being in couples post-stroke as well as stroke-specific quality of life. Though more research is needed, this represents a promising first step in a novel dyadic intervention for this population with exciting potential clinical implications.