Abstract

BackgroundFamily caregivers provide invaluable support to stroke survivors during their recovery, rehabilitation, and community re-integration. Unfortunately, it is not standard clinical practice to prepare and support caregivers in this role and, as a result, many experience stress and poor health that can compromise stroke survivor recovery and threaten the sustainability of keeping the stroke survivor at home. We developed the Timing it Right Stroke Family Support Program (TIRSFSP) to guide the timing of delivering specific types of education and support to meet caregivers’ evolving needs. The objective of this multi-site randomized controlled trial is to determine if delivering the TIRSFSP across the stroke care continuum improves caregivers’ sense of being supported and emotional well-being.Methods/designOur multi-site single-blinded randomized controlled trial will recruit 300 family caregivers of stroke survivors from urban and rural acute care hospitals. After completing a baseline assessment, participants will be randomly allocated to one of three groups: 1) TIRSFSP guided by a stroke support person (health care professional with stroke care experience), delivered in-person during acute care and by telephone for approximately the first six to 12 months post-stroke, 2) caregiver self-directed TIRSFSP with an initial introduction to the program by a stroke support person, or 3) standard care receiving the educational resource “Let’s Talk about Stroke” prepared by the Heart and Stroke Foundation. Participants will complete three follow-up quantitative assessments 3, 6, and 12-months post-stroke. These include assessments of depression, social support, psychological well-being, stroke knowledge, mastery (sense of control over life), caregiving assistance provided, caregiving impact on everyday life, and indicators of stroke severity and disability. Qualitative methods will also be used to obtain information about caregivers’ experiences with the education and support received and the impact on caregivers’ perception of being supported and emotional well-being.DiscussionThis research will determine if the TIRSFSP benefits family caregivers by improving their perception of being supported and emotional well-being. If proven effective, it could be recommended as a model of stroke family education and support that meets the Canadian Stroke Best Practice Guideline recommendation for providing timely education and support to families through transitions.Trial registrationClinicalTrials.gov: NCT00958607.

Highlights

  • Introduction to the programMy family member has had a strokeMy family member’s condition has stabilizedMy family member is preparing to go homeMy family member has just returned homeAdapting to life in the communityAdditional resources

  • This research will determine if the Timing it Right Stroke Family Support Program (TIRSFSP) benefits family caregivers by improving their perception of being supported and emotional well-being

  • Research objectives and hypotheses The objective of this multi-site mixed methodology singleblind randomized controlled trial is to determine if the TIRSFSP delivered across the care continuum contributes to positive caregiver outcomes

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Summary

Discussion

Caregivers play a central role supporting stroke survivors as they transition from acute care, through rehabilitation, and return to community living. With no standard clinical practice to prepare and support these individuals in the caregiving role, many experience stress and poor mental health outcomes [4,5,6] This can compromise the quality of care provided to the patient [7] as well as jeopardize caregivers’ abilities to keep the stroke survivor at home [8,9]. Improving the timing with which caregiver support is provided may address caregivers’ changing needs as stroke survivors transition across care environments and may result in caregivers being better prepared for their caregiving role. As a result, their quality of life may improve and they may be better able to contribute to stroke survivor recovery, rehabilitation, community re-integration, and quality of life.

Background
Methods
Introduction to the program
Stroke Support Person TIRSFSP
Self-Directed TIRSFSP
Standard Care
24. Cohen S
34. Grant JS
42. Jones F
Findings
48. EmPOWER
Full Text
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