The effects of a family-focused dyadic psychoeducational intervention for stroke survivors and their family caregivers: A randomised controlled trial

Abstract

BackgroundStroke can cause a variety of physical and psychosocial disturbances for both survivors and their family caregivers (i.e., stroke dyads). Dyadic psychoeducation appears to be a promising approach for providing knowledge of stroke and self-care or caregiving skills to improve stroke dyads' health outcomes. Therefore, a family-focused psychoeducation intervention was designed and tested to improve the health outcomes of stroke dyads. ObjectiveTo examine the effects of a family-focused dyadic psychoeducational intervention on the functional and psychosocial outcomes of stroke survivors and family caregivers. DesignA single-blinded, parallel-group randomised controlled trial with repeated-measures design. SettingsTwo general hospitals and one rehabilitation facility in Jinan, China. ParticipantsStroke survivors and family caregivers (N = 162 dyads). MethodsThe dyads were randomly allocated to either psychoeducation or control group with usual care only (N = 81 dyads per group). The intervention included three structured face-to-face education sessions (one hour per session) in hospital pre-discharge and four weekly telephone counselling calls post-discharge. Study outcomes included survivor functioning and caregiver burden (primary outcomes), and other secondary outcomes (i.e., caregiving competence, dyads' coping, depressive and anxiety symptoms, family functioning, and dyadic relationship, as well as survivor healthcare utilisation and caregiving-related injury). Data were collected at baseline (T0) and immediately (T1) and 3 months post-intervention (T2). The intervention effects were estimated using generalised estimating equation models. ResultsParticipants in the psychoeducation group revealed significantly greater reductions on caregiver burden than the control group at T1 (β = −6.01, p = 0.026) and T2 (β = −6.73, p = 0.039), but non-significant effects on survivor functioning, except in emotion domain at T1 (β = 7.22, p = 0.015). In addition, the intervention demonstrated significantly greater improvements on caregiving competence (β = 0.98, p = 0.013; β = 1.58, p < 0.001), survivors' depressive symptoms (β = −1.56, p = 0.007; β = −2.06, p = 0.005), and dyadic relationship (β = 0.26, p = 0.012; β = 0.27, p = 0.022) at T1 and T2, as well as on survivor coping at T2 (β = 6.73, p = 0.008). ConclusionsOur study added values on the benefits of family-focused dyadic psychoeducation to routine stroke rehabilitation and family care. Future research can evaluate its long-term effects for families of stroke survivors with diverse socio-demographic and stroke-related characteristics. RegistrationChinese Clinical Trial Registry (ChiCTR2100042684). Recruitment: March to June 2021.