Caregivers’ effects of augmented cognitive-behavioural therapy for post-stroke depressive symptoms in patients: secondary analyses to a randomized controlled trial

Abstract

Objective:

To investigate the concomitant effects of two patient-directed interventions for post-stroke depressive symptoms on caregivers’ well-being.

Design:

Secondary analyses of the results of a randomized controlled trial.

Subjects:

Fifty caregivers of stroke patients receiving outpatient rehabilitation.

Interventions:

Stroke patients and their caregivers were randomly allocated to either cognitive-behavioural therapy augmented with movement or occupational therapy (n = 23) or computerized cognitive training (n = 27) to alleviate depressive symptoms in patients.

Main measures:

Emotional burden (Involvement Evaluation Questionnaire), practical burden (Caregiver Strain Index), mental health (General Health Questionnaire) and emotional complaints (Hospital Anxiety and Depression Scale).

Results:

Caregivers of patients who received cognitive-behavioural therapy reported significantly higher mental health levels (mean difference (MD) = 1.78, 95% confidence interval (CI) = 0.43–3.13, P = 0.01) and less worrying about patients’ well-being (MD = 1.9, 95% CI = 0.56–3.24, P < 0.01). In addition, there were positive time effects on the Involvement Evaluation Questionnaire for Brain Injury, particularly the subscales Worrying, Supervision and Tension.

Conclusion:

The results suggest that augmented cognitive-behavioural therapy aimed at improving patients’ emotional, behavioural and social functioning positively affects some aspects of caregivers’ well-being.

Keywords

Stroke caregivers depression randomized controlled trial secondary analyses

Get full access to this article

View all access options for this article.

References

Cameron

Cheung

Streiner

et al . Stroke survivor depressive symptoms are associated with family caregiver depression during the first 2 years poststroke. Stroke 2011; 42(2): 302–306.

Gillen

Tennen

Affleck

et al . Distress, depressive symptoms, and depressive disorder among caregivers of patients with brain injury. J Head Trauma Rehabil 1998; 13(3): 31–43.

Mintz

van Horn

Levine

MJ.

Developmental models of social cognition in assessing the role of family stress in relatives’ predictions following traumatic brain injury. Brain Inj 1995; 9(2): 173–186.

Smeets

van Heugten

Geboers

et al . Respite care after acquired brain injury: the well-being of caregivers and patients. Arch Phys Med Rehabil 2012; 93(5): 834–841.

McCullagh

Brigstocke

Donaldson

et al . Determinants of caregiving burden and quality of life in caregivers of stroke patients. Stroke 2005; 36(10): 2181–2186.

Carnwath

Johnson

DA.

Psychiatric morbidity among spouses of patients with stroke. Br Med J (Clin Res Ed) 1987; 294(6569): 409–411.

Scholte

Reimer

de Haan

Pijnenborg

et al . Assessment of burden in partners of stroke patients with the sense of competence questionnaire. Stroke 1998; 29(2): 373–379.

Visser-Meily

van Heugten

Post

et al . Intervention studies for caregivers of stroke survivors: a critical review. Patient Educ Couns 2005; 56(3): 257–267.

Krieger

Feron

Dorant

Developing a complex intervention programme for informal caregivers of stroke survivors: the caregivers’ guide. Scand J Caring Sci 2017; 31(1): 146–156.

10.

Legg

Quinn

Mahmood

et al . Non-pharmacological interventions for caregivers of stroke survivors. Cochrane Database Syst Rev 2011(10): CD008179.

11.

Geurtsen

van Heugten

Martina

et al . Three-year follow-up results of a residential community reintegration program for patients with chronic acquired brain injury. Arch Phys Med Rehabil 2012; 93(5): 908–911.

12.

Kootker

Rasquin

Lem

et al . Augmented cognitive behavioral therapy for poststroke depressive symptoms: a randomized controlled trial. Arch Phys Med Rehabil 2017; 98(4): 687–694.

13.

Kootker

Rasquin

Smits

et al . An augmented cognitive behavioural therapy for treating post-stroke depression: description of a treatment protocol. Clin Rehabil 2015; 29(9): 833–843.

14.

Kootker

Fasotti

Rasquin

et al . The effectiveness of an augmented cognitive behavioural intervention for post-stroke depression with or without anxiety (PSDA): the Restore4Stroke-PSDA trial. BMC Neurol 2012; 12: 51.

15.

Van Wijngaarden

Schene

Koeter

et al . Caregiving in schizophrenia: development, internal consistency and reliability of the Involvement Evaluation Questionnaire – European Version. EPSILON Study 4. European psychiatric services: inputs linked to outcome domains and needs. Br J Psychiatry Suppl 2000; 177(39): s21–s27.

16.

Geurtsen

Martina

Van Heugten

et al . A prospective study to evaluate a new residential community reintegration programme for severe chronic brain injury: the Brain Integration Programme. Brain Inj 2008; 22(7–8): 545–554.

17.

Geurtsen

Meijer

van Heugten

et al . Experienced emotional burden in caregivers: psychometric properties of the Involvement Evaluation Questionnaire in caregivers of brain injured patients. Clin Rehabil 2010; 24(10): 935–943.

18.

Goldberg

Use of the General Health Questionnaire in clinical work. Br Med J (Clin Res Ed) 1986; 293(6559): 1188–1189.

19.

Politi

Piccinelli

Wilkinson

Reliability, validity and factor structure of the 12-item General Health Questionnaire among young males in Italy. Acta Psychiatr Scand 1994; 90(6): 432–437.

20.

Piccinelli

Bisoffi

Bon

et al . Validity and test-retest reliability of the Italian version of the 12-item General Health Questionnaire in general practice: a comparison between three scoring methods. Compr Psychiatry 1993; 34(3): 198–205.

21.

Robinson

BC.

Validation of a Caregiver Strain Index. J Gerontol 1983; 38(3): 344–348.

22.

Ugur

Fadiloglu

‘Caregiver Strain Index’ validity and reliability in Turkish society. Asian Pac J Cancer Prev 2010; 11(6): 1669–1675.

23.

Zigmond

Snaith

RP.

The Hospital Anxiety and Depression Scale. Acta Psychiatr Scand 1983; 67(6): 361–370.

24.

Mykletun

Stordal

Dahl

AA.

Hospital Anxiety and Depression (HAD) scale: factor structure, item analyses and internal consistency in a large population. Br J Psychiatry 2001; 179: 540–544.

25.

Spinhoven

Ormel

Sloekers

et al . A validation study of the Hospital Anxiety and Depression Scale (HADS) in different groups of Dutch subjects. Psychol Med 1997; 27(2): 363–370.

26.

Marsh

Kersel

Havill

et al . Caregiver burden at 1 year following severe traumatic brain injury. Brain Inj 1998; 12(12): 1045–1059.

27.

Wolfe

CD.

The impact of stroke. Br Med Bull 2000; 56(2): 275–286.

28.

Davis

Sander

Struchen

et al . Medical and psychosocial predictors of caregiver distress and perceived burden following traumatic brain injury. J Head Trauma Rehabil 2009; 24(3): 145–154.

29.

Brereton

Carroll

Barnston

Interventions for adult family carers of people who have had a stroke: a systematic review. Clin Rehabil 2007; 21(10): 867–884.

30.

Herrmann

International experiences with the Hospital Anxiety and Depression Scale – a review of validation data and clinical results. J Psychosom Res 1997; 42(1): 17–41.

Supplementary Material

Please find the following supplemental material available below.

For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.

For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.

0.00 MB

0.30 MB