Stroke Clinical Trial
Official title:
Evaluating the Therapeutic Effects for Stroke Survivors and Their Family-caregivers Using an Online Mindfulness-based Intervention Together
Stroke survivors and their family caregivers often experience stress, anxiety, and
depression. The psychological wellbeing of stroke survivors and family caregivers is thought
to be interconnected and can have an important role to play in rehabilitation outcomes.
Mindfulness meditation can help improve psychological wellbeing, but it often involves people
attending groups by themselves and engagement can be poor. One solution is for stroke
survivors and family caregivers to learn mindfulness meditation together online.
This study aims to explore the feasibility, appropriateness, meaningfulness, and
effectiveness of mindfulness meditation delivered online for stroke survivor and family
caregiver partnerships.
Introduction Stroke survivors and their family caregivers often experience stress, anxiety,
and depression. Research suggests the emotional wellbeing of the stroke survivor and family
caregiver might be interconnected, which means optimum outcomes will only be achieved when
they are supported as a partnership (Atteih, et al. 2015).
Mindfulness-Based Interventions (MBIs) can help psychological wellbeing, but usually involve
people attending groups by themselves, which might not suit everyone. Sometimes accessing
group-based MBI can be difficult and/or people might not want to learn MBI within a group
environment (Wahbeh, et al. 2014). Web-based MBIs have become more readily available in
recent years, but little attention has been given to partnership orientated web-based
interventions. Research is needed to explore the potential effects of web-based MBI for
stroke survivors and family caregiver partnerships (Bakas, et al. 2017). This study aims to
explore the feasibility, appropriateness, meaningfulness, and effectiveness of web-based MBIs
for stroke survivor and family caregiver partnerships.
Method Purposive sampling will be used to recruit community-dwelling stroke survivor-family
caregiver partnerships (n=5 dyads). These partnerships will complete a four-week asynchronous
tutor-led web-based MBI. The web-based MBI aligns with the eight-week Mindfulness-Based
Stress Reduction (Kabat-Zinn and Hanh, 2009) and Mindfulness-Based Cognitive Therapy
(Teasedale, et al. 2000) courses, but in a shorter format. The course involves ten online
interactive videos (30 minutes each), twelve daily practice assignments (with supportive
emails), five audio downloads, and online tools for reviewing progress.
The design will involve a mixed method multiple single-case (A-B) design: two-week baseline,
four-week intervention, and four-week follow-up phases. Stroke survivors and family
caregivers will complete the Hospital Anxiety Depression Scale (HADS) (Zigmond and Snaith,
1983) weekly to evaluate psychological wellbeing and clinical effectiveness. Paired
semi-structured post-intervention interviews will be completed at follow-up and
Interpretative Phenomenological Analysis used to contextualize the results and explain the
meaning associated with the findings.
Results Recruitment and completion data will be reported using descriptive statistics to help
evaluate feasibility and appropriateness. HADS outcome data for stroke survivors and family
caregivers will be presented in individual graphs and using raw data to facilitate future
meta-analysis. Visual and statistical analysis of outcome data will be completed to evaluate
clinical effectiveness, effect size, and whether any changes were statistically significant.
The Interpretative Phenomenological Analysis will be reported using relevant themes and
participants' quotes to provide a coherent analysis of the feasibility, appropriateness,
meaningfulness, and effectiveness of stroke survivors and family caregivers using web-based
MBI.
Discussion The findings will inform the feasibility, acceptability, and clinical
effectiveness of web-based MBI for stroke survivors and family caregivers partnerships. The
study will explore the usefulness and meaning of learning MBI online and in a partnership.
These findings could help determine whether using web-based MBI in a partnership has any
therapeutic value for participants and help tailor such intervention for stroke survivor and
family caregiver partnerships.
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