Mental-health support by telephone shows promise both for caregivers of stroke survivors and for patients themselves


Mental-health support by telephone shows promise both for caregivers adjusting to their new roles and for stroke survivors recently released from the hospital, according to an article in the August issue of Stroke.

About 80 percent of American stroke survivors return to their homes after rehabilitation, according to previous research. It is often difficult for family members to adapt to their new roles as caregivers charged with managing the physical, cognitive, emotional, and personality changes associated with stroke. Research has shown that caregiver depression is not only a burden for the caregiver but it can also worsen a stroke survivor’s depression and rehabilitation. The researchers hypothesized that adequate supports might benefit both caregivers and patients, resulting in better household mental health and in improved likelihood that the stroke survivor can remain at home.

The current study examined social problem-solving telephone partnerships ? a program in which nurses used the telephone to help family caregivers resolve challenges of caring for stroke survivors. Previous studies have examined social problem?solving therapy using face-to-face contacts with individuals or groups.

“The telephone may be a cost-effective method that nurses and other health professionals may use to assist family members to feel good about themselves, to solve problems optimistically, and to use a systematic and objective method to manage caregiving problems,” says lead author Joan S. Grant, D.S.N., R.N.

The American researchers divided 74 primary caregivers into three groups. One received the problem-solving assistance phone conversations (intervention). Another group got phone calls that did not have the goal of solving problems but instead gave information about health care services received by the stroke survivor (sham intervention). The third group got no phone calls (control group). In the phone intervention, nurses conducted an initial three-hour home visit before making regular telephone calls to help caregivers use effective problem-solving steps to manage caregiving problems.

Over four weeks, those in the intervention group improved significantly in how they viewed caregiving problems. They improved an average 56 percent in depression (decrease from a mean baseline score of 15.4 to a mean final score of 6.8) and 50 percent in negative problem orientation (from 12.2 to 6.1). Participants also improved in emotional well-being, mental health, and vitality.

Telephone sessions may be effective because they identify and address the unique concerns and issues of individual caregivers, Grant says, and the support technique may be applicable to other situations involving patients with chronic disease or disability who are being cared for at home.






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